The Parish Church of St John-at-Hampstead

1/12/2015

Island Hospice      Alan Brooks

One of the charities supported by the parish
Island Hospice and Bereavement Service (UK) have been working closely with Island Hospice and Healthcare Zimbabwe for several years now, initially involved with administering funds raised in the UK (principally from The Diana Princess of Wales Fund) to ensure that these funds were received and utilised, without interference from outside, by the intended recipient. After a period of consultation over the past few months Island Hospice and Bereavement Service (UK) has approved a specific project that we have undertaken to fund……………..

“INTRODUCTION
Established in 1979 as the first hospice in Africa, Island Hospice (Island) was born out of the recognition that there was need for direct home-based palliative care for those with life threatening illnesses and their families, as well as a comprehensive bereavement service.  It pioneered the development of expert palliative care services, including bereavement services both for families   where the patient had been registered with Island and also for the general community suffering loss due to any cause, including trauma and political violence.  Island, from its beginning until the present, has played a major role in scaling up palliative care in Zimbabwe and regionally.  At one time it had 11 satellite sites (today only 3 remain) within Zimbabwe, thousands of health professionals and home-based caregivers trained among public and private providers, and a successful record of training and mentoring developing or existing palliative care programs in Namibia, Zambia, Botswana, Kenya, and South Africa.  In addition, it has hosted international palliative care providers from Australia, North America, Europe, and numerous African countries.  It was recognized by the African Palliative Care Association as a Palliative Care Centre of Excellence.
BACKGROUND
Island Hospice and Healthcare (Island) has identified social enterprise as part of its 2014-2016 strategy. A social enterprise is any program that uses commercial strategies to maximize its social impact, and Island intends to run a payment based nursing service to meet the rising need for care of seriously ill people in Zimbabwe, including, AIDS and cancer patients. The rationale for this project is based on the following:
1. 
1.
    Because Island is currently operating on a staff complement which is less than ideal, there is need to bring another clinical staff member onto the team.
2. 
    The desired nursing service will allow Island to reduce unsafe gap measures in palliative care delivery, for example, situations in which families hire maids to take care of their ill patients instead of hiring trained professionals whose services are of quality, reliable and are backed by a reputable brand in the field—precisely what Island has to offer. The nursing service is also strengthened by the fact that Island has created a big pool of palliative care-trained persons whose knowledge and services are being underutilized. With this nursing service, some of these unemployed home-based caregivers can be employed for their own economic emancipation.

THE GOAL
Island is proposing that a resource be hired to set up and run the nursing service facility. The main advantage of this setup is that when not administering the service, he or she can participate as part of the clinical services team to boost organisational capacity and relieve the workload of other strained team members. Note, however, that the key duties of this person will be to recruit; train and place home based carers with families who are in need of nursing care at home and are willing to pay for it. 

JUSTIFICATION
Our primary target population is that portion of ill patients and ageing parents whose children and close of kin are able and willing to pay for these services (many are in the diaspora) —a considerable portion of the population. This is mainly because current Island workers have observed the tendency of families to hire domestic workers to care for their terminally or seriously ill family members, all of which is assurance that people are able and willing to pay for these services. In addition, since Island is already highly acclaimed in the field of palliative care in the country, it will have an added advantage of relatively easy client mobilization. Ultimately, the proposed nursing service is a worthy and almost obligatory next step as it will allow Island to extend its palliative care reach, especially using the strength of the Island brand name to attract both caregivers and clients and to give them security in the event of a crisis. For instance if the nurse is in any way unavailable Island can quickly organise a replacement – this can’t be done when one has hired a domestic worker to care for the sick.

 The primary beneficiaries of this program will be first, the patient who is being looked after by a trained palliative care nurse aid in the comfort of their own home. The second beneficiary will be the nurse aides as this provides an opportunity for them to receive training that will go towards their own economic emancipation. An indirect beneficiary of this project will be the families of patients as they will have peace of mind knowing that their loved ones are well taken care of in a supportive and loving environment. Their link to Island will also provide them with access to a wide range of services which include home visits from nurses, counselling and bereavement care.

 In order to be competitive in the field—more proof that there is a market for our service—Island proposes to charge a mid-range fee for home-based care, where the carer takes the majority and Island collects an administration fee.  This model is being used countrywide and has proven effective. These discounted prices are meant to make the service affordable and attractive to those in need of the service, yet still provide enough income to allow Island to remunerate the nurse to be hired and keep the program sustainable in the long term and to collect a commission for the handling service. BUDGET AND ACTIVITY PLAN We believe that we can quickly and easily establish a small start-up running from January to December 2016 that will be our entry point into this market.  With a small fund of £11,000 as capital, Island will be able to:

1. 
1.
    Recruit a nurse or social worker (to be remunerated from the start-up capital),
b. 
    Establish a simple but thorough training programme for carers,
c. 
    Equip carers to work in the home ( uniforms, equipment)
d. 
    Build a database of available carers to be hired out, and
e. 
    Brand and develop the necessary communications around the service.

This initiative will allow Island to make considerable progress towards achieving its vision of being a sustainable centre of palliative care excellence.”

The funds that have recently been received from St Johns Hampstead Parish Church will be committed to this project and I have requested quarterly update to be supplied to me that I will forward.

Alan Brooks
UK Trustee
Island Hospice and Bereavement Service (UK)