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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

Moshoeshoe - lessons from an African icon - by Prof Frederick Fourie
2004-11-03

(The full text of the article that appeared in City Press and Sunday Independent)

Our understanding of history informs our understanding of the present. No wonder the contestation over historical figures in South Africa’s past is so fierce and so divisive.
The question is: could it be any other way? I would like to think that it could; that black and white South Africans, across linguistic, cultural, religious and other divides, can develop a shared appreciation of our history – at least with certain periods and personalities as a starting point.

One such personality whose legacy I believe offers a possible platform for unifying our still divided country is King Moshoeshoe, who lived from 1786 to 1870, and is acknowledged as the founder of the Basotho.

King Moshoeshoe is the topic of a documentary that has been commissioned by the University of the Free State as part of its Centenary celebrations this year. It is part of a larger project to honour and research the legacy of Moshoeshoe. The documentary will be screened on SABC 2 at 21:00 on November 4th.

Moshoeshoe rose to prominence at a time of great upheaval and conflict in South Africa – the 19th century, a time when British colonialism was entrenching itself, when the Boer trekkers were migrating from the Cape and when numerous indigenous chiefdoms and groupings were engaged in territorial conquests. It was the time of the Difaqane, a period when society in the central parts of the later South Africa and Lesotho was fractured, destabilised and caught in a cycle of violence and aggression.

In this period Moshoeshoe displayed a unique and innovative model of leadership that resulted in reconciliation, peace and stability in the area that later became Lesotho and Free State. It made him stand out from many of his contemporaries and also caught the attention of his colonial adversaries.

Such an evaluation is not a judgment about which model of leadership is right and which is wrong, or which leader was better than another; but merely an attempt to explore what we can learn from a particular exemplar.
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Historians point to the many progressive leadership qualities displayed by Moshoeshoe which he used effectively in establishing the Basotho nation and in defending it.
First, there is his humanism and sense of justice worthy of any great statesman. Confronted by a situation in which cannibals murdered and devoured his grandfather, Moshoeshoe chose not to take revenge. Instead he opted to rehabilitate them and feed them as he believed hunger drove them to cannibalism.

Secondly, there is his skilful alliance-building with his contemporaries such as Shaka in an attempt to neutralize those rivals who were intent on attacking his followers. This is also displayed in the way he sought the protection of the British to keep the Boer forces at bay.
Thirdly, his emphasis on peaceful options is also seen in his defensive military strategy which saw him retreat to a mountain fortress to be able to protect and build a burgeoning nation in the face of the many forces threatening its survival.

Fourthly, there is his remarkable inclusivity and tolerance for diversity which saw him unite disparate groups of refugees from the violence and hunger that displaced them and then weld them into the Basotho nation. He also engaged with French missionaries, inviting them to stay with him and advise him on Western thought, technology and religion.
These are but some of the qualities which belie the notion that all 19th century African leaders were merely marauders and conquerors that gained their ascendancy through violence. Instead Moshoeshoe is a prime example of the human-centred, democratic and pluralist roots of South African, indeed African society.

The Moshoeshoe project that we have initiated (of which the documentary, called “The Renaissance King”, forms but one part) derives from our location as a university in the Free State, a province with a particular history and a particular political culture that developed as a result of this very model of leadership. This province has benefited tremendously from leaders such as Moshoeshoe and president MT Steyn, both of whom many observers credit with establishing a climate of tolerance, respect for diversity of opinion, political accommodation and peaceful methods of pursuing political objectives in the province. Their legacy is real – and Moshoeshoe’s role can not be overstated.
In addition the project derives from the University of the Free State being a site of higher learning in a broader geo-political sense. As a university in Africa we are called upon to understand and critically engage with this history, this context and this legacy.
Besides the documentary, the UFS is also planning to establish an annual Moshoeshoe memorial lecture which will focus on and interrogate models of African leadership, nation-building, reconciliation, diversity management and political tolerance.

In tackling such projects, there may be a temptation to engage in myth-making. It is a trap we must be wary of, especially as an institution of higher learning. We need to ask critical questions about some aspects of Moshoeshoe’s leadership but of current political leadership as well. Thus there is a need for rigorous academic research into aspects of the Moshoeshoe legacy in particular but also into these above-mentioned issues.
While the documentary was commissioned to coincide with the University of the Free State’s centenary and our country’s ten years of democracy, it is a project that has a much wider significance. It is an attempt to get people talking about our past and about our future, as a campus, as a province and as a country – even as a continent, given the NEPAD initiatives to promote democracy and good governance.

The project therefore has particular relevance for the continued transformation of institutions such as universities and the transformation of our society. Hopefully it will assist those who are confronted by the question how to bring about new institutional cultures or even a national political culture that is truly inclusive, tolerant, democratic, non-sexist, non-racial, multilingual and multicultural.

I believe that the Moshoeshoe model of leadership can be emulated and provide some point of convergence. A fractured society such as ours needs points of convergence, icons and heroes which we can share. Moshoeshoe is one such an African icon – in a world with too few of them.

Prof Frederick Fourie is the Rector and Vice-Chancellor of the University of the Free State

* The documentary on “Moshoeshoe: The Renaissance King” will be screened on SABC2 on 4 November 2004 at 21:00.

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