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09 October 2023 | Story André Damons | Photo André Damons
A multimillion-rand grant will assist UFS to develop palliative care structures and services in FS
The palliative care team consists of (at the back, from l.t.r) Rethabile Matuka (M&E Officer), Matron Mitta Sauli and Khomotso Makhura (social worker student). In the middle: Viaan Lucas (left, social worker) and Thobeka Maziya (social worker student). In front: Sr Elizabeth Lekoeneha, Dr Dalene van Jaarsveld and Prof Alicia Sherriff.

A multimillion-rand grant will assist the Department of Oncology at the University of the Free State (UFS) to initiate the implementation of palliative care services in the Free State province and help to improve the quality of life of patients and their families living with a life-threatening disease.

The grant from the Bristol Myers Squibb Foundation (BMSF) has already improved the quality of life for patients living with advanced progressive life-threatening diseases (cancer, renal failure, heart failure, AIDS, lung disease) as well as for their families. Prof Alicia Sherriff, head of the UFS Department of Oncology, and Dr Dalene van Jaarsveld, Lecturer and Medical Specialist in the same department, are project leaders for the grant that UFS administers. The grant is for a period three years.

According to Dr Van Jaarsveld, they have also planned for a 10-bed inpatient facility at the Universitas Academic Complex that will be able to accommodate a family member of patients receiving care in preparation for their down referral for home-based care. This unit will also be used as a training facility for all undergraduate health-care students. The grant will provide staff for a limited period to assist the Free State Department of Health (FSDOF) in preparing to absorb the services. They are currently awaiting commitment from the FSDOH to start with renovation of this unit. 

Situation in the Free State 

Palliative care, explains Dr Van Jaarsveld, provides a service that improves the quality of life of a patient, and his/her family, diagnosed with a life-limited disease. “It is not only for patients who are terminally ill and should ideally be implemented much earlier in the patient's disease journey. Palliative care is a basic human right,” she says. 

“A National Policy Framework and strategy on the implementation on palliative care for South Africa for 2012-2022 was published by National Department of Health. We recognised in 2019 that there was no implementation initiated in the Free State, and no budget allocated to the implementation of this critical service.  

“Many patients in the province live with these advanced progressive diseases and experience a very poor quality of life that translates into a poor quality of death with a high symptom-burden and suffering during their last days. Similarly, the family will suffer immensely,” says Dr Van Jaarsveld. 

Prof Sherriff says they applied for this international grant to assist with the startup of these structures while the FSDOH is given the opportunity to setup the necessary budget to ensure long-term sustainability of this human right as a health-care service. 

In the Free State about 16,000 patients die every year with a high need for palliative care. Dr Van Jaarsveld says of the 15 functioning hospices in 2014 and home-based carers that were offering hospice care in most of the sub-districts in the Free State, there are only four registered hospices remaining. Of these only one has four beds where patients can be admitted. The others provide limited care to a very small area, leaving most of the districts in the Free State without any form of palliative care and support.  Most of the other provinces have different levels of palliative-care services available. The grant provides funds to initiate the implementation of this service in the Free State. 

They are working closely with the FSDOH on a provincial implementation plan that will eventually, once the grant has ended, be taken forward by the province, says Dr Van Jaarsveld. 

Impact of the grant

Through the grant a project manager, professional nurse and administrative support are employed as part of a core team at Universitas Academic Hospital with a social worker. They have received training in palliative care supported by the grant. This team, together with Dr van Jaarsveld, provides a consultation service at the Universitas Academic Hospital Complex. 

“Nearly 700 patients have been referred for palliative care in the past year and have therefore benefited (with their families) from the grant. Another two professional nurses have been employed via the grant as hub managers for the Thabo Mofutsanyane and Lejweleputswa districts. Both are currently doing training in palliative care. Once a patient is seen by the team, a palliative care plan is developed, family meetings are held, and a discharge care plan set in place. 

