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Community and Home-based Care for People Living with HIV/AIDS

Courageous Heros

Our community-based care-givers are often called heros and they are an inspiration. Many AIDS patients live kilometres from even the nearest dirt road and so our care-givers walk up to 20km a day to reach them.

Before the project began many AIDS patients had no access to medical care as those in advanced stages of AIDS often cannot reach even a local clinic.

The Role of a Community-based Care-giver

Living among the communities they serve and getting around by foot and bicycle, our care-givers are well-known and typically are approached for help by neighbours, community health workers or family when someone in their area becomes sick. Around 80% of our patients are HIV+. They then visit the family and give advice on how to care for the sick person, subsequently visiting regularly when required, and providing basic medical attention.

Being trained AIDS counsellors and ARV adherence trainers, their presence has lead to a markedly greater uptake of HIV testing as well as the numbers of people accessing ARVs.

Current pressing needs:

More nurses; it is difficult to recruit into such a deep rural area
Adult nappies in large quantities for patients in the latter stages of AIDS.
Drugs, particularly pain relief.
More bicycles

Ingwavuma Orphan Care has 18 teams of community-based care-givers, covering 1500 square km. They are supported by two full-time nurses, a doctor and a chaplain who visit each team in turn.

It's biggest funders are the Elton John AIDS Foundation, the EU and the Global Fund, but also supplemented by many valuable smaller contributions.

The care-givers see around 1200 patients each month, some of them intensively.

Monthly Statistics:

Month	Patients visited	% HIV+	% ART	% with TB	% bed-ridden	Cost per patient
November 2005	442	82	0	17	13	R 113
December 2005	599	77	0	12	13	R 107
January 2006	774	84	0	13	10	R 88
February 2006	877	81	0	14	9	R 98
March 2006	1035	76	24	11	8	R 95
April 2006	923	83	30	13	6	R 104
May 2006	1129	90	32	13	4	R 90
June 2006	1316	94	34	15	5	R 78

The following graph shows patient numbers from 2002 to 2005: