In South Africa we have a challange of paediatric doctors and centres. Forinstance we only have one Hospital with enough mordern medical equipment for special needs of children, which is Red Cross Hospital in Cape town. The fact that this Hospital is not only catering for the children in South Africa only but the SADAC and Sub Sharan African region it shows how we lack behind interms of infrustructure. When it comes to the care of children in our health care sector we still lack behind the palliative care for children. In many cases one would notice that children do not get the hollistic care because of our constitutional barriers, eg the participation in decision making of the treatment by children it is disregarded by many health care workers. From the above point I also value the age appropriateness but one woul rarelly see this happening. I also find it very interesting that when it comes to mourning greaving and bereavement care, children are regarded as people who do not feel the loss but this is not true they feel everything we feel but the difference is expression. I think what we need is to seat down and challange our health care system as they have signed the agreement of the WHO and the UN health care standards to include palliative care in our universities. It does not matter where one prctices as a professional we are all affected by palliative care issues.

I feel that it also depends on where you are in South Africa,in the Metropolitan areas there are far better resources available for children.In the rural areas the resources are very thinly spread ,if you are thinking of holistic care there are not even enough social workers to psychosocial interventions and there is a growing need for Prof nurses to fullfill this role and with heavy workloads they often neglect to identify the emotional needs of children

I belive that human resource and infrastructure is what you are refering to. I totally agree with metropolitan areas and infrustructure, but with equiped human resource thats another debate on its own. please refer back to my last comment about constitutional barriers as well as the challenge of building the a palliative care foundation in our Universities, then you can best agree with me that there is only one University in the western Cape offering the palliative care course to the medical or clinician students, when it comes to the training of the psychosocial personell from the University I know none except the fact that it has been in the pipeline for so many years. I would like to also highlight the fact that dealing with physical pain needs to deal with emotional, social, spiritual, cultural and psychological pain as well, we can't focus only on one aspect of paliative care development in this era. I thankyou Kimberly Hospice for your comment it was constructive in a way.