Keeping the sunshine on terminally ill
The retired police logistics expert has gracefully accepted that he might not live long enough to see his grandsons arriving from the UK in a fortnight.
"The sun may go down on me any time now, but I am at peace," says Piet van Tonder, 60.
Five tumour-excision operations have failed to stop a rare cancer, chordoma, from slowly and painfully destroying the bones of his skull and spine over the last two decades.
He has spent over two months in intensive care, but, with dedicated support and regular pain management, Van Tonder has led an endurable life.
After doctors gave up he was referred for palliative care at Sungardens hospice in 2011. In two weeks Van Tonder was back on his feet and moved to a home-based care programme.
"Without palliative care the last few years would have been hell," he says.
With insufficient support from government, the Hospice Palliative Care Association of SA (HPCA) says thousands of terminally ill patients have no access to palliative care.
The association says hospices are battling to raise funds from corporates, government and donors, their only lifeline.
Dr Liz Gwyther, HPCA CEO, said government funding only covered a fraction of some hospices' costs.
"It is a small fraction of hospice costs nationally - less than 10%," she says.
Deputy Minister of Health Gwen Ramokgopa said palliative care has been included in a three-year plan for the control of non-communicable diseases.
Life not death
"We avoud the discussion of death, we avoid people who are close to the end of their lives, and after the funeral we don't visit the bereaved very often. This avoidance has been one of the reasons for the stigma associated with hospice," laments Hospice Palliative Care Association CEO Dr Liz Gwyther.
Gwyther says hospices, and palliative care, focus on life and living. "We may not be able to change the diagnosis, but we do work alongside the oncologist to make sure that a person can live with the illness as actively as possible."
Last year, 32257 terminally ill patients were admitted to the 160 hospices in SA. Of these, 23290 were discharged and put on home-based care and monitoring: 8 967 died comfortably.