Making connections : towards a holistic approach to the training of women volunteers in community home based care.

Abstract

In the midst of hope and suffering due to the challenges posed by HIV and AIDS in South Africa, communities have literally witnessed a glimmer of hope in women volunteers who have readily and willingly provided care and support to people living with HIV and AIDS (PLWHA) and their families. Policy-makers have maintained that if the care of sick people is to be both comprehensive and cost-effective, it must be conducted as much as possible in the community, with hospitalization only when it is necessary. However, the strains on those caring for people with HIV and AIDS are enormous. This paper argues that neo-liberal policies are reinforcing the divide between the 'haves' and the 'have-nots', by placing strain on women volunteers in the field of community home-based care. The study was conducted in the area of Mpophomeni Township, in KwaZulu-Natal province. The research participants consisted of 10 community home-based care (CHBC) volunteers and their supervisor, 3 CHBC trainers, and 1 counselling trainer. Using a qualitative design, this study examines a specific CHBC training course and how effectively it prepares voluntary caregivers for the challenges experienced in individual homes. Ascertaining how the training helped caregivers to confront their own fears and problems before dealing with those of others, and exploring how community caregivers coped with the stress inherent in their jobs was the primary focus of this study. For these purposes, a qualitative methodology was deemed most appropriate for it allowed me to gain in-depth information through observations, semistructured interviews, a review of relevant documents, and training materials. Inspired by feminist perspectives, the findings revealed that already overburdened and poor people provide the bulk of voluntary services in the area of CHBC. Consequently, they are unable to provide quality care for people living with HIV and AIDS without external support from the government. The findings further established a mismatch between the training content and the reality of work of caregivers. The training puts more emphasis on practical aspects, by providing basic nursing care, often only relevant in helping a bedridden patient. However, many voluntary caregivers reported that the demands placed on them do not end with the death of the patient. This poses a challenge for those in the CHBC training environment as they need to offer relevant and well-researched information linked to the reality of voluntary caregivers' work. The study also highlighted a need to consider the personal long-term goals of volunteer caregivers and begin to realize the importance of using the training to put them on a career path. I therefore argue that the burden of care for people living with HIV and dying from AIDS in resource-poor settings cannot be shifted entirely to communities with the false assumption that they are able to cope. As we continue to grapple with moral and ethical issues in the context of HIV and AIDS, we also need to be concerned about moving women volunteers' efforts from invisibility to visibility through a social transformation agenda.