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At the Coalface of Tragedy

Poverty, a simple lack of money is one thing. Chronic illness and disability, both intellectual and physical, is another. Where poverty and chronic illness intercept, as they often do in Alex, you have real, live, terrifying human tragedy. Every Wednesday, the Home-Based Care volunteers are in Alex seeing to the spiritual, emotional and physical needs of people.

A day spent with the volunteers of Rays of Hope’s Home-Based Care project in Alexandra will leave an impression that long remains in the memory of any visitor. The images are of desperate poverty and seemingly hopeless situations, yet overlaid with compassion, love, and real practical help given by the volunteers. A stone’s throw from the Sandton CBD, with its skyscrapers, five star hotels and penthouse suites lies Alex, a sprawling township where crudely-built houses crowd upon one another down tortuous alleyways; highly-treasured outside toilets, locked to prevent their use by passers-by, serve entire communities; electrical wiring in the home is haphazard and dangerous; and roofing is likely to cave in during the next thunderstorm. Poverty, a simple lack of money, is one thing. Chronic illness and disability – both intellectual and physical – is another. Where poverty and chronic illness intercept, as they often do in Alex, you have real, live, terrifying human tragedy. And that is where Home-Based Care operates, at the coalface of tragedy. Four volunteers go to Alex once a week, loaded with basic foodstuffs, essential over-the-counter medications and simple household necessities like nappies, rubbing gel for muscles, and sanitary items for young girls. It is a mobile source of love, hope, comfort, prayer and palliative care for people with no-one else to help them. Kgosi is a young single mother, in her twenties. She is smart, well-groomed and desperate for a job. She has a daughter, Nicole, who is eight. Nicole suffered a stroke several years ago, is profoundly intellectually disabled and cannot walk, is incontinent and has intermittent seizures, and has to be restrained because she chews her right arm. Kgosi cannot leave Nicole and find a job as there are no social services that she knows of in Alex to look after Nicole. As a result she has to physically carry Nicole to a taxi to travel across Alex and collect anti-epileptic medications from the clinic. In a tumbledown shack where the roof leaks when it rains, wedged amongst a host of other houses down a narrow alley lives Elizabeth, who is eighteen. She, like Nicole, is profoundly intellectually and physically disabled, abandoned at birth, now living with her grandmother who is over eighty, and another elderly man who lies incapacitated on a cardboard mat on the floor. Elizabeth clings onto the home based care worker, laughing and crying with joy. She needs contraceptive intervention as she is at risk – shockingly – of sexual abuse. 61-year-old Nora was hit by a car in 2010, is paralysed below the waist and cannot walk. She sits on the floor in her tiny room all day. She knits and uses her precious deep freeze to make little popsicles of fruit juice which she sells to neighbours to augment her meagre social grant. The volunteers give her over the counter pain medication, but warn her to use it sparingly and only with food. Her kettle and hot plate have not worked for some time, but she is grateful that she has an old fridge. James is also over 60, is HIV positive and very weak. He has lost a lot of weight and has generalised pain. His son takes his social grant; an ashtray full of cigarette butts on the floor indicates how he spends his father’s money. Johanna is much better after receiving anti-hypertensive medicine from the clinic. Her blood pressure is now back in the normal range but her arthritis gives her constant pain and her sugar is dangerously high. She is taking oral meds for her diabetes, and tells the volunteers how blessed she is. Finally there is Grace, a lady over 60 who is care-giver to a three-year-old baby boy. She is severely ill with back pain, tremors and she has difficulty breathing. The volunteers find a neighbour to look after the boy and pile her into the bakkie. They drive to the local clinic where they somehow manage to get a consultation with a nurse after a long wait. Grace is told to report back to the clinic the next day and the volunteers take her home. Next Wednesday, the Home-Based care volunteers will be back in Alex, seeing to the spiritual, emotional and physical needs of people. This day ends with some good news; in the storeroom at Rays of Hope they find an ancient pushchair and a creative idea develops. They fix it and then take it to Kgosi so she does not have to take Nicole to the clinic by taxi anymore. Rays of Hope would welcome any assistance in relieving the lives of people in Alex that it serves.

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