“To ensure continuity of care, the patients are handed over to one of the nurses managing the districts where the patients are from for further follow-up and support. This is sadly not possible in all districts,” says Dr Van Jaarsveld. 

With the grant, the palliative care team, in close collaboration with Hospice Bloemfontein, have started with accredited palliative care training for nurses and other health professionals working for the FSDOH in all districts of the province. This will help with down-referral pathways and support for patients from districts without a dedicated palliative care nurse. 

UFS and Vision 130

Dr Claire Armour Barrett, Head: Research and Development in the School of Clinical Medicine at UFS says this project is critically aligned with the second key tenet of the UFS Vision 130, maximum societal impact with sustainable relationships. Although this project is still in its early phase, almost 700 patients and as many as 2100 family members have been positively affected by this work. 

“We believe that we are bringing the UFS closer to the theme of the World Hospice and Palliative Care Day for 2023, Compassionate Communities: Together for Palliative Care. We are actively increasing awareness in communities, advocating for patients and families in need not only through service delivery, but also by education and collaboration. We are stronger together.”

World Hospice and Palliative Care Day is celebrated every year on 14 October.

News Archive

Questions about racial integration in residences answered
2007-07-31

Answers to frequently asked questions about the racial integration of student residences at the UFS

1. Why does the UFS want to change the current situation in the student residences?

There are many reasons why a new approach to placement in the student residences is necessary. However, the main reason is of an educational nature. As a university, the UFS should create an environment in its residences where students can learn to appreciate and respect the rich diversity that is on offer at the university. A university accommodates students from many different backgrounds in terms of race, language, religion, economic status, culture and other aspects. If a student can learn to appreciate the value in this rich diversity at university, he or she will also be able to appreciate the value of this diversity in the workplace and broader society.

The current situation of predominantly white and predominantly black residences has not been able to cultivate such an appreciation for diversity and respect for one another as human beings, and will not equip students with the knowledge and skills required to manage diversity.

Besides this, there are many other areas of life in the residences that need attention. For one, we need to urgently establish a human rights culture in the residences so that the rights of all students can be respected. We need to address the abuse of alcohol, provide disabled students with their rightful place, and last but not least, really entrench a culture of learning in student residences.

Let us make the residences places we can be proud of – places of learning, of diversity, of respect; places of growth and development. This is the ideal we should all strive to achieve.  

2. Why does the management want to force us to integrate?

It is a false argument to debate the issue in terms of “force”. Any decision by a University, or any other organisation, regarding matters of policy, rules and regulations implies a restriction on the choice of an individual and an obligation to comply.  What we should focus on is whether this decision of the Council is in the best interests of our students.

The management of the university believes that it has a responsibility to give students the best education possible, not only in terms of what you learn in the lecture rooms, but especially in the residences as well. The residences can be very powerful places of learning about matters of great importance, both academic and non-academic.

The parallel-medium language policy separates students into largely white/Afrikaans and black/English classes. Efforts are being made to bridge this divide in the classroom, but we can also try to eliminate it in the residences.

The university is committed to building a new culture for the entire institution that is based on values and principles – such as an academic culture, non-racialism, respect for human rights and diversity – among staff and students.

In the context of student residences, the application of these values and principles still allows substantial room for the voluntary exercising of choice by individuals as well as by Residence Committees, notably with regard to the placement of students (they can still place 50 percent of first-year students), as well as the determination of the future character and traditions of a diverse residence.

Furthermore, students can still choose their residences (subject to availability of places), can choose a roommate, and so forth.

3. What about freedom of association?

The rights we enjoy in a democracy must be balanced against other rights, as well as the laws of the country. This means that the right to freedom of association must be balanced against laws that make it illegal to discriminate against other people on the basis of race, language or religion, for instance.

Freedom of association pertains to the right of individuals to form voluntary organisations such as clubs or private boarding houses, or their right to join or not join existing organisations.  You exercise that right when you decide to become a student of the UFS, and again when you choose to live in one of its residences.

