Promoting Palliative Care in South Africa


Two primary care district hospitals (False Bay and Wesfleur), two 24hr Community health centres with Emergency units (Delft and Gugulethu), and three 8hr Community Health Centres with emergency rooms (Heideveld, Grassy Park and Nyanga).

Disease Prevalence

In SSA, including South Africa, there is a high prevalence of advanced Chronic Obstructive Pulmonary Disease (COPD) at young ages, linked to exposure to biomass smoke, TB and HIV, untreated asthma, poverty and undernutrition. COPD is the fourth leading cause of death globally. After first hospitalisation, median survival is 3.6 years. In advanced COPD, symptoms and concerns span the dimensions of palliative care (pain, dyspnoea, fatigue, sleep problems and depression). Many require support with spiritual problems as the disease progresses. Little is known of current management in the community. National care guidelines focus on lung disease management,1 and do not emphasise the role of a palliative, person-centered and holistic framework.  


  1. Abdool-Gaffar MS, Ambaram A, Ainslie GM, et al. Guideline for the management of chronic obstructive pulmonary disease–2011 update. South Afr Med J Suid-Afr Tydskr Vir Geneeskd 2011;101:63–73.