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Dying art of caring: lessons from 34 years in a Hospice

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“Some day, we will all die, Snoopy,” is the declaration of Charlie Brown in the Peanuts cartoon by Charles Schulz. “True, but on all the other days, we will not,” is Snoopy’s famous, gentle retort. It’s this cartoon that palliative nurse Janice Malkinson carries with her as a reminder of the deeper philosophy behind her work, which spanned 34 years at St Francis Hospice in Port Elizabeth until her recent retirement.

Looking back on a career that started with training at Groote Schuur Hospital in Cape Town at the age of 17, Malkinson says she hopes to have made “whatever path the patient was on that little bit lighter or easier”.

It’s a humble reflection for a medical professional who has received international recognition for her humanitarian work by being awarded a Paul Harris Fellow through the Rotary Foundation. She also served as a past chair of the Port Elizabeth Union of Jewish Women and on the committee of the city’s Jewish Benevolent Fund.

Born in Pretoria shortly after World War II, Malkinson grew up in the small Western Cape towns of Mossel Bay and Worcester. As a child, she says nursing “was the only thing I ever thought of doing”.

In those days, student nurses immediately began working as part of their studies. She recalls feeling “overwhelmed” the first time she entered Groote Schuur Hospital.

“I couldn’t even find the ward where I needed to go. It was the surgical ward, C Ward, on the third floor, and I remember I was late because I got a bit lost. I walked in, and the sister asked me who I was. When I replied, she said, ‘G-d, een bliksem se Jood [one damn Jew] in the whole lot of student nurses, and I had to get her!’

“At the end of my three months with her, she said to me, ‘Ek wil net een ding sê: as ek hoer al ooit daar is nog ’n Jood, ek sal sê, Ek wil haar hê!’ (I want to say just one thing: if I ever hear there is another Jew, I will say, I want her!).”

When Malkinson graduated, she was still so young that she couldn’t get her epaulettes until she turned 21. By then, she was training to be a midwife in London, first at the Chelsea Hospital for Women in South Kensington and later in the countryside in Ealing, replete with her very own “Call the Midwife” bicycle.

She recalled a time that it was pouring with rain, and she was pushing her bicycle because it had a puncture. “A big truck driver stopped, and I thought, ‘Oh boy! He wants to put my bike on the back and offer me a lift!’ Instead, he stuck his head out the window, and asked if I could give him directions – everyone knew the nurses knew the area. So I gave him directions, and he left me standing in the pouring rain, still pushing my bike!

“It was great fun!” she says with a laugh. “It was about bringing life into the world.”

In the interim, she returned to South Africa and settled in Port Elizabeth, where she got married and had three children. She also studied to be a paramedic and volunteered in the field, later teaching the course to first-year-university pharmacy students.

In 1978, a friend told her about meetings that were being held at a local hospital on palliative care. Malkinson went along to a meeting, and soon started working as a volunteer. When St Francis Hospice was later formally established, she first volunteered and then later became a full-time staff member.

Her first patient was a young mother who had a brain tumour. “Her children were the age of my youngest child.”

The night before Malkinson was to visit, she remembers getting so nervous that she lost her voice. She had to be coaxed by Port Elizabeth’s Hospice founder, Lesley Lawson, to go, and it was with this gentle nudge that she began her true calling.

From that first visit onwards, she took steps to place herself in the right frame of mind to care for the terminally ill.

“Generally, I walk quickly and work quickly. I remember on that first visit, parking my car, and jumping out – and then stopping, thinking, this patient is in bed, she can hardly move. I need to slow down.”

It’s a practice she adopted over the next decades of work.

“Before each patient, I would take a moment to be aware of where I was and the patient’s circumstances.”

Malkinson worked both in the in-patient unit of Hospice when it was in operation and travelled door-to-door across the length and breadth of Port Elizabeth communities attending to patients at their bedsides.

“My job became the opposite of paramedic work. I couldn’t save or cure them. It was about making them have a life, day-by-day, as they were, and where they were. It was to make each day for them as kind and as good as it could be, to help alleviate symptoms and to listen.

“Especially in the early years, the families of patients couldn’t bear to hear the reality of their experience. People kept telling them, ‘It’s going to be okay; you’ll see, you’ll be better’. It was so hard for the patients. They needed them to acknowledge the reality, to have them say, ‘I hear what you say.’”

Malkinson has seen society grow tremendously in its ability to cope with these difficulties. However, she laughs wryly that mentioning she’s a Hospice nurse is still a definite conversation killer at dinner parties!

Yet, the truth is that the work isn’t just the doom and gloom people imagine. “There is such warmth, because in these circumstances, life is so real and kind. There are still happy times around the table as families gather. You see families grow together and come nearer. You see people take in other people who haven’t got a place to stay. I remember there was one woman who heard about a school friend she had last seen when she was 15. Her friend was now ill and not being cared for properly. She went to fetch her friend, and brought her to her home. You hear of incredible women who take back the man they divorced and care for them in their days of need.”

