Sandra, a 21 year old woman was referred to Helderberg Hospice for HIV and TB support. She was also diagnosed with Kaposi’s sarcoma. At the time of referral, Sandra had been diagnosed with TB for the third time.
Both she and her partner had a history of substance abuse. Sandra has two small children aged five and two. Her two year old son was also diagnosed with HIV and was placed on ART.
Challenging circumstances faced
During the first assessment by Hospice staff, it became evident that Sandra lived a very risky lifestyle and this impacted negatively on her physical health. She was admitted to hospital several times as a result of her having defaulted on both HIV and TB treatment. She was known to be a defaulter.
Her home circumstances were so poor that an urgent referral was given to the social workers of Helderberg Hospice. Due to drug abuse and other factors, it was evident that Sandra was also neglecting her two small children. The children were malnourished and physical abuse of the children was suspected. Neither of their births had been registered either. The family were immediately referred to a partner in child protection in order to address the concerns regarding the children.
In that time period, Sandra was sexually assaulted by her partner, which led to her contracting an STI. A few weeks later, he also raped an eight year old, and was subsequently sentenced to five years in prison, a sentence he is still serving. Despite an influx of support for both Sandra and her children, she made no effort towards positive change, even with the threat of her children being removed from her care.
Frustration and helplessness
Despite feelings of frustration and at times helplessness, Hospice staff continued to visit Sandra on a weekly basis. She received continued support from both nursing and social work staff. They continued to try and motivate Sandra towards change. With each visit, it became apparent that Sandra was more compliant on her medication and the children also appeared to be better cared for.
Light at the end of the tunnel
With the support of a neighbor, Sandra was able to register the births of both of her children, and the neighbor ensured that Sandra’s HIV positive son attended clinic appointments regularly and was also receiving his treatment. With the assistance of the Hospice social worker, Sandra applied for child support grants for her children and these grants came into effect soon after. Sandra used the child support grants to buy clothes for the children and to ensure that their nutritional needs were met, something she had not worried about before.
Perseverance is key
Perseverance from Hospice staff saw Sandra successfully complete her TB treatment and her viral load is currently undetectable. Hospice staff put a lot of time and effort into supporting Sandra and her children. Sandra has now placed her children in a day care facility which allowed her to seek employment. She has obtained temporary employment at the crèche where her children go.
Hospice staff maintain regular contact in order to keep Sandra motivated and encourage her towards consolidation of the positive changes in her life. They continue to work hand in hand with child protection service to ensure that Sandra’s children and safe and well cared for.
We salute the good work our hospices do especially Helderberg Hospice!
