Time to recognise care work

Chimoio, Mozambique; For the past five years, 67-year-old Joana Mathlombe has had a crash course in care work, a profession she embraces reluctantly.

Working from her home in the Nhamaonha neighbourhood, a squalid suburb of Chimoio, Mozambique’s fourth largest city, she says although she is never paid enough, she continues to do the job.

“Someone has to help those who cannot in their time of need,” says Mathlombe, who originally became a care worker when her younger sister fell ill with tuberculosis in 2006 and needed someone to help her take medication.

In the sprawling city Mathlombe calls home, diseases such as tuberculosis and other HIV and AIDS related infections have taken a toll. The government and privately-owned institutions have not been able to cope with the high numbers of sick people.

“Most people now prefer to care for their sick relatives at home and regularly get medication from health posts,” she says. “This is a burden to some families who at times have to take care of two or more sick relatives at the same time, and care givers are often children or the elderly.”

It was because of this that Mathlombe was approached by relatives of several sick people who needed help taking care of loved ones. She has since lost count of how many sick people she’s cared for.

Although not formally trained as a care worker, she now gets some recognition from health authorities who even at times refer patients to her.

However, her main concern is that she never has enough supplies to care for patients and at times she is even forced to work without gloves when bathing them. This puts her at risk of infection from some of the diseases her patients suffer from.

The increase in care work on behalf of women like Mathlombe is on the rise, not only across southern Africa (where high HIV infection rates have weighed down health services), but throughout the world.

Care givers, who are mainly women and girls, tirelessly carry on with this often unpaid work, which is not even recognised as formal work by statutes in many Southern African countries.

According to a Gender and Media Southern Africa (GEMSA) 2010 policy development handbook, recent research indicated that around three quarters of care providers in the Southern African Development Community (SADC) are women.

In a foreword to the handbook, Magdalene Mathiba-Madibela, Head of the SADC Gender Unit, wrote: “Despite the fact that women and girls are at the forefront of care provision for people living with HIV and AIDS, there is very little of their massive contribution that is recognised at policy-making level.”

The handbook further notes that the current state of care work in many parts of southern Africa is “unsustainable and promotes poverty and inequality.”

In Mozambique, an operational manual indicates that care workers should receive an amount equivalent to 60% of minimum national monthly wage, but care workers like Mathlombe have never received such amounts.

“At times I get food parcels from nongovernmental organisations that now recognise my work but this is not paid every month and I cannot demand it,” she said.

Mozambican care workers interviewed said they had not seen their country’s care work manual, nor were they aware of its existence. One of the biggest problems around care work policy is implementation and sensitisation. Many of those affected have no idea there are laws in place to protect them.

Namibia is the only country in the SADC region that has a policy on care work remuneration. It stipulates a monthly payment of between US$31-62 for care workers as well as the provision of transport and supplies.

Yet this is obviously not yet enough. As the HIV and AIDS pandemic and other infectious diseases continue to take a huge toll on the region, governments need to work swiftly to set up policy frameworks that will not only save our nations, but alleviate work on the overburdened national health systems. Until then, care workers such as Mathlombe will continue to plug holes in national health systems, work for free, and worse, remain at risk of also falling ill.

Fred Katerere is a Mozambican journalist. This article is part of a special series on the 16 Days of Activism for the Gender Links Opinion and Commentary Service that offers fresh views on everyday news. For more information on the 16 Days Campaign go to www.genderlinks.org.za