Despite the fact that state hospitals cannot afford to care for those dying of AIDS, government’€™s failure to work with non-governmental organisations is undermining volunteer home-care projects in KwaZulu-Natal.

Over the past six months, Sinosizo, a home-based care organisation started by the Catholic Church, has closed its operations in the entire Western Region ‘€“ including Hammarsdale, Shongweni, Inchanga and the inner west.

This follows a decision by local authorities in these areas ‘€“ without consulting local NGOs — to set up their own programmes and to pay a few people to do the services that Sinosizo’€™s volunteers have been providing for the past five years without being paid a cent.

“Our volunteers were very demoralised when they found out that other people were now being paid to do what they have been doing,” said Sinosizo manager Liz Towell.

The saddest thing, according to Towell, is that the local authorities’€™ approach is “unsustainable”. As more and more HIV positive people develop full-blown AIDS, government will not be able to afford to pay all the carers needed.

In case of the inner west, for example, the 35 home-based carers are being paid R750 a month out of funds raised from outside the council’€™s budget. They are on two-year contracts and it is unclear whether the money will be found to renew these.

The South Coast Hospice, which has researched the costs of home-based care nationally, estimates that a combined hospital, clinic and home care model would cost government R146 million in 2001. In contrast, a volunteer-based programme would cost R37 million.

Sinosizo is presently caring for over 600 patients in 14 areas in the greater Durban area, and Towell says proudly that the standard of care is so high that not one of their patients has ever had bed sores.

Communication between HIV/AIDS NGOs and the provincial HIV/AIDS coordinator, Wanda Mthembu, also seem to be non-existent.

Mthembu has, according to a number of provincial NGOs, shown little interest in the work they are doing despite the fact that some get a small amount of money from her department.

In addition, standards of care vary greatly within the province yet Mthembu’€™s department is making no attempt to set basic guidelines. One glaring difference lies in training, with government taking five days to train carers while NGOs take up to six months.

Despite numerous attempts over a period of three weeks to get comment from Mthembu on what her department is doing about home-based care and whether she is working with NGOs, she failed to respond.

Although hospitals countrywide are sending people living with AIDS home to die, the national department of health has also given little direction to provincial and local government on how they should approach home-based care.

The Department of Health was tasked by a MINMEC meeting earlier this year with developing models for home-based care.

However, at a follow-up meeting last month Health MECs were simply presented with a choice of five different home-based models.

According to Health Director General Ayanda Ntsaluba, “provinces have to decide which models suit them best in order to provide quality home or community-based care to HIV/AIDS infected and affected persons”. ‘€“ Health-e News Service.