In 1976 a group comprised of community nurses, health educators, social workers and community leaders formed a community based organisation, Muthande Society for the Aged (MUSA). It focused on issues affecting the elderly in the community; their social, physical, economic and emotional needs.
From its inception the main challenges were to implement programmes that alleviate poverty, reduce social isolation, assist in acquiring skills and help the frail and ill through illness.
Over the years the scope of operations has expanded widely to include programmes such as HIV/AIDS and training for family members and care givers on health and social issues.
Muthande was formally registered in 1982.
It is a registered NGO (non-government organisation) and it is a not for profit organisation. MUSA is governed by a 21 member Board of Management who are mostly women coming from the 6 different townships that the Society (MUSA) services, they all come with diverse backgrounds and skills. It is a policy organ of the organization, which meets once a month with the Senior Management, to look at activities, challenges, progress and to give guidance and support. An Annual General Meeting (AGM) is held where this body gives a detailed report to its members as well as audited financial statements.
Muthande employs 94 staff members the (organogram is available on request) within this structure and operates within the following divisions.
Social Services with 1 x qualified Social Worker, 4 qualified Auxiliary Social Workers, 2 Paralegals and 3 Clerical staff.
8 Service Centres that operate to ensure its members have a nutritious meal each day, are kept active by engaging in activities such as crafts, singing, dancing and daily exercise routines.
The Home Based Care Unit is a large part of the organisation and has a fully qualified Registered Nurse and Nurse’s Aide. All the care workers have certificates for courses in Home Based Care.
These careworkers are usually the first contact with the elderly, new cases are reported on a weekly basis.
Muthande’s mission is to improve the quality of life of senior citizens in their homes and within the community to ensure they live with dignity as independent members of society. This is achieved through programmes that promote positive ageing and some of these programmes are highlighted below.
o STRENGTHENING OLDER PEOPLE’S INVOLVEMENT ON THE HIV/AIDS PANDEMIC
Muthande continues to encounter many older people that have limited understanding of the pandemic and how it is transmitted though they are primary carers of those infected and affected. It has also been established that while HIV/AIDS is going to be an ongoing problem and as the Society keeps coming across new people and new areas.
Ever since Muthande started to realise this vicious cycle; its HIV/AIDS programme has always prioritised on a holistic approach that includes both the infected and affected groups of the Society i.e.
• People living with HIV/AIDS (PLWHA)
• Orphans and Vulnerable children (OVC’s)
• Carers who are mostly family members and older people as primary carers
• Community Caregivers i.e. MUSA Caregivers as well as volunteers
o CHALLENGES & INFORMATION ON ALZHEIMER’S & DEMENTIA DISEASES
Muthande Society has very limited and basic information on Alzheimer’s and Dementia diseases and yet it is the first contact with those suffering and affected with these diseases. The irony of these diseases in communities, is that those affected are mostly surrounded by stigma and associated with witchcraft due to a lack of information on this disease.
This exposes the sufferers to abuse, ridicule and barbaric activities by some members of communities and can result in brutal attacks.
o ABET – ADULT BASED EDUCATION TRAINING, literacy and numerous training.
o FAMILY AND PEER EDUCATION PROGRAMMES – this includes capacity building with the families and friends of the older person, training them on how to better take care of the elderly, taking medication timely etc... The objective of this application is to increase the number of Care givers within the family in order to reduce the individual caseloads and thus improving the quality of the given service
Muthande relies on donors to fund most of its activities. Community Chest is a regular source of funding and the Department of Social Development subsidises about 75% of the Social Workers salaries and a portion of the Service Centres activities.
The challenge is the ever growing HOME BASED CARE REQUIREMENTS that are not subsidised.
This proposal focusses on Muthande’s Home Based Health Care Program, which is guided by its vision and mission.
Muthande provides the abovementioned programs to support those older people (OP) who, due to hardships and realities of life, have either become frail; housebound; bedbound; demented and HIV affected and infected. To achieve this, presently the society employs 36 Home Based Care Givers (HBCG) who provide a basic home nursing service to older people within its areas of operation.
Since the HBCG are field workers that are involved in community services, they are the first contact with the OP, their family or lack of family, their needs and are therefore instrumental not only for the main nursing service at home regarding non-communicable diseases but also in assisting reporting and dealing with cases in the following areas:
• Bed-bathing and prevention of bed sores
• Basic and relevant physical exercise
• Advice on taking chronic medication
• Transporting and linking with pensions offices, transporting to clinics and hospitals
• Sharing of information
• Washing of spoiled linen
• Nail cutting
• Basic counselling
• Provision of loaned equipment such as wheelchairs, commodes and walking sticks
Caregivers (Community Caregivers/Musa HBCG & Volunteers) experience a lot of challenges in the field while they are doing their Home Care activities such as scarcity of resources e.g. latex gloves, plastic aprons, incontinence nappies. This is to protect themselves and also for the comfort of their parents. Most Caregivers provide care under very deprived conditions, both those volunteering and those employed by NGO’s because those NGO’s are struggling themselves. Besides the financial burdens of the family our HBCG are at least trained and able to give emotional comfort and support by sharing of information.
Presently Muthande Society’s case load on Home Care is 1401 cases that covers the following locations:
• Lamontville (Township)
• Tafelkop (Rural)
• Chesterville (Township)
• Clermont (Township)
• Richmond Farm (Semi-rural)
• KwaDabeka (Township)
The targeted beneficiaries’ are1400 older people that need care, the carers are people who have training in Homebase care and are allocated a certain area and caseload. They make their way by foot or by local transport (unreliable). The Caseloads are divided into categories ranging from frail and bedridden to assistance with medication etc.
The beneficiaries being cared for include older people who are affected by common health problems which include poor physical condition, failing mental health, arthritis, diabetes, tuberculosis and malnutrition caused by poverty and cardiovascular disorders e.g. heart attack, hypertension and strokes.
They need regular health checks and medical attention. Access to health services is often limited by lack of transport and the means to pay at private institutions. Muthande tries to bridge this gap by providing assistance where possible through home visits by Care Givers where they will engage in all aspects of personal hygiene, physiotherapy, exercises, and help with household chores including preparation of food. They also help with transport to and from clinics and/or hospitals and collect medication for them.