“Given that life-threatening diseases make some of the most disenfranchised communities more vulnerable, FHSSA’s work is critical in bringing comprehensive palliative care capacity and support to Africa. AJWS has been proud to partner with FHSSA over the last three years to make quality, holistic hospice care accessible to rural people of Zimbabwe.”

Ruth Messinger, President, American Jewish World Services

“The Zimbabwe Palliative Care Initiative” (PCI-Z), represents a collaborative response to the urgent and vast need for hospice and palliative care services across the country. Currently, Zimbabwe has a 20% HIV/AIDS prevalence rate, with over 3,000 people dying every week and over a million AIDS orphans (UNAIDS, 2006). It is ravaged by poverty, hunger, and unemployment, and currently has one of the world’s lowest average life expectancies at birth: 34 years female; 37 years male (UNAIDS, 2006). PCI-Z is the coordinated effort of multiple partners and donors to scale-up palliative care, particularly in rural areas. The main implementing partner of PCI-Z is Island Hospice Service located in the capital city of Harare and Africa’s first hospice program.

The central approach of PCI-Z is to add palliative care to existing rural, volunteer home-based care teams, with Island Hospice providing training and ongoing mentorship in palliative care. Securing access to palliative medicines is a main emphasis, with active work being done with suppliers such as Direct Relief International, and the Government of Zimbabwe. The project also helps to identify vulnerable and marginalized youth, and provide them support through rural Youth Care Clubs. In addition, long-term palliative care leadership is being developed through physician certification in palliative medicine, and includes planning for the addition of palliative care curriculum in the medical school at the University of Zimbabwe.

The other implementing partners in Zimbabwe to date are the United Methodist Church health system, Seke Rural Hospice, and the SAYWHAT organization.

Funding partners in this initiative include: UK Department for International Development (DFID), Ford Foundation, Open Society Institute, American Jewish World Services, UMCOR, Direct Relief International, and US hospices that are partnered with PCI-Z hospices in Zimbabwe. These partners include Arkansas Hospice, Community Hospice, Hospice of Central New York, Hospice of Larimer County, VITAS® East Bay, and VITAS® San Bernandino. Initial funding for PCI-Z was provided by the St. Paul’s and Bel-Air United Methodist Churches in Maryland, and members of the FHSSA Board of Directors.

Results to date include the development of palliative care at 3 rural implementing sites: Chikwaka, Mutambara, and Seke. In addition, training and mentorship has been provided to 9 non-profit agencies delivering home-based care. As a result, over 1,000 beneficiaries are being served each day in home-based care, and over 1,000 youth are active in the Youth Care Clubs. Currently, four physicians have completed the diploma course in palliative medicine at The University of Cape Town and a committee is actively working on a similar course at the University of Zimbabwe. An Essential Palliative Care Medicines list has been produced, and Direct Relief has provided twice-a-year shipping consignments of needed medicines and supplies.

These efforts will continue and grow, with continuation and additional funding to be solicited in the coming years. Future sites for palliative care development include Bulawayo, Matabeleland North and South, Nyadire, and Old Mutare. Additional US hospices will be partnered with these developmental sites. The complex clinical, economic, and political issues related to medication availability will continue to be addressed through collaboration, advocacy, and planning based on outcomes data. In the future, the inclusion of palliative care in a widely accessible and sustainable health care system is the key objective.

FHSSA thanks every individual donor, funding partner, and partner hospice for their support in this effort.

PCI-Z Supervision and Mentorship Checklist

PCI-Z Zimbabwe Essential Palliative Medicines List

For further information, contact Phil DiSorbo at pdisorbo@fhssa.org

Reference: UNAIDS, “Report on the Global AIDS Epidemic”, 2006