For eight months after it was opened four years ago the Ethembeni Care Centre stood empty. Today it offers much-needed help to those in crisis from long-term illness
Niki Moore
From the outside, it looks like any ranch-style colonial home in the middle of a timber plantation in Zululand. An electric fence, huge spreading canopy trees and a bungalow facing an expanse of lawn. The peace and quiet is palpable.
But under the unbroken surface, this place is fomenting a revolution. It is achieving what many government projects have failed to achieve a change in people’s attitudes towards HIV/Aids.
The Ethembeni Care Centre is in a tranquil country setting 12km north of Richard’s Bay on the Zululand coast. The unskilled and semi-skilled industry workers live in sprawling townships adjacent to the port.
From the early Nineties, it was obvious that Aids was having an impact on the industry workforce. From the business point of view, the main concern was that there were not enough facilities for stricken workers.
The concept of home care was undeveloped. The occupational therapy clinics were overloaded, hospitals were expensive and could not treat patients long-term but people had nowhere else to go.
Five large companies joined forces through the Zululand Chamber of Business Foundation and donated the money to establish an Aids care centre, which opened with a flourish on World Aids Day, December 1 1997.
The centre stood empty for eight months.
“We under-estimated the stigma attached to Aids,” says project manager Jenny Rogers, with a rueful laugh. “We thought we would advertise ourselves as an Aids care centre. But no one in Zululand will admit to having Aids.”
So the centre management did some lateral marketing and advertised step-down health care of all kinds, from tuberculosis to strokes, diabetes and convalescence. The response was immediate and varied but 90% of the patients at Ethembeni are living with Aids.
The centre has four areas of focus. The most dramatic is the 15-bed care facility, which offers a short stay in the centre to those who are in crisis from the epidemic. “Sometimes all they need is a course of vitamins and a tonic,” says Lana Oatway, the centre’s manager and a registered nurse.
“With some skilled care, the improvement is remarkable. Often they recover so much they can go back to work.”
Sometimes, though, the patient is beyond recovery and can only be kept comfortable and pain-free till the end. “We get a lot of transfers from other hospitals. We are registered as a step-down facility we bridge the gap between the hospital and home.”
The second area of focus is a home-based care unit. Workers are trained to go back to their communities, visit patients in their homes and teach families how to look after their terminally ill relatives. Part of this teaching has to do with awareness and prevention and also takes in schools and community.
The drop-in day service is a counselling service for people and their families who need to go somewhere where they can take a respite from the problems of the world and get some encouragement from trained staff. “It’s extremely wearying to look after somebody with a terminal illness,” says Oatway, “and very often the care-givers need counselling and encouragement as much as the patients.”
The centre offers a comfortable lounge with TV and video, games and relaxation. Patients and their families can drop in for a few hours of tea and sympathy and leave feeling recharged for the weary task ahead. Counselling is available for all stages of terminal illness, assisting with coping skills and support, to grief and bereavement counselling for families.
In its formative stages, but going from strength to strength, is the training centre. Seminars and training courses are offered to business and industry, both for management and employees. Staff at the unit have also developed a special training programme for school teachers in rural areas who would otherwise have little access to resources.
Always mindful of the stigma attached to Aids, the centre’s staff are also trained to deal with tuberculosis, sexually transmitted diseases and other opportunistic ailments. The traditional leadership of the area is supportive of the centre, and have in fact nominated people for training as “health workers”.
The services at Ethembeni are not free, otherwise the centre would be unsustainable. The industry donors in Richard’s Bay provided the set-up costs and patients are expected to pay for their stay. Sometimes the employer might subsidise a portion of the cost. And the centre is registered with the Medical Aid Association of South Africa.
However, the charges are minimal in relation to normal private clinics and the management and staff of Ethembeni exercise considerable ingenuity to keep going. Donors in the region have to be fast to keep one step ahead of the Ethembeni team.
‘We were looking for some furniture,” says Rogers, “and we heard about a large company that was busy refurbishing its staff accommodation. I asked if we could have some pieces of furniture. The company MD said that we could help ourselves. So we did!” The results of the raid now furnish the day rooms of the centre.
Outsiders get sucked in as well body and soul. Lana and Lou Oatway came out to Zululand from Canada to visit their daughter. Lana is a nurse and Lou is a paramedic. They heard about the clinic and decided to help out for a while. Their six-week visit has lasted six years. Between them, they provide a skilled and human face to the centre.
But the human component has not always been cooperative. For the first time in our interview, the enthusiastic smile on Jenny Rogers’s face slips and she gets a look of despair: “When we first opened, we were plagued by robberies. Our furnishings were stolen, our vehicles were hijacked, our staff were robbed. We could not understand how criminals could be so callous.
“Now we are forced to have security. The property has an electric fence and we have armed security guards. This is costing us R6?000 a month. Just think how much medicine we could buy for R6?000 a month.”