Effective altruism and global palliative care: One project case
This is the case for effectively impacting present and future generations through palliative care. Globally, palliative care relieves suffering—whether through serious illness, impending death, poverty, displacement, climate impacts, famine, migrations, etc. It also positions community-based agencies and health systems to proactively be positioned with resilience and infrastructure to respond to future shocks and impacts that arise within the vulnerable populations they serve. For an overview of applicable studies and projections, please review the recent Lancet Commision Report on Palliative Care: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X%2818%2930082-2/fulltext This is a case for philanthropic support for the Kath Defilippi Fund at South Coast Hospice in South Africa: https://www.schospice.co.za
Forty years agao, Kath Defilippi was the founder of this early pioneering hospice in South Africa. She later became the first Board chair of the continent-wide African Palliative Care Association: https://www.africanpalliativecare.org Kath and her hospice developed the community-based model of palliative care that has become the standard of care in much of Africa for non-profit palliative care organizations to be intimately connected to vulnerable populations with health and social services to relieve suffering and promote wellness. Tens of thousands of beneficiaries are served each year by South Coast Hospice, in collaboration with a network of health and social services providers. The Hospice has been remarkably adaptive in identifying and responding to emerging challenges to the people of KwaZulu Natal Province in South Africa. Some of these challenges include the impacts of climate change on the eastern coast of Africa, the critical water shortage for rural families (so necessary for survival, and for the uptake of HIV and other medications), electrical power grid load-shedding, devastating mental health issues within all ages of the population, and the need for vastly more efficient technology in the operation of public health services. The flexibility, grass roots base, and resilience of this program (like many palliative care programs globally) renders is a most suitable candidate for effective giving philanthropic investment to address both present and future needs.
With the population of Africa exploding to the point of becoming the most populous continent, the youth dividend on such investments will be significant. And for a continent that has contributed so little to global warming, the investment in renewable energy will have huge impact of the future state of poverty and wellness. The cost-effectiveness of South Coast Hospice services today ($7 per beneficiary) will be increased with the added efficiencies to be realized from the Kath Defilippi Fund investments. However, it is the positioning of South Coast Hospice to assist vastly more future beneficiaries that makes the proposed one-time investment in the Kath Defilippi Fund a real impact multiplier.
The Fund proposed approximately $200,000 to be invested in three key infrastructure components:
> Inverters and conversion to Solar Energy for all facilities
> On-site borehole and water filtration and distribution system for facilities and for
home-based clients in the communities and villages
> Purchase of state-of-the art software and hardware for operations and
communications.
This Fund will also be a model for other global palliative care programs that serve vulnerable populations challenged with similar trends and shocks now and in the future.
This is an opportunity to support a very local grass roots effort in a developing country, in an established agency that has a proven track record over many years, and is positioned to effectively impact future generations holistically with a demonstrated model of care.
Please visit the South Coast Hospice website (above) for more information. Donations in the USA may be made to Global Partners in Care, https://www.globalpartnersincare.org
a 501(c)(3) organization that receives donations, provides IRS recognition, and transfers funds to the Africa-based Kath Defilippi Fund. International donors may also contribute directly to South Coast Hospice on their website, or to the African Palliative Care organization. A one-time gift will generate returns long after the technical components of the Kath Defilippi Fund are implemented. Thank you for your consideration!
NOTE: The Kath Defilippi is not part of the GiveWell system, as it is a one-time initiative outside of GiveWell’s current priorities. The studies that support the effectiveness of palliative care are generic to the field of palliative care, and have not been specifically applied to South Coast Hospice. Studies are available through the Center to Advance Palliative Care in New York City: https://www.capc.org
Phil Di Sorbo, MS, BCPA pdisorbo@fairpoint.net
Can you clarify what the $7 represents? is this $7 donor money or $7 spent by South Coast Hospices? What services are covered by the $7 figure? (How many days/weeks of palliative care, what are the health/social services covered under $7 etc)
Is this also covered in the $7? What exactly has been done here / do you have an estimate of impact?
I do have a soft spot for palliative care personally but I’d be interested in some more clarity around the cost-effectiveness estimates you’ve provided.
Bruce,
Thanks for the questions. No, the $7 per beneficiary is the operational expenses in the most recent year divided by the number of beneficiaries in that year. In reality, this includes a large amount of donor funds, which is raised locally every year, but it is not part of the special project being proposed here as one-time funding for the special project. The $7 includes all services, including those such as the inpatient unit that is open 24⁄7, and a host of home care services some of which are basic (received by most beneficiaries) and some of which are targeted to special populations (e.g. Aids Adherence Programs, Medication Distribution Programs, Water Insecurity Supplementation Programs, and Mental Health re-patriation programs.
Yes, this resilience/adaptive phenomenon is part of the $7, as the programs just mentioned are all programs that have been developed to meet emergent issues in real time for vulnerable populations in the service area. So, we view the cost-effectiveness as the impact the operating expenses are having today, as well as the relevant impact they will have on even greater numbers for future generations. For those of us investing in the current project, I would say that:
Renewable energy, water access, and technology infrastructure are being installed by local South African vendors, several at below market value due to the fact those vendors’ families have used hospice services and know that community value.
The infrastructure project will improve efficiencies and broaden services, so the dollar to beneficiary ratio will be improved, although I don’t have specific metrics on that, but I can get estimates if you would like.
The future impact is built into the one-time investment in the current project. There are no project continuation funds to be raised as part of this project; yet, major impact will continue: Less expensive renewable energy, electrical grid independence, access to fresh water on site for inpatient facility use and distribution to seriously water stressed patients and families, networked software and hardware employed to full capacity.
IMPACT QUESTION #3 above are the specific impacts for the proposed Kath Defilippi Fund project. As far as South Coast Hospice services, the impacts have been effective provision of hospice and palliative care services (SCH Annual Report, and Report to the South African Ministry of Health), success in delivering target projects to achieve desired outcomes: water to stressed families achieved; mental health patients supported in community settings, medications distributed and lives saved in medication access deserts, inpatient services delivered to terminal and near terminal patients (high consumer satisfaction ratings), etc.
I hope this helps, let me know. Your “soft spot” is greatly appreciated, and I would love to see the EA community become more aware of palliative care!
Sincerely, Phil
Dear Bruce,
Did my replies come through OK? Let me know what else might be needed. I look forward to the next steps to possibly getting the palliative care project word out!
Many thanks, Phil
Hello Bruce,
Just checking in again regarding my submittal. Hope all is well.
Happy to clarify more if needed.
Thanks,
Phil Di Sorbo