In the report on last year’s projects you may remember that K.P. made funds available to start a basic ‘district nursing service’ for about 10 domiciliary patients. The nurse was to work three days each week spending most of her time ‘in the community’ in patients’ homes, and the balance of the time spent attending those residents in the Old Age Home who needed assessment and nursing care.
We met with Peter several times in Kattakada, visiting the Old Age Home, looking at the home based bakery that Peter got K.P. to support to help a widow have some level of independent income, and accompanying the nurse on one of her domiciliary visits.
These are the three confirmed projects (bold type above) for 2014 / 2015.
A fourth project is being considered by Peter: expanding the service at Old Age Home to provide a sort of ‘day centre’ facility for a small number of lonely, elderly local people. I will write more about that a little later on.
– Nursing Service: The funds have been increased so the nurse is able to work 5 days each week. (Salary of £50 per month). We discussed with Peter and Nurse about how to use these days in the most effective way. For example, having looked at the monthly expenditure statements for Old Age Home, it seemed clear that the cost of hospital care / treatments had decreased since nurse’s appointment, and her starting to attend the residents. So, if a resident became ill ( unless ‘critically so’) the nurse was available to call rather than immediately taking the resident to a government hospital where, inevitably, some direct or indirect costs would be incurred.
The broad agreement is that two days equivalent will be available for Old Age Home, and three days for community / domiciliary patients. The nurse will communicate with the person’s local Doctor / G.P.
We talked about how to use these three days – might it be something like the ’15 minute visit’ approach used at times in NHS / Social Care?…. No.
On the visit we made with nurse the patient was a lady in her 50s who had suffered a stroke. Her speech was lost and she had paralysis down one side; she is bedridden and needs someone to wash,feed,toilet her, and to provide companionship. Her husband is now unable to go for work as he provides this care. When we arrived at the house (nurse was there already) the husband had gone out and we realised that nurse was taking a lot of time to carry out the ‘basics’ and she was talking to the lady a lot. Nurse’s plan was to stay for several hours and try some simple therapy with the lady and make her some food as well as carrying out eh essential nursing tasks.
This was as much a ‘respite’ visit as it was a care / treatment visit; it provided the full-time carer (the lady’s husband) some much needed time to go out.
We have asked Peter to speak with nurse about how many patients can be on her caseload in the three days; it needs to be a balance between providing some ‘respite’ service and delivering more intensive / rapid treatments and care services.
We wanted to give this detailed report as another example of how we work with the volunteers to try to ensure your donations are used to ‘best effect’.
(NOTE: no photo available – as it was clear the lady could not communicate and her husband was not present, then securing permission to take and use a photo was not possible.)
– Home-based bakery: We referred to this ‘self-employment’ project in a recent newsletter; one widow had been working in a bakery earning about £1.50 to £2 per day of work, but the bakery was some distance from her home (meaning bus fares to be paid), and also she had started to become harassed by some of the male workers. The lady approached Peter as she believed she could use her skills to bake simple items in her home that she could then sell locally (direct to neighbours and local people, and to small, local shops). To do this she would need to buy the cooking utensils and have a small ‘working capital’ sum (cash-in-hand). The lady felt she could make £1 per day profit.Total sum required to start the small business: £60
In mid-2013 K.P. made this grant via Peter as a ‘petty business’ scheme. It was good to arrange a visit and to meet the lady. Her circumstances are very poor; she eagerly showed us the ‘sweets’ she bakes, wraps in cellophane in packs of 6, and then packs into carrier bags to take around to sell.
The shops take them on a sale-or-return basis and while there is no guarantee of fixed sales every day, she is indeed earning an average of about £1 per day.
But she supports three family members – a 14 year-old son, her elderly father and his elderly sister. All live in the house which is an old style mudbrick wall construction with a concrete slab roof, although its surface has not been properly ‘sealed’. The result is that the walls are crumbling though age and weathering, and the roof absorbs and leaks during the rainy season. In the kitchen where the cooking takes place over an open fire there is no proper chimney or escape for the wood smoke. This means that when she cooks / bakes the small house fills with smoke, and when it rains the rainwater comes in through the ceiling and the upper part of the crumbling walls. (See photos in ‘photo gallery ‘ Kattakada – bakery).We had to wait for smoke to clear before we took some of the photos and in the shot above you can see a bit of a haze!
The lady sleeps in the main room, son in an adjoining room, and her father and aunt in two separate lean-to areas attached to the front of the house. The aunt sleeps on the ground as there is no bed. There is an outside India-style toilet but it has no door.