Overall, says Malkinson, “the work has given me much more than I’ve given”.

Nevertheless, according to her colleagues, Malkinson’s legacy is profound.

Lawson says Malkinson’s gifts lie in both her head – in her extraordinary expertise and knowledge – as well as her heart. “She is just fully present to her patients.”

Trevor Wiblin, the director of Hospice who retired alongside Malkinson after nearly two decades of service, says he has received countless letters from the families of patients in gratitude for the work she did.

He jokes that she had to often be “reigned in”, so unconditional was her sense of service and dedication.

Hospice’s Dr Niel Malan said her work could be described only in superlatives, recalling times when she went into dangerous areas and even after experiencing problems with this, still “went back because they needed her”.

He said she was, in fact, the first Jewish person with whom he had ever had close contact. “My goodness, what an example of humanity, of kindness, of sincerity!” Malan says. “She has taught me so much.”

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Zaka honoured for bravery in Bank of Lisbon inferno

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Jewish rescue and recovery organisation Zaka SA has been awarded a medal of bravery by the Gauteng province for its assistance with the fire in the Bank of Lisbon building in the Johannesburg CBD more than two years ago.

Zaka SA was honoured on International Firefighters Day on 4 May, a day in which the City of Joburg remembered all firefighters who had “courageously put others’ lives before their own, saluting them for their selfless dedication and bravery”.

Three firefighters lost their lives in the blaze, one plunging to his death on the pavement below, after trying to put out the fire near the top of the high-rise building. The building was subsequently found to be only minimally compliant with health and safety regulations, and firefighters faced a lack of water and oxygen. It has since been demolished.

Zaka SA “rescued the rescuers” by offering psychological support to devastated and exhausted city firefighters, and food for 100 firefighters, with the assistance of the South African Jewish Board of Deputies (SAJBD).

However, when they reached the scene, Zaka and the SAJBD discovered that 700 students housed in a building next door needed to be evacuated for fear of smoke inhalation, and more food was urgently required to feed them. Zaka was honoured for assisting with the evacuation of these students, and for providing necessary relief.

“Bank of Lisbon was a complicated story,” said Daniel Forman, the head of Zaka SA. “There was a vacuum of resources including water availability, and we encountered a challenging scene as the three firefighters lost their lives soon into the crisis but firefighters had to continue to fight the fire. The biggest challenge was that the fire was so high up in the building, so firefighters had to preserve their oxygen supplies going up.”

Zaka SA was set up in 2015 to assist the community with emergency search and rescue, body identification and recovery, and fire-containment services. Like Zaka around the world, it’s entirely staffed by volunteers, and relies on communal support to keep going.

It has two trailers which each hold 600 litres of water, and is often the first responder in suburban fires, where early detection and response can eliminate the need to call city firefighters. However, Forman cautions that 600 litres is used up in just seven minutes, and a house can burn down in minutes, making additional resources mandatory.

Zaka is sometimes called on to fight more than six fires a month, he said, particularly in the winter months when people rely on heating devices in their homes, and fires are lit by the homeless and security guards to keep warm.

“Zaka’s fire-containment unit came about through challenges which exist in the system,” Forman said, “including the long wait for firefighters.” Another of these challenges is theft of brass parts from neighbourhood fire hydrants, rendering them ineffective.

However, he stressed that the City of Joburg had been involved in a major upgrade of these hydrants, and was amazingly supportive of Zaka generally. He praised the Gauteng government for exposing the organisation’s communal efforts.

“Not once have they not responded to our call or thanked us for our help,” he said of Joburg’s firefighters. “They do an amazing job.”

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Yummy Shavuot from Yaddies

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Seven hundred families in financial difficulty in the community can now enjoy Shavuot treats including cheesecake, mac n cheese, and pizza thanks to generous monetary and food donations from the community, Jewish schools, and the Rabbi Kraines Chessed Challenge (RKCC).

Their generosity made it possible for Yad Aharon to distribute these special treats, as well as healthy, nutritious food, to community members to make sure that they also have a joyful chag.

RKCC is an initiative which has challenged the community to maximise acts of good deeds and loving kindness during the 49 days of the Omer.

The initiative was formed in honour of Rabbi Kraines (zt”l), whose untimely passing left a void in the Johannesburg community. It celebrates the legacy of a man who was known to be a champion of the mitzvah of chessed.

In addition to the RKCC, Yad Aharon’s Shavuot drive has involved more than 20 Jewish schools as well as local and international donors who realise the importance it plays in alleviating nutritional insecurity in the community.

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A portrait of PE through a life of service

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As Port Elizabeth community stalwart Isaac Rubin reflects on his 90th year, his life story emerges as a portrait of this once thriving, now diminishing, but always impactful, Jewish centre of life.

Having offered decades of service as head of the Chevrah Kadisha and the Jewish Benevolent Society, as well as a vice-chairperson and member of the Port Elizabeth Hebrew Congregation Council and serving as its choirmaster, Rubin has lived a life firmly entrenched in service. His has been a contribution that has helped ensure that Jewish tradition continues to be fulfilled in this small seaside town.

