They Have That Heart and Caring for the Care Providers
on Alex MacMillan (Namibia), 04/Jul/2012 14:00, 34 days ago
Since we completed the two rounds of research trips interviewing men involved in home-based care, we've been writing the subsequent report. It hasn't been an easy process - we've ended up with over 200 pages of notes, 20 lists, over 400 pictures (mostly blurry/badly taken) and an overwhelming sense of responsibility: towards VSO, towards our bosses, and most importantly towards the care providers, whose story we were telling.We then had to figure out how to write a report about male involvement in home-based care in Namibia. Grouping the large amounts of information under thematic headings, and whittling quotes down to the most useful and/or representative of what the care providers were saying, we eventually managed to work out a structure and necessary chapters for the report. Choosing a title for the report was the fun part - over a few glasses of wine, we came up with a choice between 'Care Bears: Male Involvement in Community and Home-Based Care' or 'They Have That Heart: Male Involvement in  Community and Home-Based Care'. The second choice won out, obviously, as it was a phrase we'd heard repeated time and again throughout our travels in Namibia. Writing the substance of the report came next, and took a long time - writing, writing, re-writing, ironing out, re-drafting, proofing, editing, re-editing, tearing up, crossing out and adding in. I suddenly had a much greater appreciation for writers, academics and publishers during those long evenings fuelled by little more than wine, caffeine and a sense of purpose.During the research trips, our colleague Tricia from the Philippines was also investigating the extent of implementation (or not) of the government's policy on community and home-based care. She then wrote the report 'Caring for the Care Providers', detailing the fact that implementation and levels of support vary widely between Namibia's many regions. Most of the funding that fuels care providers in Namibia currently comes from foreign donors - who are now pulling out of Namibia following its re-classification as a middle-income country. Care providers - who provide frontline health services in Namibia - are going without any support at all, and are not paid. Imagine if, in the UK, our community health visitors and district nurses were volunteers, unpaid, with little or no support. This is Namibia's situation - and the government is resting on its laurels, reporting on the volunteer's hard work on ARV roll-out to donors, whilst volunteers prop up its health system for free.The health system in Namibia makes me feel very lucky to live in a country where health care is free. Here in Namibia, when you call an ambulance they ask about money first, problem second. Alex had to call an ambulance a few months ago when a pregnant colleague collapsed at work, they asked him how much money he had on him before they would agree to come and get her (and then they didn't turn up 'cos they couldn't find the place). Alex and I are lucky - VSO covers all our health care needs. But even then, we see how difficult it is, living in a system where health care is privatised. VSO argued for months about whether they would pay for my wisdom teeth to be extracted here in Namibia as the insurance company didn't consider it an 'emergency' and so wouldn't pay for the procedure. I was left in considerable pain while they debated the issue. I didn't have the money to pay for a flight home to my dentist, and VSO wouldn't fly me back as it was cheaper to have me treated in Namibia - so eventually, they caved and put me out of my misery, paying the equivalent of£400 for the ten minute (pain-free) procedure. When Alex fell ill two weeks after we first arrived, VSO organised and paid for everything - here, even just an MRI can cost the equivalent of£1,300. Imagine if you are a caregiver, earning the equivalent of £5 a month, how can you afford insurance for yourself and your family, let alone the procedures themselves? Even the state hospitals still cost money - there was a case a few months ago where doctors turned away a woman and child because they couldn't afford the N$10 entry fee (about 90 pence). The child died in the mother's arms as a result. To the idiots in the UK who think it's a good idea to privatise our health care system, think for a minute. We are so lucky to have a system that looks at you, and not your wallet. Yes, the NHS has its problems (much to learn from the French system), but it still provides an excellent standard of health care, and I will take the NHS' problems any day over the issues and inequality that private health care entails. It is in the context of unaffordable and low-level health care that Namibia's care providers work, and therefore one of the reasons why the service of the care providers is so vital. And VSO is passionate about advocating for their rights. Writing these reports is part of VSO's advocacy strategy, as VSO can then use the results to lobby decision makers to make greater provision for care providers.Once written, getting the reports designed was pretty difficult - VSO London has very strict brand guidelines: a 15% slant line on the front, certain fonts and colours, copyright issues, etc. Each of our organisations also wanted their input on the reports, asking for certain things to be changed (frequently contradicting each other), and our Namibian designer nearly went mad with the constant comments on the drafts streaming from the London office and the various organisations. She came up trumps, however, and we proudly went to print just in time for the VSO Caregivers Conference, with the ISBN registered and printed on the back of both reports. Since then, we've used the reports in various advocacy events and they've been very well received - even quoted by parliamentarians. As for us, we're now drinking a fair amount of South African wine to wind down again. I'm thrilled to have had the chance to write this report, to conduct research and to be published. VSO has given me a chance where many organisations would require you to have 10 years' experience and a PhD. It's going proudly on my CV and is, for me, a highlight of my time in Namibia, having given me the opportunity to travel twice around the country and to talk to hundreds of people who accomplish amazing things every day in their communities. If only I had half their energy, I might have been able to write the report in half the time!