We know this is not uncommon but it is sad to see a family with elderly relatives living in such conditions.
The lady was not complaining and in fact had gone out and spent some of her earnings on packs of biscuits to give us as gifts, as well as packs of her home-baking, because had told her we would be visiting.
The house needs extensive renovation but we did not have funds for that. Jane was puzzled why there were so many empty beer / drink bottles in a heap in front of the house. Peter explained the family go around the local area collecting them from the roadside as they can be sold for about 2p per bottle.
Peter is going to think about what more might be done to help this cheerful and resourceful lady keep her family together.
Note: you might question whether setting up a bakery project was a good idea in a house in such condition but on reflection the ‘new disadvantages’ are less than the the old ones; the lady is now free from unwelcome advances and is earning for herself.
Photo shows Jane learning about the type of sweets that are baked.
Creating ‘petty businesses / self-employment schemes’ is a great way to help a family / individual; £50 – £60 does it. Think about a donation perhaps next time you can’t think what to buy someone as a special gift! We can let you have full details of what project you have funded.
– Old Age Home: By the end of our two week visit we had agreed with Peter and the volunteers on three matters relating to the Home;
- K.P. contribution to the daily running costs would remain at the same level as in 2013/2014
- Funding of the small ‘special care’ annex at the rear of the Home
- Proposal to start a ‘Pakal Veedu’ – a ‘day house’
Monthly grant toward the running costs of the Home: This will remain at Rs20,000 (£200) per month. Typically, the total cost per month is £600 and for several years this has been provided by K.P. (£200), a group based in Germany (£300); and Peter and the volunteers getting about £100 from local people (normally more wealthy business people).
The Home cares for about 20 people so the average cost is £30 per person per month, or about £1 per day. This provides for everything including any costs for hospital care and medicines. As well as Peter and any volunteers there are three staff; only the three receive pay. Confirming the nurse’s position and continuing involvement with the residents means her services should relieve the ‘hospital charges’ bills in the coming year.
We feel the Home provides ‘value for money’ but more importantly it provides a loving and caring HOME for elderly people who essentially have been abandoned.
Special care annex:
In the January 2014 newsletter (see ‘News’ page for the link to the newsletter) we reported on the need to build a small annex at the rear of the main Home to accommodate either very ill residents and / or those suffering with incontinence. The plan is for a 4-place annex to be divided into 2 x 2 small rooms.
We saw the work completed to date which has been funded from local contributions. Each time Peter has secured some money he carries out the next bit of work; maybe a few courses of concrete blocks. The work had been at full-stop for several months as local contributions had dried up (remember Peter is still needing to get £100 per month to ensure the running costs are covered – that is the priority use for local funds).
The need for the annex is clear as those residents who are suffering have to remain in the dormitories, but sadly their condition does cause disruption and distress for the others.
While we were in kerala we obtained an extra donation to K.P. funds sufficient to comlete the project! This is about £600. The remaining work can now be carried out – watch the ‘news’ page for more updates and photos.
A good result.
‘Pakal Veedu’- a ‘day house’: We feel that elderly people are a priority-need group for K.P. Providing companionship and enabling volunteers and others to keep an eye on elderly individuals are actions that can make positive improvements to the person’s life.
With these thoughts and views in mind we talked with two of the volunteer leaders at Kattakada (Peter) and in Neyyattinkara (see further down on this page) about the idea of pakal veedu (translated from Malayalam into ‘day house’ – we don’t want to use the term ‘day centre’!)
In Kattakada the Old Age Home is quite a busy place with 20 – 23 residents, staff and volunteers there during the day, but it still felt like it had capacity to do more without becoming overcrowded. Remember that the completion of the annex in due course will mean several residents will move into this new space. So we have asked Peter to consider creating a pakal veedu on a small scale to assess its effects and benefits for those who would come as ‘day visitors’, and the effect on the Home’s residents.
Our thinking is that the day visitors will get variety to their present daily routines, and the residents will have ‘new people’ for conversation and so on.
The criteria for the visitors would be to invite those who are ‘below poverty line’ and in need of company, and who can reach the home under their own steam. We cannot afford to arrange transport to collect and return but maybe there might be scope for refunding bus fares if that was necessary – we’ll have to see.
The home will provide a snacks (tiffin) and lunch and nurse could review their general health when she is at the home.
We asked Peter to think in terms of perhaps 2-5 days per week, with 2-5 visitors on each of the days. peter is willing to do this as it will use the home to a better effect! Thankyou Peter and please watch out for news on whether this initiative gets off the ground, by looking at the ‘news’ page.