Rose has been a Home Base Care (HBC) volunteer since 1998, almost twenty years! She is responsible for 35 patients, whom she visits regularly. She honoured us with an interview, which gave us an insight in how the HBC program works.
Background: The HBC program is a government run program where volunteers like Rose visit patients who are too sick to come to the dispensary or who are suffering from chronic diseases which reduce their mobility.
This government program is severely underfinanced and as a result TATU Project in collaboration with the local health institutions, tries to support the volunteers by providing them with trainings. We are looking into the possibility of providing more financial and technical support to the HBCs.
Why is the HBC program important for the community?
Rose: It is important because it can help people before they go to the hospital, which is very expensive, so it helps if people can first talk with an HBC volunteer. We have the capability to address small diseases or inconveniences and we have some medicines we distribute for free. Most of the time though we have to refer people to the hospital.
The most important aspect of the HBC’s is the psychological aspect. Talking to people, showing interest and giving advice is already of great importance and a great help for our patients.
Besides that the HBC’s play a huge role in educating the community. By this I mean to fight stigmatization. Mainly because there still lies a great taboo on HIV/AIDS in the community. We are fighting that taboo every day.
How are you fighting that stigmatization?
Rose: For example, for a long time, I took care of a girl who was HIV positive. I took her in my house, because she was not welcome anymore in her own community because of the disease. Via antiretroviral drugs and personal care, the disease is now more or less contained. This helped convince her family that there is no witchcraft involved and now this girl is living back with her family. We fight stigmatization by explaining why a person is sick and the science behind it, but it is often difficult.
How do you feel personally with your work as HBC volunteer?
Rose: I think I am speaking for all the HBC volunteers when I say we love the work we do. We all do it in our free time, next to our other occupations. It is hard because of the lack of support, but we still love what we do, because we feel it is very important and this is proven when we go visit our patients.
People know they can count on the HBC’s, so we are available day and night. People call us when they need help.
What are the main challenges for the HBC’s?
Rose: We face a lot of challenges, transportation costs us a lot and sometimes, we visit patients who do not have food, so we have to cook for the patients. Also the walking around in the burning sun, or the fact we have to work in our own clothes and are not provided with a uniform, these are all factors that make work hard as an HBC volunteer.
One of the biggest challenges in the community is the fact that we as HBC volunteers have to fight the beliefs of people in witchcraft. Often, people are reluctant to trust science and we have a hard time convincing the patients of the lack of scientific proof for witchcraft. It is frustrating to see families who do not want to accept advice or treatment for a relative who is sick because they put their faith in the local way of medicines.
Sometimes we as HBC’s are like salespersons. We have to promote modern health care.
Rose continues: Also, the overall poverty makes it a hard job. For example as a handicapped person you can have a wheelchair from the government, but you have to contribute 50,000 shillings (appx. 22 Euro) to have the wheelchair. This is a lot of money for someone in Msitu wa Tembo, so disabled people just do not have a wheelchair. Or the fact that patients expect to receive food from the HBC’s, just because they don’t have another option.
People with mental problems is another big challenge. There are medicines that prove to work, yet the continuity is not assured, so it is better to not start a treatment. This because there were examples in the past of people who went better for three months, but then the medicines ran out because they were too expensive and the patients were again in a very bad mental state.
After this interview, your TATU reporter joined an outreach with Afya Project Manager Samuel and HBC volunteer Herman. We visited ten patients of whom we measured their blood pressure. The sun burned, it was incredibly hot. This modest outreach gave an insight in the incredible work the HBC volunteers do.
They deserve a lot of respect, working in these circumstances, voluntarily, to take care of their community.