“My best saying is, ‘Zeh hayom asah adonai, nagila v’nismicha bo.’ (This is the day that G-d created; let us be happy and rejoice in it.) To rejoice and be happy, you have to have your health, financial resources, a partner, a family.”

He hopes that he has been able to assist in making this a little more of a reality for those around him.

“It’s a blessing that Hashem has given me, to have the strength to do mitzvot,” he says.

The history of Port Elizabeth can be traced back to a group of at least 16 Jewish families that came with the 1820 British settlers. Later, a wave of German immigrants also arrived. Rubin’s family, from the town of Ludza in Latvia, were part of a wave of Eastern European Jews fleeing pogroms and antisemitism in the latter part of the century into the 1900s. His uncle came first, followed by his father. Later, his mother and oldest brother, Solly, arrived – both speaking only Yiddish.

Rubin, born in 1931, was one of four siblings born in Port Elizabeth itself. Building a life in this foreign country was difficult for the family especially as they hit the Depression years; yet his parents, both tailors, persisted throughout.

When it came to Rubin’s first day of school, he remembers how his father couldn’t come because of work and his mother because she didn’t speak English. A friend came with to help settle him in.

During the war years, he recalls having bomb drills at school where “we had to duck under our desk and put a cork between our teeth in order to prevent our jaw breaking in the event of an explosion”.

Rubin also attended cheder from the age of eight until matric. He was inspired by his studies there to complete Hebrew as a matric subject at school.

His family, in spite of financial struggles, persisted in maintaining cultural traditions. “Hard as it was, every Rosh Hashanah, we would get a new suit of short pants and a jacket. My father would close the shop on all major Jewish holidays, and we would go to shul. We kept a kosher home.”

Community life flourished in these years, with a Jewish population of about 5 000 people. “I was a troop leader in the Jewish Boy Scouts in the 1940s,” Rubin says. Always a keen sportsman, he established a Maccabi Jewish cricket club in the city which eventually had so many members, it played across three leagues. He also played in Port Elizabeth’s Jewish rugby team.

Rubin remembers some antisemitism at one school he attended – where the Jewish children were called “porkers”. Yet, he recalls proudly how when his own grandson attended the same school decades later, the outcome of such provocation was very different.

“My grandson’s teacher made a remark about how ‘you must look after your money, and be like the Jews’, and my grandson went straight to the teacher and said, ‘You aren’t allowed to say that.’” A meeting was held with the principal and family, and the teacher had to make a formal apology.

Meanwhile, after his own schooling, Rubin went on to become a pharmacist and travelled around the world, working at one time at a catering facility for the American army in the Arctic Circle. “I had a contract as a dish washer, and graduated to become a waiter,” he laughs.

Later, he married and settled back in Port Elizabeth with his wife, Shirley. They had a daughter who sadly died at age 37, as well as two sons and four grandchildren. Rubin opened his own pharmacy and his one son has followed in his career. Although Rubin retired at 67, he went back to work part-time 12 years ago.

Once a keen runner who completed 11 Comrades and 11 Two Oceans marathons, Rubin swims in the sea, does yoga, and walks. Both he and his wife are keen bridge players. Over the years, he also volunteered for Lifeline and Hospice. Yet, even this wasn’t enough for Rubin – at the age of 72, he decided to improve his musicality, and learnt to play the piano.

Always a committed member of the synagogue, over the years, he became increasingly active in communal leadership. Twenty years ago he became a member of the council of the Port Elizabeth Hebrew Congregation and then adopted his roles in the Chevrah Kadisha, Benevolent Society, and shul choir.

His love of liturgical singing stems from his father who also loved Jewish and Yiddish songs, and would “sing softly”.

Rubin decided to join the Chevrah Kadisha “when I saw what it had done for my mother, father, and daughter” on their passing. In his role, Rubin would respond to calls night and day, going to the homes of the deceased, comforting the mourners, and organising all the logistics of burials. It was only at the age of 80 that he stopped even helping to dig the graves.

Earlier this year, Rubin stepped down as chairperson, although the organisation then elected to appoint him honorary chair for life.

Gidon La Grange, his successor to the position, recounts once being with Rubin when a call came through from a family who had tragically lost a loved one. “He couldn’t speak. For at least three minutes, he just sat. Silent. He took out his hanky, and wiped tears.” They then began discussing the practical arrangements.

“I remember thinking, this is the quality you should have in responding to people’s loss. This compassion is the way he deals with everybody. The whole community loves him because he carries everything close to his heart.”

Rubin stills heads up the shul choir and the Port Elizabeth Jewish Benevolent Society, whose role is to ensure that the basic needs of all members of the community are met. Although the community has shrunk drastically, its needs have increased.

While Rubin laments the diminishing numbers in the community – the Port Elizabeth Hebrew Congregation now has 182 members – he says the community can hold its head up high. “We have a community that we can be proud of – we’ve upheld our yiddishkeit throughout.”

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