Sustainability lessons from a pandemic

The Hospice Palliative Care Association’s (HPCA) 103 member hospices across South Africa, who care for patients with a variety of life-threatening diseases, predominantly in the comfort of their own homes, implemented strict Standard Operating Protocols (SOP) early on in the pandemic to protect the highly vulnerable patients that they care for. As the lockdown has continued, some hospices have extended the SOP to offer care for those that have been affected by Covid-19.

All of this has been undertaken within challenging healthcare environments with service delivery as the focus, and funding cuts experienced across the board. This created a challenge for hospice and palliative care organisations both in terms of their normal fundraising and in ensuring that their services were safely and seamlessly administered to all of those that needed them, whilst often being financially challenged.

But there is a light at the end of this tunnel.

Digital. And the understanding of it and how it can be used as a tool to assist NGOs with new ways of creating relationships and raising funds, even for those who operate in landscapes where connective relationships have traditionally been forged face-to-face.

According to Patrick Schofield, Director and CEO of Backabuddy (and co-founder of Thundafund.com and Uprise Africa): “Right now, within the time of Covid-19, there are a lot of challenges. But, from a hospice and palliative care space, it’s an opportunity to raise and grow support – people are aware of their own mortality and cognisant of getting ill. It is an opportunity to turn a negative into a positive. When you empower people with information and an opportunity to support, people become fundraisers for you. The world of digital allows for the activation of a much wider audience of people than your immediate community. Families and friends become touchpoints of global awareness. A community is not just the people who live in the neighbourhood, it’s a global neighbourhood of people that are no longer bound by geographical boundaries.”

This sentiment is echoed by Kate Jackson, former Communications Manager of the Worldwide Hospice Palliative Care Alliance (WHPCA) who says: “Who led your digital transformation? Was it the CEO or CFO? Or was it Covid-19? Digital might have been the last thing on the agenda, with service delivery and fundraising as the priorities and digital at the end of the list. The light at the end of the tunnel for hospice and palliative care during this pandemic is that it’s necessitated the learning of new skills that will ultimately serve not only the hospices, but also the general public.”

The WHPCA went the route of intensive digital empowerment of hospice and palliative care associations worldwide by sharing their skills, digital tool kits and working with organisations to upskill individual members to utilise technology for World Palliative Care Day, which took place on 10 October.

South Africa has taken up the challenge with gusto, with the HPCA hosting digital fundraising webinars and individual hospices launching their own activities with digital footprints in the first two weeks of October.

The HPCA also launched a new app in September, to bring access to palliative and emotional support directly into the homes of ordinary South Africans. The app “WeCare” was developed by the HPCA and draws on their three decades of work across all nine provinces.

The app, explains Dr Ewa Skowronska, CEO of the HPCA, makes their services more accessible to ordinary South Africans in a time when it is needed more than ever before. “Hospice provides more than just end-of-life services. Our emotional, social and spiritual counselling work supports government’s Covid-19 relief efforts.”

The app allows South Africans to virtually, and directly, connect with hospices and is available for free download via Google Play.

HospiceWits (HW) is another example of pivoting to digital. Over the past six years they have presented a fashion extravaganza for SA’s Top Designers to showcase their latest designs, dressing models, celebrities and artists. Called “Night with the Stars”, this event has traditionally attracted more than 100 local performing artists, fashion designers, celebrities and influencers, who graciously offered their time, free of charge, to walk the longest red carpet in Africa.

The purpose of the event is to raise awareness, but also to drive customers to HW Charity Shops with interest generated on items that were modelled on the night. Or they could purchase items worn from the charity shop on the night via the HW online shopping app.

With Covid-19 rearing its head, this annual event could not take place.

They decided to see the positive in the situation. Which was that they had access to a global audience if they went online and at the same time, could assist the creative industries that were negatively impacted by lockdown restrictions. The tagline was: “Collaborating for a Cause. United for Life”.

The idea behind all of the work that went into the digital version of this event was to sustain it for a few years; to give it longevity so a full marketing plan was devised, specialist partners brought on board and multiple digital channels activated, including email.

Says Jacqui Kaye, CEO of HospiceWits: “This was really an eye opener. It is a huge amount of work, but the effective use of the various technologies available to us today become so apparent. Our partners brought incredible expertise to the table and the creative industries that we worked with shared the benefits. The end result is not only the funds that were raised, it is also the brand awareness that we managed to generate and the new audiences that we had not traditionally reached.”

Grahamstown and Sunshine Coast Hospice launched their Sponsor a Nurse campaign on Backabuddy in July. Donations will help cover the salaries of eight part-time Hospice professional nurses working in Grahamstown, Bathurst, Kleinemonde, Port Alfred, Kenton-on-Sea, Bushmans River Mouth and Alexandria in the Eastern Cape of South Africa.

Says Angela Hibbert, Fundraiser for Grahamstown and Sunshine Coast Hospice as well as the Administrator of Sunshine Coast Hospice: “The successes we have had during lockdown have been largely due to the success of our growing Facebook page. Soon after lockdown, we appealed to our Facebook community by marketing our virtual cupcake sale and were delighted to make half of what we would have made with the actual event without any baking. Our most successful event during lockdown has been “The Walk for Hospice” initiated by our own palliative care specialist, Dr Barbara Matthews and her friend, Sandy Smith in response to our funding crisis. They garnered support from all over the world and we promoted the event via email and with videos and daily updates on Facebook. We had hoped to raise R20,000 and made R110,000!”

The pandemic has also led many NGOs to adopt a hybrid model of paid-for and free service delivery and has forced many organisations to relook at their models in terms of long-term sustainability.

Says Marcus Coetzee, a South African management consultant who works with organisations that are changing the world: “This Covid-19 lockdown has had a profound impact on non-profit organisations and businesses in South Africa. While a few have managed to scale their services to meet the demand, many have needed to shift how they do things to keep their doors open. Those who’ve been unable to do this, or who’ve simply been unlucky, have sadly needed to downsize or even close. During the lockdown however, I’ve been marveling at how willingly and rapidly some South African organisations have adapted.”

The HPCA is embarking on a number of projects to ensure the sustainability of hospice and palliative care provision in South Africa. Whilst many of these projects were in birthing stages pre-lockdown, they have now been escalated to priority stage. Says Skowronska: “a critical component of sustainability will be that medical aids work more closely with us for provision of the critical quality care that hospices are providing. We have to start working with sustainable models to ensure our survival in the new normal, but will never close our doors to those who are financially disadvantaged. Our goal is to serve all who need palliative care. That care is a human right and it is written under Universal Health Coverage.

“We have shown ourselves capable of rising to the challenge of this new world and we will be embracing new ways of working with relationships to build back better.”