Positive lessons from Tshidilong home-based care

GREG KELEBONYE
Staff Writer | Friday June 4, 2010 00:00

 

Not because they do not care about their sick relative, but because of the emotional and physical toll it takes on them. Patients it is said, sometimes die when they could have recovered, because they did not receive proper care.

And there are many reasons why that may happen: the patient may not have adult relatives who are willing to take care of them, or may simply be too far from family; the person may have had conflicts with family in the past, who may now decide not to help him or her in their hour of need; the patient's family may simply be irresponsible.

That is when community home-based care comes in. Ntlhantlhe Village's Tshidilong Home Based Care group is a case in point. The nine-member group made up of mostly elderly women has seen many a dying person recover thanks to their dedication. Every morning the women brave the howling winter wind or the scorching summer day or the dusty July noon- day and walk to their patients homes where they do not only help to cook for the patients, but re-train the patients to walk, feed them and ensure they take their medication amongst many other things.

They even bathe the patients - a very challenging task considering the women are not paid for their services. 'We started this project in 1999 after seeing the amount of suffering and humiliation that patients were subjected to because no one was taking care of them,' says Keamogetse Senna. She is the secretary of the care group.

Senna remembers the case of a 'sojouner' who the group had to provide care to. 'This man came here and was working as a traditional doctor, but he became ill. All efforts by authorities to trace his family were ineffective.

Worse, the man lost his cognitive and speech abilities and started communicating in gibberish,' she says. Even the gibberish he spoke was just one word. 'Mma Seleka was the only one who understood his language,' she says as she glances at Kehumile Seleka in cue for her to say some of the gibberish. Seleka is the coordinator of the Village Health Team, which was really the one behind the formation of the home-based care group.

'The only word that the man could utter was 'khwa!'. For example if he wanted to tell me that his head or legs were aching he would touch the head or the legs and say 'khwa!'. If the pain was too much he would go 'khwa! khwa! Khwa!'.  The man got so sick that he became bedridden.'We had to bathe him, feed him, clean his house and do his laundry,' says Senna. Unfortunately the man died. But he died with dignity as these mothers' care covered his shame.

There have been many others. On the day that we meet the two women, they are preparing to go for prayers at the house of one of the patients.

'He was young but became too ill. Despite the treatment he still died,' says Senna, her face momentarily betraying her grief. It is the type of grief that she has had to endure every time one of her patients dies.'You see, we build a relationship with these people. We talk, joke and laugh together and build close relationships. So when they die we grieve,' she says.

It is the laughing, the care and the knowledge that there are people who care that takes away some of the pains from the patients. For the women, it is something that comes from deep within, something that even they cannot describes that propels them to take care of fully grown adults who are not related to them as they would babies.

Senna looks up, as if seeking some answer from above and then shrugs her shoulders before answering, 'I guess it is our duty to God,' when asked why they would commit their lives to such a difficult task for no pay. She also thinks it might have something to do with the gratification that the women get from seeing someone that they cared for up and well again.

'We had this case whose family kept a secret. The mother claimed that her daughter had been fed some traditional poison and would not allow anyone to visit. On the day we decided to visit, the patient's mother was very cold and unwelcoming, and we had to find a way of dealing with her - if only to save her dying daughter. All the time that we chatted with her cold as she was, the patient remained draped in a blanket from head to toe. As we were about to leave we asked if we could pray with the family. She consented.

As we all said amen, the patient uncovered her head and told us that she was in a lot of pain. We used the opportunity to convince her mother to take her to hospital for the girl to at least receive some pain killers as they waited for the girl's brothers to take her to some place to see a traditional doctor.

Once at the clinic there was no turning back. The girl was referred to Lobatse where she was placed on treatment. Today the girl is back on her feet and as healthy as anybody else,' she says.

The disdain that the young woman's mother treated the women is what they initially received when they started.

'People expected them to work as their house maids. They expected them to clean, do laundry and fetch water, but not deal with the patients. We had to do a lot of education to turn around that mindset and yes, today people are very appreciative of the women's group,' chips in Seleka. In fact over the last few years many families with bedridden patients have invited the women to come and assist as they now appreciate what they are doing.

The patients form part of the larger group that the women take care of.' At the moment we have seven referrals from doctors and seven others that we identified or whose families brought to us,' says Senna. The numbers used to be big though. When the women started the group, HIV treatment was not yet provided for free in government clinics and hospitals. ' At any given time one woman could have up to five patients to take care of, but with the advent of treatment the numbers have shrunk to almost nil. In fact the patients that we find ourselves taking care of are largely older people with conditions not related to HIV.

These could for example be a stroke or some sugar diabetes related illness. We do occasionally get an HIV related case, but these are usually young people,' says Senna. Other than the treatment, she attributes the low levels to greater awareness that the community has been receiving from the media and other forums such as the Kgotla. The women's group has also avidly played its part. 'Whenever we see a patient whom we believe should be advised to visit and test for HIV, we do so,' she says. Despite all the challenges, the women are determined to go on. 'These women only receive P150, which is given not as a wage, but so that they can buy the canvass shoes that soon get worn out as the women travel long distances to attend to their patients,' says Seleka the coordinator.

In an attempt to raise funds, the women tend a garden at the clinic.

'Some of the produce we sell and buy for our patients food and clothes. Some of it we cook for the patients. But that is not enough. In fact lately, our work at the garden has suffered as there is a water problem in the village,'  says Senna.

The women, whose group is registered with the registrar of societies would like to build a house which will not only be used as an office,but will also be used to accommodate ill vagabonds. '

 We would really appreciate help of any kind to do this. Had we something like that, we would not have suffered the way we did during the time we were taking care of the foreigner who unfortunately died,' she says. While they await help, the women tread on, determined to bring dignity to other mortals.