Mother of Mercy Hospice
Chilanga, Zambia
The early nineties saw an increase in AIDS as the HIV-positive population in sub-Saharan Africa became symptomatic. Sister Leonia Kournas, a Polish nun and registered nurse, recognized the need for home-based palliative care within the local community and manages the Mother of Mercy Hospice in Chilanga. The Mother of Mercy Hospice was established in 1992 to provide care for terminally ill AIDS patients in the community of Chilanga, approximately 16 km south of Lusaka.
Over the last decade, Mother of Mercy has expanded, responding to the growing needs of individual adults, families, and children in the local community who are impacted by HIV/AIDS. The organization outreaches into the community to identify households in need. The most common support needed is medical care and palliative support of AIDS patients, food, and schooling for children.
The core of Mother of Mercy is a home-based care program, though additional assistance is provided through a twenty-two bed inpatient hospice, an outpatient clinic, and a community school.
Partnership with POL
Power of Love Foundation supports the pediatric hospice care unit at Mother of Mercy, an excellent model for a hospice serving a partially rural area on the outskirts of an urban area. Mother of Mercy and Power of Love have the opportunity to learn how to design and manage a hospice in a rural environment, which poses different community care-giving challenges than an urban setting.
Programs
Home-based Care
Mother of Mercy Hospice is connected to the Archdiocese of Lusaka Home-Based Care program, which has an office on the grounds of Mother of Mercy Hospice. The home-based care program serves over 500 patients – half of them are children – through a network of community caregivers who receive updates on patient conditions, assess their situations, and provide medical care to those who are unable to come into the clinic. The caregivers oversee eight home-based care (HBC) zones in the community surrounding Mother of Mercy Hospice. Each HBC zone has between 3-20 caregivers, all of whom are volunteers from the community. Each HBC zone is visited 2-3 times per month. The hospice has a vehicle available for use (the ambulance), though money is not normally available to purchase fuel. Thus, the caregivers typically use public transportation to travel to the zones.
The caregivers help bathe patients, clean their clothes, and feed them. The caregivers look out for all members of their community, not just their patients.If they see that any individual is ill, they will speak with the person, asking them if they would like medical attention.
Hospice
Many of the inpatients at the hospice were home-based care registrants that now require intensive care. The hospice provides physiotherapy and extensive laboratory testing. All inpatients are screened for HIV if they have not already been tested and agree to voluntary counseling and testing (VCT), have a full blood count, and urine and stool analysis. The hospice approaches palliative care for HIV/AIDS patients with a combination of symptom management, aggressive curative therapy for opportunistic infections that are common in HIV/AIDS patients, counseling and nutritional support. The hospice has a refrigerated three-body mortuary onsite. The deceased are kept here until the family is able to make funeral arrangements.
Outpatient Clinic
The outpatient clinic has an x-ray machine, ultrasound machine, a pharmacy, a treatment room, and a full pathology unit. The treatment room has three bays, as well as a minor surgery room.
Guardian Angel School
This community school grew from a small day center for children of patients aimed at providing education, activities, and food during the daytime. The school now has approximately 130 pupils, ranging in age from six to sixteen, and four teachers. Although government schools are considered free to attend, the money necessary for required supplies, uniforms, and shoes excludes many children from attending. The community school implements a reduced curriculum for grades 1-7. It offers morning classes that include mathematics, science, English, reading and history and afternoon classes that offer music, art, sports and drama. The school aims to provide education, food and enrichment activities for community children affected by HIV/AIDS and unable to afford government schools.
Nutrition Program
A combination of poverty and drought has created widespread starvation and malnutrition in many communities. In addition to HIV/AIDS, a significant number of illnesses and deaths are a direct result of, or exacerbated by, nutritional deficiencies. Food is one of the most important treatments offered at the hospice. Mother of Mercy programs receive food aid through the UN World Food Program. Additionally, local farmers and donors bring in surplus vegetable crops while an Irish donor provides a weekly ration of meat for the hospice inpatients. The hospice prepares three main meals a day. These meals consist of the local staple, Nshima (made from maize meal), vegetables, and a source of protein: beans, meat or fish. The hospice also provides high protein porridge in the morning and smaller snacks between meals. The school prepares at least one meal per day for the students. Food is also given to more than 300 of the patients in the home-based care program.