Our experience has shown that the place to provide the best form of care for the chronically ill and the terminally ill is at home. In a country like Malawi, where there is a serious shortage of trained doctors and nurses, this is all the more true. Where there is a strong tradition of family values, it is not difficult to find carers and volunteers who can be trained to provide the services needed.
The MMMs at Chipini have funded bicycles for home-based care volunteers, providing two bicycles for each cluster of villages. At present the bicycles are used to get the volunteers from village to village on their rounds of mercy.
As they visit the homes, the volunteers assist the family members in their care of the person who is ill. When they see that a visit from the doctor is needed, they inform Sister Cecily, who arranges to come.
Sister Cecily Bourdillon is an MMM doctor, responsible for a network of home-based care services in seventy-six villages. These villages have an estimated population of 22,544 people living in 5,633 households. The villages are scattered throughout the Shire River Valley within an area of about 200 sq. km.
Sister Cecily told us, “Villages are clustered into centres, each centre having a trained home-based care volunteer. Initially, the volunteer attends the health centre at Chipini for a basic introduction. This covers essential information on how to help families care for children or adults with a disability and care of the chronically ill, those with cancer and the elderly. We also provide essential information on HIV/AIDS and how to pass on this information in the villages where they serve. This initial training is followed at intervals with various upgrading courses.”
In addition to the trained volunteers who provide the home-based care, another essential member of the health-care team is the Health Surveillance Assistant, seconded by the government. People gather in the shade of a large tree to learn about topics such as malaria prevention and treatment, HIV/AIDS, re-hydration and nutrition. After the talk, children are weighed, screened and vaccinated.
Sister Cecily said that home-based care provides great satisfaction for both patients and carers alike. “It brought great satisfaction and joy to everyone involved when Elina learned to walk again after a stroke. The care provided by her family members, supported by the home-based care volunteer in her village and the staff at the Chipini Health Centre, all meant this young mother could resume a normal life.”
MMM handed over Chipini Health Centre in 2014.