South Africa: Empower the Home-Based Care Workers

With an adult HIV prevalence rate of 21.5 percent, South Africa is struggling to provide AIDS-related services to patients. Those on the front lines of disease-fighting efforts there say the government should embrace and support one often overlooked option -- home-based care.

"Home-based care is probably the only workable solution in the South African context, but it should not be regarded as a cheap solution. The state does not provide nurses who provide home-based care, so they should really empower the home-based care workers," said Chloe Hardy of AIDS Law Project, an organization based at the University of Witwatersrand in Johannesburg. The lack of funding for workers, however is a big obstacle to home-based care, she said.

Nombuso Mdluli is one of 40 volunteer caregivers at Soweto Hospital. Like many other caregivers across the country, she receives a monthly stipend of about $40 for her efforts. Currently, Mdluli is in charge of 13 patients.

"My visits usually start with 'category three' patients, those who are bedridden," Mdluli explained. "I do bed bathing, dressing of calluses and sores, and provide counseling. Most of the people I visit are extremely poor, and in most cases cannot even manage taxi fare to a hospital. When a patient is in need of medical care or needs medicine to be prescribed, then I contact one of the nurses at the hospice who will do a house visit."

In the four years that Mdluli has been a volunteer caregiver, she has seen a softening of attitudes toward people and families affected by the pandemic. "People understand the disease a lot better and we also teach the families how to take care of the patients," she noted.

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