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South Africa: Home care provided by Red Cross an essential complement to public health structures
28 November 2007
Jean-Luc Martinage, International Federation
South Africa is at the centre of the HIV pandemic, which affects at least 12.3 million people throughout the Southern African region. Anyone walking the streets of Mabopane, a medium-sized town on the outskirts of the city of Pretoria, the South Africa capital, is struck by the abundance of funeral homes, a flourishing sector on account of the number of AIDS deaths.

In recent years, significant progress has been made in improving the access of people living with HIV to antiretroviral treatment. However, people on treatment also require assistance at home, including visits to ensure that they follow their treatment properly and eat well and to develop the health and hygiene skills of people living with HIV and their families.

In 2004, the South African Red Cross Society launched a home care programme in the Pretoria region. A total of 246 adults and 162 orphans benefit from it in the Mabopane area.

Patricia Sebiji joined the South African Red Cross Society as a volunteer two years ago. Each morning, from Monday to Thursday, Patricia rises at dawn and, after putting on her work clothes, visits the people in her care. Her first stop - a short walk from her little house in the Mabopane suburbs - is the neighbourhood clinic, where she picks up some drugs for one of her clients, who has tuberculosis.

Patricia is well known at the Tlamelony clinic. The work she does is particularly appreciated by Sheila Silinda, the nurse in charge of monitoring patients with tuberculosis. "Red Cross volunteers often do what we can't," explained Nurse Silinda, who believes that it is extremely important to have someone who will check on patients at home and alert her if their health deteriorates.

Patricia regularly makes the 20-minute walk to bring drugs to Eunice, a 24-year-old whose illness makes it difficult to look after her four-year-old son Refentsi.

"I make sure that Eunice takes her medicines properly and give her health advice and psychological support," explained Patricia, as she played with the little boy. "People often find it very hard to deal with things and get depressed, especially when they feel rejected by the people around them and their neighbours because of their health problems," she said, adding that most people are reluctant to speak openly about being HIV positive.

She cannot stay long. After another 15-minute walk, Patricia comes to the house of Amanda, who is now completely bedridden. "I have to do a bit of housework for her. I help her to take her drugs, and the first thing I do when I arrive is to make her some highly nutritional porridge, because it is very important for her to eat well," Patricia said. The Red Cross volunteer then helps Amanda to get washed and dressed. If she notices that Amanda's state of health has deteriorated, Patricia immediately accompanies her to the nearest hospital.

As Patricia approaches the bed in which Amanda is now confined, it is evident that there is close bond between the two of them. "I don't know what I'd do without her," Amanda admits, as Patricia gently takes her hand. In spite of her suffering, Amanda keeps a smile on her face, and it is obvious that Patricia's visits also help to alleviate her sense of isolation.

When she is not visiting clients, Patricia likes to meet with other volunteers involved in the home care programme. They meet regularly at the local South African Red Cross Society branch in Pretoria to sing in the Red Cross choir. "Our singing sends out a message of hope in the midst of so much hardship," explained Tlalane Ndlala, the home care programme coordinator for the Pretoria region.

The South African Red Cross Society intends to further develop its home care programme. "By 2010, we aim to be helping 2,000 beneficiaries in the Pretoria region," said David Stephens, the South African Red Cross Society health coordinator. "We are also going to step up our prevention programmes, particularly in schools, and we want to improve training for new volunteers," he added.

The South African Red Cross Society is one of ten National Red Cross Societies in southern Africa involved in the 384 million Swiss franc (USD 300 million, EUR 241 million) HIV programme launched on 1 November 2006, which includes a massive scaling up of International Federation HIV action over five years, defined as a top priority. It is also part of the International Federation's Global Alliance on HIV. There are plans to launch similar programmes in the near future in the rest of Africa and in other parts of the world.
Patricia Sebiji begins her day with a visit to the clinic, where she picks up Eunice’s drugs from Sheila, the nurse. (p16733)
Patricia Sebiji begins her day with a visit to the clinic, where she picks up Eunice's drugs from Sheila, the nurse. (p16733)
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Eunice prepares to take the drugs brought to her by Patricia, as her four-year-old son Refentsi looks on. (p16734)
Eunice prepares to take the drugs brought to her by Patricia, as her four-year-old son Refentsi looks on. (p16734)
Patricia brings Amanda, who is now bedridden, some porridge and the drugs she needs. (p16735)
Patricia brings Amanda, who is now bedridden, some porridge and the drugs she needs. (p16735)
"We plan to extend our home care programmes and prevention activities," explains David Stephens, the South African Red Cross Society health coordinator. (p16736)
"We plan to extend our home care programmes and prevention activities," explains David Stephens, the South African Red Cross Society health coordinator. (p16736)