in Harare (Salisbury), Zimbabwe, the first in Sub-Saharan Africa. In spite of skepticism in the medical community, the hospice movement spread, and in 1987 the Hospice Palliative Care Association of South Africa formed. In 1990, Nairobi Hospice opened in Nairobi, Kenya. As of 2006, Kenya, South Africa and Uganda were among 35 countries offering widespread, well-integrated palliative care. Programs adopted the United Kingdom model, but emphasise home-based assistance. Following the foundation of hospice in Kenya in the early 1990s, palliative care spread throughout the country. Representatives of Nairobi Hospice sit on the committee to develop a Health Sector Strategic Plan for the Ministry of Health and work with the Ministry of Health to help develop palliative care guidelines for cervical cancer. The Government of Kenya supported hospice by donating land to Nairobi Hospice and providing funding to several of its nurses. In South Africa, hospice services are widespread, focusing on diverse communities (including orphans and homeless) and offered in diverse settings (including in-patient, day care and home care). Over half of hospice patients in South Africa in the 2003–2004 year were diagnosed with AIDS, with the majority of the remaining diagnosed with cancer. Palliative care is supported by the Hospice Palliative Care Association of South Africa and by national programmes partly funded by the President's Emergency Plan for AIDS Relief. Hospice Africa Uganda (HAU), founded by Anne Merriman, began offering services in 1993 in a two-bedroom house loaned for the purpose by Nsambya Hospital. HAU has since expanded to a base of operations at Makindye, Kampala, with hospice services offered at roadside clinics by Mobile Hospice Mbarara since January 1998. That same year the Little Hospice Hoima opened in June. Hospice care in Uganda is supported by community volunteers and professionals, as Makerere University offers a distance diploma in palliative care. The government of Uganda published a strategic plan for palliative care that permits nurses and clinical officers from HAU to prescribe morphine. North America Canada Canadian physician Balfour Mount, who first coined the term "palliative care", was a pioneer in medical research and in the Canadian hospice movement, which focused primarily on palliative care in a hospital setting. Having read Kübler-Ross, Mount studied the experiences of the terminally ill at Royal Victoria Hospital, Montreal; the "abysmal inadequacy", as he termed it, that he found prompted him to spend a week with Cicely Saunders at St. Christopher's. Mount decided to