Madagascar: Care work that counts

My name is RANDRIARIMANANA Fanjaniaina Emélie and I am a 36-years-old journalist and care giver. I am a member of the Federation pour la Promotion Feminine et Enfantine (FPFE) in the Eastern Coast region of Madagascar (Atsinanana TOAMASINA).

I didn’t originally have any intention of becoming a care giver. But being a journalist, people have a tendency to turn to me for advice or to talk about their problems. This is how I have embraced, so to speak, this work: I have become an advisor, or even mediator in many cases.

For that reason I am interested in, and committed to, care giver’s work. Up till now I have been “freelance” but I am working in collaboration with the HIV and AIDS institutions and networks in Madagascar.

After being trained on psychological care for people living with HIV and AIDS in Madagascar, I become a volunteer care giver in 2005.

As a psycho-social care giver, my work begins by giving advice to people in response to their HIV-related questions. I sensitise them on the benefit of knowing their HIV status and give them the testing locations so they can go for voluntary testing. Most of the time, these people are convinced and are ready to get tested. I encourage them to receive their test results, either positive or negative, with calm and awareness.

If the test is negative, my duty is to sensitise them on how to keep their status that way. This includes coaching them to have less risky sexual behaviour, use of condom and get re-tested after three months.

When a test result is positive, my assignment is to provide appropriate support based on their needs. Mostly I have to comfort and ensure my client that they should not be desperate. I let them know that science is making progress and that access to medicines and follow-up are free and accessible across Madagascar.

At that point it is also my duty to give further explanation if needed. I accompany them to the specialist doctor for care. If Anti-retroviral Treatments are not yet prescribed, I help them identify individual and collective issues related to their HIV status and determine relevant and appropriate actions to be taken to ensure quality of living and healthy behaviour.

As a care giver, my work also involves conducting face-to-face discussions with my clients about their lives and how they should prepare for their future. I help them find jobs, tell their family about their status and other important life steps.

One of the major issues related to this job is searching for those who have tested positive. To illustrate this: an 18-year-old pregnant woman tested positive during an Antenatal care visit then she disappeared after discovering her result. After being contacted by the counsellor and asked to search for her, I carried out an investigation with the family and neighbour circle, without revealing her status. Up to now I am still looking for her.

I am married and I have two children. Sometimes my volunteer care giver work takes up much more of my time than planned. But my family tries to understand because I have explained that I want to secure a healthy future for my country and for my family.

From time to time my husband actually gives me a hand in difficult circumstances, such as investigations like the one I mentioned.

My biggest challenge is financial resources. I work with my own resources, paying for all phone cards and trip fares.

But as an HIV activist, the officers and health authorities or other institutions recognise my work and give me the opportunity to deepen and increase my knowledge and skills and my experience. This includes participating in addiction treatment training, national planning and results dissemination and acting as active member of communication and coordination networks at the regional level. This makes it all worthwhile.

This “I” Story is part of the Gender Links Opinion and Commentary Service special series on care work.