They were being taken into the government hospitals, with whatever their symptoms were, they were told in no - it just wasn't told gently, they were told that they were going to die, they were taking up a bed and they would just have to go home and wait to die. And there was nobody, absolutely nobody . If they had somebody at their home, that was their good fortune: if they didn't they went back to their huts and they just lay there and waited to die. And that was it, there was just absolutely nothing available.⁴

Table 2 Patients cared for by Hospice at Home 2002 - 2003
Source: Thulie Msane ⁵

The Swaziland Community Care Programme was established in Mbabane by the Salvation Army in 1985. Due to the ever-increasing number of HIV/AIDS patients a palliative care programme was initiated in 2000. Provision includes:

• home care
• HIV clinic - in the Mbuluzi district of Mbabane
• bereavement care
• orphan care – currently 300 children⁶

Around 180 clients are seen daily.

Located in Manzini, Hope House is an inpatient unit modelled on the Swazi homestead which caters for the needs of AIDS patients at the end of life. The facility opened in 2000 and consists of a group of bungalows which provides accommodation for HIV patients and caregivers.

The Hope House concept was developed by World Vision International⁷ in partnership with the Roman Catholic Church during the late 1990s. Funding was provided by the National Office of World Vision International: Austria , Germany , Ireland and Taiwan . Other support has come from The Italian Co-operation,⁸ and Women and Law in Southern Africa (WILSA).⁹

Patients may be referred to Hope House by a number of organisations, including Swaziland Hospice at Home and the Swaziland AIDS Support Organisation (SASO).¹⁰

Parish Nursing

This three year project began in 2000 supported by the ‘Secure Future' programme of the Bristol Myers-Squibb Company.¹¹ Located in the Roman Catholic Diocese of Manzini, it is run in partnership with Maternal Life International (MLI).¹² The project is summarised as follows:

Swaziland has under-developed health infrastructure and is predominately a rural area with a shortage of health care professionals specializing in HIV/AIDS care. By working through the Catholic Church, this program will demonstrate how countries can tap into existing infrastructure and draw the community into HIV/AIDS work. Community-Based Parish Nursing's project plan covers curriculum development, use of telecommunication for ongoing training, direct patient and family care, HIV testing and counselling, education and training of community volunteers.¹³

Thandiwe Dlamini , administrator of Parish Nursing, describes the care provided by parish nurses and outlines its underlying principles. She writes:

Parish Nursing aims to integrate the practice of faith with the science of nursing. It links nurses with churches to focus on health related issues and to provide a holistic approach in the healing and caring process of a patient. The programme offers patients a holistic health approach which combines physical and spiritual dimensions. The Parish Nurses work part time and are assisted by community members who have been trained in home-based care. Each nurse sees around five to eight patients per day and approximately 240 patients per month.¹⁴