The Real Work of Home Based Care Givers, Uganda

Originally posted Nov 7, 2010 8:35 PM by Project Africa   [ updated Nov 7, 2010 8:55 PM ]

By Raina Clark (GPIA)

During my previous two visits with the volunteer home based care givers I went along visiting terminally ill and elderly patients, sometimes bringing foodstuff, praying with them-both in Lusoga and Arabic-noting down their conditions and any immediate needs in term of first aid essentials. Those visits were powerful on their own but after deeper conversation with SWID and the volunteers I learned that in fact, this was not the full scope of what they do for their neighbors. When these 23 volunteers move through the parishes of Walukuba Masese they do so with a passion for service to others. One must to undertake this work, an act uncompensated, greatly appreciated by recipients of their care but above all mentally and physically draining. The idea of governments or international donors paying volunteers a small stipend to clean, bathe and burn soiled clothes is, surprisingly, a new concept in the development realm and one too few governments are willing to address in national health budgets. But in countries with extremely high levels of HIV/AIDS this service, largely led by grassroots women, continues unnoticed because it is part of the larger care economy that is not accounted for in country GDP.

Home based care givers of SWID visit nearly 100 patients twice per month. Perhaps this does not seem as

impressive as twice per week, so to put those two days each month into perspective one must expound upon the very specific nature of this work. First, the travel between patients is time consuming. The majority of women in the group I accompanied are both widows and living positively. They have mobilized simply because the need to assist the most vulnerable has not been met by anyone else-a sad comment on the aid industry. They’ve been given a shoulder bag in which to carry a few first aid supplies-namely latex gloves, washing soap, alcohol, and brushes to scrub clothing. When they arrive at a person house there is a strong chance that the women will encounter resistance. The person eventually relents and the caregivers discover that the initial hesitation to accept help did not arise from stubbornness, fear of stigma from being positive, or entrenched patriarchal attitudes, rather it is because the individual has defecated on his clothes and thrown them in the corner because he’s too weak to clean them or move himself the 200 feet to his doorway to toss them outside. So the gloves are vital because the first task is to wash all of the clothes and linens in the home. This process requires several trips to a for-pay water source to fill gerry cans with money that just may be contributed by the caregivers who already squeeze out a living through the informal economy and are themselves considered “the poorest of the poor”.

A group of caregivers can easily spend 2 hours washing, scrubbing the pit latrine, sweeping and mopping the house, bathing the patient, cutting finger and toenails, cleaning sores, and finally burning the soiled clothes. A day in the field with any caregiver leaves one humbled, inspired, and most certainly infuriated that governments and international donors around the world should so willingly bypass compensating these humanitarians in favor large scale infrastructure projects that will run past deadline and over budget. Rather than looking inwards and supporting the good work that is being done on the ground, by the people because it is for their people the international community, from analysts and researchers to policy makers and practitioners are failing those lives it purports to be “developing”. Who then is development for if the capacities of the “identified beneficiaries” are not authentically considered?

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