Long-term care in South Africa is a complex remnant of the Apartheid era. The Long-term care “industry” has accommodation for approximately 2% of the over 65 population in the country, of which 98% are white (European) South Africans. Historically funded by the Apartheid government, these homes are now in dire straits trying to redress racial quotas and cater for the diverse population of the country.
As a result of migration (African men working in mines), the African extended familial piety no longer exists, with many older African Elders being destitute in rural areas of South Africa where primary healthcare is non existent. The impact of HIV/AIDS can be seen everywhere in our country, where Elders are now the primary Caregivers of and breadwinners (on their meagre ‘Old Age Pension’) for their grandchildren. Many Elders who should be in Long-term care, are kept hostage for their pension money that often feeds an entire extended family.
South Africa has eleven official languages, of which a very small percentage speak Afrikaans (a modern version of Dutch) and English. The rest of the languages are indigenous African languages, for example Sotho, Tswana, Venda, Xhosa, Zulu, Phedi etc. These languages are often spoken only rural, tribal areas, where certain “Western” concept do not exist. In most of these languages, there are no words for concepts like dementia, loneliness, helplessness and boredom, as often these issues do not feature in these cultures.
Implementing the ideas and philosophy of The Eden Alternative present many issues within the diverse cultural context of SA. We are fortunate to not have the strict legislation that often paralyses the care industry, but for the same token we battle to have minimum standards of care adhered to when there is a total absence of legislation. Caring is an instinctive attribute within the African culture, but it is more often than not killed by the institutional hospital culture.
Having said that, it takes very little effort to tap into the intuitive nature of the African spirit of Ubunu, which is a natural part of the African psyche. According to the principles of Ubuntu, we are all there for one another, caring for each regardless, and sharing that across boundaries of age. Despite the challenges and complexities of our dark continent, I believe that African people are inherently good carers, and if we could challenge the system, we will tap into this natural resource with huge benefits to everyone in our society.