Elderly caregivers — unsung heroes

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A frail-looking Tatenda(21) lies on a tattered mat under the mopani tree. With the sun beating down mercilessly, weak and weary Tatenda devours the porridge served by his 68-year old grandmother, Merina Zulu.

Merina Zulu’s day has to start very early if she wants to make sure her ailing grandson is well taken care of. “I wake up at 4am and walk down to the borehole which is about 600 metres away to fetch water. By the time I arrive there, a long queue would have formed,” she says.

This borehole is the only source of water for more than 300 households living at Caledonia Farm, a makeshift squatter camp on the outskirts of Harare. It sprouted up soon after the government carried out Operation Murambatsvina in 2005.

After preparing porridge, she carries Tatenda from his bed and takes him outside for fresh air. If he has messed himself she has to wash him and change the soiled sheets.

Tears fill her eyes as she explains how she has had to accept her new role in life, which often takes its toll on her.

“The situation becomes unbearable when his condition deteriorates as I have to carry him on my back everywhere he wants to go,” she says.

Since Tatenda needs constant and close monitoring even during the night, Zulu has to share her bedroom with her grandson.

Zulu is Tatenda’s sole caregiver so she constantly worries about the fact that at her age anything can happen to her and there would be no one to take care of him. To Tatenda, Zulu is a saviour.

“My grandmother is God-sent. She has stood by me in hard times, especially when everyone abandoned me,” says Tatenda. He views his grandmother’s care as priceless.

As HIV and Aids claims the lives of the young and middle-aged members of society the toll has been heavy on the elderly.

Zimbabwean society used to thrive on the extended family system which is well understood even though there are no rules written down in any official manual.

The unwritten rule is that parents strive to educate their children who in turn will thrive and look after their parents in their old age. HIV and Aids has changed the structure and modus operandi of society.

Often a child is left orphaned or the parents are working hard to make ends meet so grandparents are being put in the position of caring for their grandchildren.

Zulu’s confidence in Tatenda’s relatives (who live on farms in Marondera) coming to the rescue is paper-thin. “Perhaps if they were better off, they would have come to my rescue,” she says.

“Most of them were also displaced by Operation Murambatsvina and are living on meagre earnings as farm workers.”

Tatenda once worked as a security guard on a farm, but was relieved of his duties because he kept falling ill. Many of his relatives turned their backs on him.

University of Zimbabwe lecturer and social commentator, Tawanda Zinyama, said:

“It is common in our African set-up for urban dwellers to return sick people to rural areas, when they become too sick to care for themselves or to be attended to by other people, thereby shifting care to rural dwellers who are usually elderly people.”

As indicated in a research report by the Commission on HIV and Aids and Governance in Africa titled The Impact of HIV and Aids on Families and Communities in Africa, “Aids deaths are most heavilyconcentrated among women and men 20 to 50 years of age . . .”

The research added that HIV and Aids are resulting in household structures changing. “The changes usually occur leaving more female, child and elderly-headed households. In some cases households dissolve completely, either because of economic destitution or the death of parents and dispersal of children.”

The report goes on to state that in Zimbabwe: “. . . the burden of care on households is significant. Most people caring for children orphaned by HIV and Aids were over 50 years of age. Of those, over 70% were 60 years or older.

This point was reinforced by Unicef in its State Of The World report in 2007, where for the first time the organisation officially acknowledged the role of the elderly members of the community who care for children orphaned by Aids. It also highlighted that in Zimbabwe 60% to 61% of sick children and orphans are under the care of the old.

Sekuru Evias Muchabaiwa, a retired teacher from Warren Park D in Harare, is caring for his eight-year-old grandson following the death of his wife.

“For the elderly like us, looking after HIV patients is like starting life all over again. I have to work in my plot, run errands, provide financial and material support and on a weekly basis take my grandson to the clinic which is a distance away.

“The fact that I have limited knowledge about HIV and Aids compromises my own health and that of my patient,” says Muchabaiwa.

The stressof caregiving is clear. Caregivers report regular concerns about adequate food and clothing, the high cost of medical fees, and inability to pay school fees for orphans. Indeed, the health of the older caregivers had deteriorated as a result of the physical and emotional stress of assisting the children.

Elderly caregivers face an inordinate burden in the era of HIV and Aids and as indicated by the research there is very little community-level mobilisation around HIV and Aids issues.

“Additionally, there islittle evidence that structures for prevention, care or support are emerging. There is need for access to advice, information and support at village level, including remote villages with little access to services.”

Muchabaiwa said the government should consider their plight as a matter of urgency before his generation was wiped out by stress.“Our main challenge is resources.The government should chip in with drugs and monetary incentives,” he says.

“While my son always gets prescriptions at referral hospitals, in most cases I can’t afford the medicines prescribed. When I run out of drugs, I often resort to buying cheap drugs from vendors, mainly painkillers, or to using traditional herbs to manage my son’s deteriorating condition.”

Zinyama concurred with Sekur Muchabaiwa saying if the government is serious about achieving the Millennium Development Goals there is urgent need of a shift in resources allocation.

“Extreme poverty amongst elderly caregivers continues to be a challenge. If the government is serious about combating HIV and Aids, financial resources should be channelled to capacitating them.

Zinyama says caring for the sick, especially the terminally ill, involves foregoing other things.

“Caring for the sick is costly. When one is caring for the terminally ill at times they usually have to take time off from work or to withdraw totally from work to provide care, which depletes incomes.

“There is a need to move the burden from traditional policies of leaving the burden of caring to the extended family structures as extended families are no longer functional. This calls for the government to chip in with financial intervention programmes.”

Meanwhile, HelpAge Zimbabwe, a registered organisation that promotes, supports and sustains the quality of lives of the aged, said they are responding to the HIV and Aids by advocating for the appreciation of older persons’ roles as caregivers.

“It is unfortunate that streamlining has not been cascading to the allocation of financial and moral support in respect to capacitating elderly caregivers. The acknowledgement is given to certain privileges, a lot needs to be done,” added HelpAge, advocacy and communications officer, Conrad Gweru.

He added that since older people were increasingly bearing the burden of home-based care while they were poverty-stricken, there is need to establish a fund through which financial and other resources can be channelled towards them to make their work bearable.

“It is our sincere hope that if the Older Persons Act is passed it will see the formation of a board that will look into issues affecting older persons. Currently, policies need to be harmonised and new laws enacted to protect and meet the needs of senior citizens who are mostly involved in caring for orphans and the sick, without necessary resources to do so.”