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Home-based care

by Howard Kasiya

Photo: Layton Thompson
Photo: Layton Thompson
The AIDS pandemic has brought many problems to communities in Malawi. As people fall sick and are unable to work, poverty and hunger increase. In most communities, essential health services are not easily accessible by the chronically ill patients due to distance they need to travel. Elderly people are overburdened by taking care of sick relatives. There is often a feeling of hopelessness. The Evangelical Association of Malawi (EAM) is responding to HIV through programmes focused on prevention of HIV infection, care and support for those living with or affected by HIV, and developing the capacity of churches to respond effectively.

EAM defines home-based care as the provision of physical, psychosocial, emotional and spiritual care and support to people with chronic illnesses, including those living with HIV, in their own homes and communities. EAM provides this care through a network of church volunteers and through training family caregivers. The volunteers visit those who are sick and the care they provide includes prayer, providing medicines and nutritional supplements, counselling and doing domestic chores.

EAM works through church congregations. Church leaders help select two men and two women from their congregation who are trained for four weeks to become trainers and supervisors of the home-based care programme. These trainers then train a further 20 men and 20 women identified through the congregations as home-based care providers. Each volunteer looks after no more than three families. As they make their home visits, they train the family members of those they provide care for, to ensure the required care and support for the sick person will continue. The focus is on building relationships with the whole family, not just the patient. This means that if one or both parents die, the church continues to support the other parent or the children who have been orphaned.

Howard Kasiya is HIV/AIDS Manager for EAM.
Evangelical Association of Malawi
PO Box 30296
Lilongwe 3
Malawi

Email:
hkasiya@malawi.net

 
Providing care 

HIV is not spread through everyday contact such as shaking hands, touching, hugging, or living, playing, or eating together with someone who is living with HIV. Many people who are living with HIV remain well and healthy. But particularly where there is no access to antiretroviral drugs or good nutrition, they may often be sick with fever, diarrhoea, or pain and will need special care. HIV can be passed on through contact with blood and bodily fluids, so cover any open cuts or sores on the patient and caregiver. When cleaning up blood, diarrhoea or vomit, wear rubber, latex or plastic gloves if possible, or clean plastic bags on your hands. Wash your hands often.

 

Whether someone is sick with an HIV-related illness, or another sickness, the quality of care a sick person receives is often the most important part of treatment.

 

Comfort A person who is sick should rest in a quiet, comfortable place with plenty of fresh air and natural light. Keep them from getting too hot or too cold. Take time to talk to and encourage them. A child who is sick for a long time should be frequently cuddled and comforted.

 

Liquids During nearly every sickness, especially where there is fever or diarrhoea, the sick person should drink plenty of liquids such as safe water, tea, juices or broths. Give small amounts often. An adult should drink two or more litres of liquid each day.

 

Good food A sick person needs to eat nourishing foods like milk, cheese, chicken, eggs, meat, fish, beans and green vegetables. Energy foods like porridges of maize, yam, plantain or cassava are also important. Adding a little sugar and vegetable oil will increase the energy these provide. If the person is too sick to eat solid foods, give them soups, milk or juices. If they can eat only a little at a time, provide several small meals each day.

 

Cleanliness It is important that a sick person is bathed every day. If they are too weak to get out of bed, wash them with a sponge or cloth and tepid water. Clothes, sheets and covers must also be kept clean, and changed each time they become dirty. Handle soiled or bloody clothes, bedding, or towels with care. Wash them separately in hot soapy water, or add some chlorine bleach. Hang them over a rope or line or put them on a bush to dry in the sun, rather than on the ground.

 

Bed care A person who is very weak and cannot turn over alone should be helped to change position in bed several times a day. This helps to prevent bed sores and can also help prevent pneumonia.

 

Adapted from Where There Is No Doctor (2007 Revised Edition), by David Werner, Hesperian


This page was last updated on 16 May 2008