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The burden of home based care in Zimbabwe
February 24, 2005

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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 action".

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.

Mrs Temberere from DananaiIn 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 basedJulieth Msengi from Hospice Zimbabwe 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.

Janet L Muteiwa from the Zimbabwe Red CrossAnother 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 changing.

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 costs.

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