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burden of home based care in Zimbabwe
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The Southern Africa
Aids Information Dissemination Service (SAFAIDS) recently hosted a public
discussion forum entitled "The burden of home based care in Zimbabwe"
on February 23, 2005 at the Cresta - Jameson Hotel in Harare.
According to SAFAIDS
the main purpose of the fora is to "hold brief yet concise discussions
and, if possible, formulate conclusions or recommendations for further
The presenters at
the forum were Julieth Msengi, Training and Support Manager for Hospice
Zimbabwe, Janet L Muteiwa from Zimbabwe Red Cross Society and Mrs N Tembere
from Dananai Home Based Care.
Physical and emotional
drain, over-use of resources, family dynamics and lack of supervision
amongst care givers, are just some of the problems faced by home based
and palliative care givers.
One of the important
points raised during the discussion is that the majority of caregivers
do not know the condition that their relatives are suffering from.
her presentation Mrs Temberere from Dananai Home Based Care an extension
of Murambinda Hospital, said the project was necessitated by the high
numbers of terminal chronically ill people who are being discharged from
hospitals for home care.
Mrs Temberere said
after they had trained people who were involved in the project they realised
they had left out a certain group which was not involved in care. She
added that there were a number of orphans or children being asked to take
care of their mothers and fathers but with very little or no information
on how to administer the home based care.
This has led to some
of these children being infected with a variety of diseases. Therefore
Dananai created a programme that gives awareness to the youth that will
equip them with the necessary information to administer care without getting
infected in one way or the other.
Dananai has also set
up a project that encourages men to get involved in Home Based Care.
On the issue of cost
Mrs Temberere said the cost of running a rural home based care programme
is minimal especially with regard to implementation costs. Most of the
volunteers stay within the communities and have at times resorted to using
herbs in a bid to alleviate some of the presenting symptoms.
According to Julieth
Msengi from Hospice Zimbabwe women are the most affected by the burden
of home based
care. She said their research findings indicated that people involved
in home based care included a family caregiver or a community member who
is involved in care at home.
Ms Msengi added that
where family caregivers are involved the burden lay with the women. This
was attributed to a number of factors:
Women are not breadwinners
and most of the time they are reliant on their spouses and do not have
a regular source of income. She said when they talk about women they also
refer to elderly women who are in need of care themselves due to various
reasons. These include being a widow, or having lost an adult child which
means having to care for sick children left behind.
Ms Msengi said that
women are expected to offer care even if they themselves are not feeling
well. School going girls have to forego their education to provide care.
She said these children face a number of challenges because of their age.
presenter, Janet L Muteiwa from the Zimbabwe Red Cross told the forum
that her organisation has been involved in a number of projects in the
country. She said her organisation is presently working with at total
number of 16 100 clients, which has seen an increased care facilitator
client ratio of 1:20.
Ms Muteiwa said that
there are quite a number of challenges they are facing. One major point
she raised is that the HIV/AIDS pandemic continues to rise despite the
98% knowledge of HIV/AIDS transmission. Thus people's behaviour is not
One of the interesting
points raised in the discussion is that family members are now quick to
disperse from funerals because they do not want to be given custody of
children who are left by their deceased parents.
Despite the burdens
being faced by caregivers in Zimbabwe, home-based care is still one of
the most cost effective ways to deal with illness against the high hospital
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