In the province of KwaZulu Natal (KZN), the Hospice and Palliative Care Association of South Africa (HPCA) set up a pilot programme to address the palliative care needs of prisoners. A formal partnership was established in 2009 with the KZN Department of Correctional Services (DCS) with the focus to equip health staff within the DCS to provide palliative care to inmates.
Staff within the prisons (e.g. chaplains, social workers, psychologists, nurses etc.) have been trained in palliative care and at Westville Correctional Centre all the staff have been trained in using the APCA African POS.
Regular palliative care ward rounds take place with a palliative care trained prison doctor, with input from the hospice team as appropriate. In some centres prisoners have been trained to support other inmates and are sleeping in the hospital wards or palliative care units to assist other inmates as needed. Access to essential medicines for palliative care has been made possible through the correctional centre pharmacies and resources such as guidelines, books etc. made available to staff. Discharged patients are being referred to their local hospice or palliative care service as appropriate.
More prison staff need training on palliative care, and there are challenges in caring or individuals within the system e.g. those awaiting trial cannot be admitted to the palliative care ward as this is for sentenced prisoners only. Palliative care is not a priority in the prisons and so trainings etc. may be cancelled at short notice due to competing demands. However, despite this, the programme has made a big impact on the quality of life of offenders with life threatening illnesses.
Zodwa Sithole, Advocacy Manager at the Hospice and Palliative Care Association of South Africa, explained how perseverance in building relationships with the relevant authorities has resulted in better care for patients, She said: “Knocking at the prisons’ doors has improved access to palliative care – the ‘Hidden Lives, Hidden Patients’ in prisons are now accessing palliative care.”
This article was first published as a case study in the report: Hidden Lives, Hidden Patients, commissioned for World Hospice and Palliative Care Day 2015. The report can be found on the Worldwide Hospice Palliative Care Alliance website and will be officially launched on 10 October 2015 as part of the World Hospice and Palliative Care Day celebrations. To find out more or to register an event for the Day, please visit the World Hospice and Palliative Care Day webpage.