A community-centred, multi-faceted approach to the consequences of poverty and HIV/AIDS in rural South Africa
HOME-BASED CARE
One of the keys to Topsy’s success has been to identify,
employ and train fieldworkers
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Topsy's Home-based Care model was a major element in the establishment of Best Practice in this field through a study by the state-appointed NICDAM (National Institute for Community Development and Management).
The key to Topsy’s success has been to identify, employ and train fieldworkers from the community in which the programme is active. Using local people as fieldworkers, and engaging them as employees rather than as volunteers, helps the programme to win confidence and support in communities where the provision of relief services for people affected by HIV and AIDS must take account both of differences of culture and belief, and of possible stigmatisation of the people affected by the disease.
Topsy’s unique approach to home-based-care helps to ensure that there is a continuum of care.
Topsy’s fieldworkers are highly trained. They are in daily contact with families affected by HIV and AIDS and related illnesses as well as the consequences of extreme poverty and lack of access to basic infrastructure and care. In the communities Topsy serves, access to health clinics, for example, is restricted to those who can physically visit the clinic and seek medical attention. For people who are in some way incapacitated, the services Topsy provides through home visits may be their only hope.
Topsy’s fieldworkers offer basic medical care for conditions such as TB, and pneumonia and also attend to wound dressings, bed baths, bed turning and the training of the patient’s family in these tasks. They develop strong relationships with the patients and their families, give guidance and support, and provide a listening ear.
Whenever expert medical or social welfare attention is required, the fieldworker will present the case to a Topsy nurse, or to one of its social workers, who will then accompany the fieldworker to visit and provide the treatment or counselling that is needed.
When not calling on specific individuals, fieldworkers go from house to house to offer necessary services. They also document information about each household such as the number of family members, who is employed, how many children live there, levels of wellness amongst family members, and so on. This crucial information helps Topsy prepare to meet future needs in the area.