"where there is charity and wisdom,there is neither fear nor ignorance."

St.Francis of Assisi 1181-1226

Team of careworkers walk from home to home caring for people who are in need of physical and emotional support during their illnesses. A major aspect of their service is palliative care which means staying with the patient during their final hours.

Thembalethu Home Based Care aims to achieve high-quality palliative care that is both sympathetic and dignified for all patients who are unable to access alternate medical care in the local community. This is achieved with basic but essential tasks such as washing and feeding the patient, moving the patient to help prevent bed sores and ensuring that the patient takes their medication as prescribed.

In addition to helping the patient, our careworkers also help the patient’s families. This can involve feeding the family, cleaning the house, washing the clothes, and getting water from the community taps.

They also try to ensure that children are not exposed to traumatizing situations. Careworkers are trained in trauma identification and counseling, especially for children, and thus are able to offer their patient and their families, emotional and spiritual counseling.

There are five major tragedies that emanate from HIV/AIDS: the psycho-social impact on children who sit by helplessly watching as their parent suffers and dies, the negative psychological impact on the sufferer, the social stigmatization of both patient and family, the physical pain suffered in the last stages of AIDS and the possibility that the HIV positive person has infected another person. When these impacts are combined with dire poverty and increasing numbers of infected people, the result on all spheres of community life are devastating.

Health Services

The Thembalethu Home Based Care Heath Services, under the operation of Coordinator Sphiwe Magagula, serves an average number of 20 community members per day, mostly female patients between the ages of 21-49 years.

Common complaints include chronic problems such as cough, generalized pain, skin rashes, and abscesses secondary to HIV/AIDS. In addition to serving community members, Health Services also distributes over-the-counter medication to over 300 trained careworkers in the Nkomazi District, Swaziland, and Mozambique who care for over 2,000 acute and chronically ill patients, orphans and vulnerable children.

Progress notes are filed on all patients who visit Health Services, which include patient’s name, age, sex, home of record, common complaint, and medication distributed as well as measurement of blood pressure, temperature, height, and weight. Counseling sessions are provided as well as health education on diet, sanitation, and disease prevention.

Our referral system includes local rural clinics and Shongwe Hospital, under the operation of the Department of Health. Critical problems requiring further assessment such as high blood pressure, pneumonia, tuberculosis, diabetic complications, fractures, pediatric cases, and any problems requiring prescription medications are promptly referred to the above mentioned establishments.

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Food and Clothing Distribution

A number of factors contribute to a high level of poverty in the community. The AIDS epidemic directly results in poverty and orphaned children who have no access to food. Additionally, the erratic climate creates an uneven harvest and unreliable income for farmers.

Unemployment is estimated to be above 60%, in part because the region’s major employers are located 30klms away.
Teachers confirm that many children arrive at school hungry and many go to bed without supper.

Careworkers and neighbors assist struggling families when they can. Also, families are encouraged and assisted to participate in the garden program.

However, food parcels are still needed for destitute families and orphans. The parcels include maize-based porridge, soup, sugar, salt, oil, beans, peanuts, matches and washing powder. Fortified nutritional meals are provided free of charge for individuals infected with HIV and those with otherwise compromised immune systems.

Thembalethu feeds over 600 people monthly, and never allows anyone who enters the center to leave hungry—whether they are officially part of the organization or not. This open armed catering program would not be possible without the hard work and dedication of the kitchen staff.

Donations of second-hand clothing are greatly appreciated and are distributed throughout all the villages in Nkomazi.

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Spiritual and Emotional Counseling

In line with Thembalethu’s holistic approach to the issues of HIV/AIDS and poverty, emphasis is placed on the spiritual wellbeing of those in the community which we serve.The organization upholds fundamental Christian beliefs and values.

Since 2000, over 200 volunteers, mainly from South African and international churches, have offered a variety of skills and spiritual and material support. Circles of support are being established in 20 villages. These circles offer further training in all aspects of HIV and emphasize the “A&B” program (Abstinence and Be Faithful). The circles offer trauma counseling and general support to those in need.

Our coordinators and counselors are trained through recognized institutions, such as the Center for the Study of Aids, (University of Pretoria,) Little Seeds (child care) and SA Family planning. This training enables them to recognize trauma situations and to offer spiritual and emotional counseling to both children and parents.

The Nkomazi community experiences an abnormally high level of rape and abuse, especially of children and young girls.

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HOME BASED CARE FAST FACTS:

• 266 careworkers covering 21 villages assisted many patients during the year in over 31,361 visits
• 1,249 new patients entered the program during the year
• 1,026 patients passed away and THBC conducted funerals in most villages
• Over 240 coffins were made to assist those families who have no means of support
• Currently the care-workers are tending to 1,900 patients. TB patients are helped with their medication and the care-workers are DOTS trained.
• The major challenge faced by the care-workers is that of poverty and hunger. This is particularly true of patients taking TB medication.
• A dedicated coordinator assists the care-workers to offer spiritual help to patients and support groups have been started in 3 villages with more on the way
• Careworkers receive training throughout the year with additional child-care training being offered
• The careworkers were treated to a special thanksgiving day when their work was celebrated and awarded with a big meal

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Burial Services

In addition to its Home Based Care work, Thembalethu provides a free, dignified, and culturally appropriate funeral service to those in need.

Initially this service was intended for Thembalethu’s patients only. However increasing numbers of deaths have led to a crisis, and families unable to cope with funeral costs, are turning to Thembalethu for support. Simple coffins are made on the premises and Thembalethu staff are often called upon to dig the grave, provide transportation and a hearse, and conduct the funeral. This service remains important in preserving a respect for life in a community that sees so much death.

In the past, a funeral was a major event in which the whole village would participate in a night vigil followed by an early Saturday morning burial and meal. However, because of the increased number of burials (a village may bury five or six people in one morning) the chief has asked villagers to curtail feasts due to financial constraints.

During 2006 THBC made 20 coffins per month.

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