On June 5th, half of our team went to the South Coast Hospice. The South Coast Hospice was established in 1983 and focused on a home care program for terminally ill people. Over the years, an in-patient unit has opened, the Integrated Community-based Home Care model was developed, and mental health counseling services have been introduced. On our day here, we each went out with a different Home Based Care team.
The goal of the MDR-TB team is to provide MDR-TB patients with their injections. The standardized MDR-TB regimen in South Africa consists of an intensive phase (also called injectable phase) of at least six months with five drugs. This phase is followed by a continuation phase of four drugs. During the intensive phase, treatment should be given at least six days per week. This strict drug regimen can make it hard for patients to adhere to their treatment. If there were no Home Based Care teams available, patients would have to travel to a clinic almost every day to receive their injections. During the injectable phase, kanamycin or amikacin, moxifloxacin, ethionamide, terizidone or cycloserine and pyrazinamide are used.
We saw a variety of patients some of whom lived in very modest homes. Some of the families were very welcoming and interested in what the nurses had to teach them. We visited families, all of whom were infected with MDR-TB, a not uncommon occurrence. Some of our travels were over considerable distances, over rough dirt roads. It was quite an adventure.