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2 December 2005

Programme Director, Dr Gwyther
Colleagues
Honoured guests
Ladies and gentlemen

Sanibonani. To those of you who have come from many miles away and from across the seas, I welcome you to our beautiful land. I hope you have time to enjoy it as we do.

It is indeed a pleasure and an honour to be with you today. I would like to take this opportunity to thank Dr Gwyther and the Hospice Palliative Care Association for inviting me to open this important event. Men and women, like you, who have committed yourselves to the care and support of people with incurable diseases, deserve to be honoured.

Palliative care is an approach that improves the quality of life of patients and their families facing problems associated with life threatening illnesses. It does this through the prevention and relief of suffering by means of early identification, impeccable assessment and treatment of pain as well as management of other physical, psychological and spiritual problems.

Palliative care centres are based around the principles of Batho Pele, which means putting people first. It is aimed at the relief of suffering of body, mind and spirit to achieve the best possible quality of life for the patient and family. Palliative care is a very important aspect in the delivery of care services in South Africa, throughout Africa and worldwide. It is person centred, holistic and requires a multidisciplinary team approach which includes doctors, nurses, social workers, priests, community members, family and friends.

It is cost effective when people with the necessary knowledge and skills are available together with the essential drugs. Palliative care takes into account the cultural beliefs and values of individuals and their families.

Palliative care can reach all areas through the community and home based programmes, but requires appropriate supervision and monitoring to ensure relief from pain and symptoms. I have become aware of this as I hear stories about the pain and loneliness that has become the experience of so many people in the face of the AIDS pandemic. I am certain that everybody present here today has an understanding of the role that palliative care plays in our patients, families and society.

Good communication skills are required in palliative care. It is very important for all providers of care to communicate at the level of the customer in order to engender trust, thus making the individual more comfortable and able to confide his/her fears and concerns.

Partnerships are very important in ensuring that quality care is delivered to all the affected people. Government alone cannot provide holistic services. Non-governmental organisations, community based organisations, faith based organisations, traditional leaders and traditional health practitioners all play an important role as entry points to services within the communities.

They reach to the furthest corners that we need to reach. We recognise and appreciate the role different stakeholder’s play in providing palliative care to affected people. We acknowledge that many on whose shoulders the responsibility of care falls are barely able to cope. We acknowledge that the burden of care falls on women, the young and the old. We recognise that many are poor and cannot afford even to put food on the table.

It is in this regard that we have sought an interdepartmental approach, working closely with social development, education, agriculture, public works, home affairs and provincial and local government in an effort in an effort to provide a holistic approach.

Similarly, we need to strengthen the public private partnerships, nurture these relationships and ensure that comprehensive care networks are established and maintained.

We need to coordinate the use of limited resources so that optimal care services are provided. We need to empower our patients and their families and strengthen community support by providing information on how and where to access the required services.

It is very encouraging to note that a group of role players, including representatives from Department of Health, professional bodies, funders and service providers are working together to develop the field of palliative care in South Africa. I would like to reassure the palliative care core working group of my support in the implementation of the three identified themes arising from the workshop held in September 2005, which are policy and advocacy, clinical management and education and training with monitoring and evaluation applied to all three areas.

We acknowledge that palliative care should be implemented in the formal health care sector and that the palliative care pilot programmes in the Limpopo and Northern Cape provinces should be extended to all provinces.

In order to reach those who need us most urgently, we must have systems in place that will enable us to identify areas where palliative care services are not accessible or are non-existent. Having systems in place will help us also in planning our recruitment strategies for the development of services and distribution of palliative care resources.

I would request non-governmental organisations to observe this and would discourage them from starting palliative care projects in areas that already have services whilst such services are non-existent in other areas.

Let us all face up to the challenges of improving quality of life by providing quality holistic palliative care services. The challenge to everyone here today is to use the information that you get from conferences such as this one, to build on the knowledge base you already have for implementation of effective palliative care services.

This conference is starting the day after World AIDS day where awareness of the disease has been raised in our country through rallies, meetings, television, radio, newspapers and ribbons. This awareness is important for all elements of the government’s comprehensive plan to combat AIDS.

For prevention - awareness raising is an obvious benefit. It can result in changes in behaviour. For good nutrition - awareness raising is obvious. The immune system needs all the support it can get to keep the CD4 count above 200 for as long as possible and give people hope. For treatment and for the requirements of compliance - awareness raising is also obvious because there comes a stage where people need to be able to make informed decisions about taking ARVs based on the best available evidence of the options. For palliative care the awareness strikes one in the face, the number of people dying and the children left without parents.

The awareness is in every township and rural community. There is a need for awareness of the wonderful work and the people who are developing systems and providing palliative care. They are providing dignity for the patients and dignity for the nation.

I wish to honour in particular the women of Africa, young, old, sick and poor. The women like those in my home village of Magog, Umzumbe, the Osindisiweni Support Group. We must support the efforts of all our volunteers who do this work, often without much support. I wish to honour also the men who care like Bishop Kevin Dowling who is at this conference and has been recently honoured as a hero by Time Magazine.

A special word of thanks goes to Hospice Palliative Care Association of South Africa (HPCA) and Family Health International (FHI). HPCA is one of the partners who have always been at the forefront in advocating and ensuring that palliative care services were rendered and continue to be rendered to those in need and FHI for their continued support to the Department, by facilitating the integration of palliative care services into the formal health sector.

I call upon you as key partners to form strong networking systems with all relevant stakeholders in palliative care. To all of you I say, “As partners standing together in unity of purpose, we can conquer and win!!”

I wish you a very successful and fruitful conference.

Thank you.

Issued by: Deputy Ministry of Health
2 December 2005