However, once you have decided to join an organisation voluntarily, you cannot subsequently demand that that organisation should provide a “club” or residence to your liking where, for instance, you only associate with your choice of co-members. You must accept the policies of that organisation.

In any case, how would that right of yours be balanced against the right of another individual who wishes to associate with a different set of co-members? (For instance – what about the freedom of a student to associate with students NOT from his own background, but indeed from another language, cultural, racial or economic background?) 

The constitutional right to freedom of association can, in any case, not be used to exclude or discriminate on the basis of race or religion (Section 18 of the Bill of Rights).

Besides, the new policy guidelines will still make provision for freedom of association. This right can be exercised freely within a diverse residence with regard to friendships, joint academic work, socialising, sport, etc.

4. Will residences not lose their traditions?

The University appreciates that there are many valuable elements of tradition in residences. However, we must bear in mind that the traditions and character of student residences have evolved and changed over time, and they will continue to evolve and to change. In addition, we do not need to accept all aspects of residence life purely on the basis of tradition, including the unacceptably high level of alcohol abuse and unsavoury, humiliating and discriminatory orientation practices. The new approach to integrated residences provides the opportunity to retain the positive aspects of the current traditions and character, but also to develop new traditions and give residences a new character.

We can now establish a tradition and a character for each residence that are reconcilable with the values of the University as a place of scholarship and are aligned with the human rights approach of our country’s Constitution, the laws of our country and the strengths and diversity of the students in a particular residence.

5. Have students been involved in this process? Is there a role for them to play after the decision has been taken by the Council of the UFS?

In the first semester of 2007, during two rounds of consultations, the primes, SRC and student organisations were consulted about the proposed new placement policy to increase diversity in residences. Some residences also made written submissions on the matter (such as Madelief, Soetdoring, Wag-'n-bietjie, Vergeet-my-nie, Emily Hobhouse). Other residences requested and were granted more time, but did not make any submissions in the end (such as Reitz and Armentum).

Management also had several meetings with the above-mentioned structures to hear first-hand from students their concerns and solutions regarding possible challenges presented by integration in residences.

During these interactions, several excellent ideas and proposals were put forward by students. These views had a definite impact on the eventual proposal that was taken to the University Council, in particular regarding the minimum level of diversity (30%) in junior residences and the fact that residences still want to have a say in the placement of students, rather than the placement decision being left in the hands of Management alone (hence the 50% placement portion of residences). Management values the effort that was put into the process by the primes and residence committees, and thanks them for their contributions.

However, it should be stressed that consultation should not be understood as a process of negotiation, nor does it imply that consensus must be reached. What it means is that Management must take a considered decision after hearing the views of stakeholders.

Management would like students to continue to provide input and ideas regarding the implementation details of the policy guidelines. Task teams have been established and students will be informed about how they can interact with the task teams on an ongoing basis.

6. But integration in the residences was tried in the past (in the late 1990s), and then it failed. Why will it work now?

Yes, the University of the Free State did integrate its residences as far back as 1993, and for a few years it worked. The UFS did it at that time and is now doing so again, because it is the right thing to do. Yet it is important to understand why the previous attempt at racial integration in residences was not successful.

Firstly, both black and white students were much polarised because of the apartheid past. Secondly, there was insufficient management support for students in the residences, the student leaders generally as well as residence heads, in terms of dealing with diversity and related issues. Thirdly, the institutional culture of the UFS and the residences in particular was not addressed as part of broader transformation and integration in residences, whereas it is now being addressed.

In addition, the current decision to integrate residences has the benefit of being implemented after several more years of integration in schooling, sport, workplaces and other aspects of life.

This decision is also based on Management’s commitment to give all the possible support it can to this process.

This is a very important initiative that the UFS is undertaking. Management, in co-operation with students, must ensure that it succeeds. Integrated residences that produce high-quality graduates equipped to deal with the challenges of the workplace and our society is a worthwhile ideal we should all strive to achieve.

If you would like to make a proposal regarding the implementation and practical aspects of the new policy, please send it to the following email address: rector@ufs.ac.za

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