African hospice tour stuns local director

The Port Shepstone Hospice program in South Africa has more than 400 patients, too. To serve them, the program has a staff of 20.

Community Hospice executive director Phil Di Sorbo, who recently returned from a two-week visit to three Hospice programs in South Africa, told The Evangelist that the above statistics are just one instance of the staggering effects of the AIDS epidemic in a country where more than 5,000 people die of the disease every day.

Eyes opened

Having more resources, the American visitors hoped to learn how they could help their African counterparts in programs in Port Shepstone, and in Mutare and Harare, Zimbabwe. But they learned some lessons, as well.

"For all of us, it was an eye-opener," Mr. Di Sorbo stated. "In America, we have a six-month prognosis requirement" for entering Hospice. But in Africa, patients can become a part of the program as soon as they develop a serious illness. The director would like to see American Hospice programs emulate this in the future.

In need

No drugs like AZT used in America to fight AIDS are available, he said, so patients have a life expectancy of about three months from the time they begin to show symptoms of AIDS.

One family the director met had moved to a "high-density area," an urban ghetto outside of Mutare. The family had hoped to find work by moving to the city, but instead ended up living in two shacks. The wife's mother was an AIDS patient.

In Kwa-Zulu Natal province, the province hardest-hit by the disease, 37 percent of the adult population is infected with HIV. Since 60 percent of the population of Zimbabwe lives below the poverty level, most people don't go to hospitals because they can't afford to.

Stigma of AIDS

One victim of the epidemic particularly touched Mr. Di Sorbo. The 19-year-old girl's family threw her out when they discovered she had AIDS, and she was taken in by a woman from her Port Shepstone church. She lived in one room of the woman's house as she waited for death to come.

Looking at a photo of her that he'd just had developed, the director said, "She's probably dead already."

5,000 deaths

Mr. Di Sorbo realized that before the patient died, "there obviously had to be physical pain involved. From a Hospice point of view, we consider that a real tragedy."

The director said he was shaken by his experiences in South Africa.

"I wasn't prepared for the numbers, because we don't hear about it," he noted. "There are 5,000 people dying a day in Africa from AIDS. Just imagine if there was a military invasion and 5,000 people were being killed. Think how the world would mobilize. AIDS is preventable, now treatable -- and yet thousands of people are suffering and dying."

Solutions

* African Hospice programs should expand their boards of directors. For the short term, that would give the programs more venues to find funds; in the long run, the programs could work toward becoming part of Africa's national health insurance program.

* The African programs should also try to "get the traditional healers in their umbrella," said Mr. Di Sorbo. Since most people there can't afford health care, he explained, they have turned to traditional healers. Sometimes, the healers perpetuated the epidemic by spreading myths: for example, advising men that they could get rid of AIDS by sleeping with a virgin. But the healers might also have herbs or other treatments for AIDS side effects like nausea. If healers were educated about AIDS, the director added, they could in turn educate those who come to them.

* American Hospices should partner with African Hospices. "We would like to find ways within our means to partner with them, because they are so under-resourced and the American dollar goes so far," Mr. Di Sorbo noted. A nurse's salary, for instance -- $150,000 in Zimbabwean money -- equals only $4,100 American money. "We could more than double their staff," he said.

Goals

But his overall goals after experiencing the AIDS crisis in Africa are threefold: to relieve suffering there through better health care and an adequate supply of drugs; to educate the population about AIDS, addressing the issues of poverty and behavioral change; and to grow the Hospice movement in Africa.

"They have a lot of education going on," he added. "The hope for sub-saharan Africa is through education."

(Rensselaer Community Hospice can be reached at 285-8150.)

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