Home care alternative provides hope in rural South Africa

KWAZULU-NATAL, SOUTH AFRICA – As the human immunodeficiency virus (HIV) epidemic continues to deplete much of South Africa’s struggling healthcare system, a new trend of home care-giving has become popularized in the rural areas of the country that blends community development and increased education together with medical assistance.

World Health Organization (WHO) research has concluded that between 70 and 90 per cent of illness care takes place within the home, making home care-giving an important component of the healthcare process.

“Health centres, home-based care, and community organizations can also play a supportive role in TB/HIV case-finding, referral, and treatment support,” read one 2004 WHO report on HIV/AIDS care and treatment.

Numerous courses are offered for caregivers around the world, providing individuals with knowledge that they pass on to others in their communities. Courses provide potential
caregivers with basic first-aid training and instruction on counselling.

“When they are educated then they can also foster political change so that the government will take care of its own people,” said Brier Pennanen, a Laurier fifth-year student who spent a summer working abroad on a home-based care project in South Africa a year ago.

Caregivers operate in networks of travelers who visit the homes of the sick, sometimes operating with funding and support from international or local organizations.

The nature of illnesses such as HIV/AIDS and tuberculosis (TB), which both have extremely high incidence rates in South Africa, mean patients can be incapacitated for weeks or months at a time.

Being cared for at a hospital would not only put an extreme strain on government health providers but it would also be unnecessary for patients.

Home-based care eases the strain common illnesses have put on clinics and hospitals and provides healthcare for those who do not have the resources to reach hospitals.

Along with easing the strain on South African clinics and hospitals, caregivers provide emotional and psychological support for patients and their families.

“I think it’s so critical that it’s local,” said Pennanen. “Caregivers actively make a change in their community and any community anywhere in the world.”

With training and education, caregivers are often viewed as highly important members of their communities.

Increasing the power of women in rural areas and the proliferation of knowledge are just two side-effects from the increase of home-based care networks.

“They’ve got a good perspective on life,” said Jo Craven of the caregivers she worked with on an initiative in KwaZulu-Natal last May.

“They just face everything head on and go with it and don’t let it affect them too badly.”
Home-based care has a great rallying effect for communities that are already very family-oriented, like that of the Zulu culture of KwaZulu-Natal.

Bongekile Mpho Ncube, a caregiver currently enrolled in a caregiver education course, operates as a caregiver in the province’s villages of Ezwenelisha and Dougoudougou. She is consistently stopped by individuals on the side of the road who recognize her jeep in their communities and ask for her services.

“It’s very hard to see people who can’t make it, but at least you know that you tried to help,” said Ncube.

Despite the stressful nature of her job as a caregiver, Ncube is optimistic about the increasing popularity of home-based care in her villages and the surrounding communities and what it will mean for the empowerment and education of women as well as the livelihood of those affected by HIV.

“I do make a lot of changes in people’s lives,” she concluded.

South Africa HIV/AIDS stats

• There are approximately 5.7 million
  HIV-positive South Africans

  About 1.4 million of the country’s
  children (those under 17 years of
  age) have lost one or both parents to
  AIDS

  Approximately 350,000 South Africans
  lose their lives to AIDS annually

  18.1 per cent of South Africans aged 15 to 49 are HIV-positive

  The country boasts the largest AIDS
  treatment program in the world

  The South African government is
  expected to commit approximately US$1
  billion in 2011-12 to it’s national
  AIDS response.

All statistics are from 2008 and are courtesy of the Joint United Nations Programme on HIV/AIDS