Botswana is in the unusual position of being an African country that is not financially resource poor. It is poor, however, in specialised human resources, and notably in the field of palliative care.

In Botswana palliative care is delivered by three organisations: Holy Cross Hospice, Gaborone; Ramotswa Hospice at Home; and the Light and Courage Centre, Francistown (Table 1):

Table 1 Palliative care provision in Botswana, 2004

Holy Cross Hospice. This faith-based organisation was founded in 1994 as a day care centre and to provide home-based care in response to the AIDS epidemic. It now offers home based services, day care for adults and orphans, and includes a drop-in centre for patients. In March 2004, 30 adults and 7 orphans were registered with the day care centre.

 Ramotswa Hospice at Home (Bamalete Lutheran Hospital).The hospice was founded in 1992, initially to provide day care for the elderly and chronically ill. It soon became used for HIV positive patients and for some cancer patients. The hospice operates a home-based care service, offering nursing and counselling to approximately 48 patients at any one time. Daily respite care is available when necessary. A day care centre operates twice weekly where patients are fed; they can also partake in occupational pursuits such as beadwork and sewing.

Light and Courage Centre. The service was established as a day care centre in 1998 by the Francistown Multisectoral AIDS Committee as a response to the growing AIDS crisis. The Centre had, by September 2003, provided day care and support to more than 210 registered clients who have an AIDS-defining illness. Those who are asymptomatic are able to access information and counselling but are not considered as day care clients. A maximum of 40 clients at any one time receive holistic care from this faith-based organisation. Home visits are limited to those who would normally attend the day centre but are too unwell.