• The FHSSA and APCA Partnership
  The Foundation for Hospices in Sub-Saharan Africa and The African Palliative Care Association are working together in an international effort to scale up hospice and palliative care services in Africa.

What is Palliative Care?
The World Health Organization (WHO) defines Palliative Care as "an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual." According to WHO, Palliative Care:

• provides relief from pain and other distressing symptoms;
• affirms life and regards dying as a normal process;
• intends neither to hasten or postpone death;
• integrates the psychological and spiritual aspects of patient care;
• offers a support system to help patients live as actively as possible until death;
• offers a support system to help the family cope during the patient's illness and in their own bereavement;
• uses a team approach to address the needs of patients and their families, including bereavement counseling, if indicated;
• will enhance quality of life, and may also positively influence the course of illness;
• is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications.

What is Home-Based Care?
The World Health Organization defines home care as "the provision of health services by formal and informal caregivers in the home.  Such care includes physical, psychosocial, palliative and spiritual activities."  WHO goes on to say that the goal of home-based care "is to provide hope through high-quality and appropriate care that helps ill people and families to maintain their independence and achieve the best possible quality of life."

What do Hospice and Palliative Care Programs in Africa Do?
Hospice and Palliative Care programs in Africa provide interdisciplinary care to terminally ill patients and their families.  As in the United States, the majority of this care and support is given within the patient's home as home-based care.  Services provided by the supportive care team include
     - pain and symptom management
     - supplemental nutrition and vitamins 
     - psychological and spiritual support 
     - bereavement counseling 
     - orphan care planning
In addition, families and community care workers are taught to provide for the personal care needs of the patient, methods for preventing HIV/AIDS transmission, and help dispelling the myths surrounding the disease. 

The hospice and palliative care movement in Africa started in 1979 with the establishment of the first hospice program, Island Hospice, in Harare, Zimbabwe. This program and others that followed in South Africa, Kenya, and Uganda were modeled on the principles of hospice care from the United Kingdom but focused on the provision of home-based care for patients and not on specialized in-patient facilities. With the advent of the HIV/AIDS epidemic, the programs modified their services to meet the needs of the ever-increasing number of AIDS patients in their communities. Now, as part of providing interdisciplinary care to HIV/AIDS patients, these programs have begun carrying out community development activities as part of their service models including expanded services for AIDS orphans, day-care programs for hospice patients and children infected and affected by AIDS, and feeding schemes for patients and their families. 

For more detail on hospice and palliative care in Africa please visit the following websites:

African Palliative Care Association   www.apca.co.ug
Hospice Palliative Care Association of South Africa  www.hospicepalliativecaresa.co.za