Мифы и реальность домашнего ухода в Нигерии: почему забота должна быть инфраструктурой

What homecare in Nigeria actually looks like: Abiola Ayilara separates myth from reality Quick Read The first time I stood in a client's living room as a homecare nurse rather than a hospital nurse, I understood something no ward had taught me. Care changes when it enters a home. Abiola Ayilara, RN The first time I stood in a client’s living room as a homecare nurse rather than a hospital nurse, I understood something no ward had taught me. Care changes when it enters a home. It becomes quieter, more personal, and far more honest. You see the food in the kitchen, the stairs the patient cannot climb, the daughter who has not slept properly in three weeks. My nursing training began in Nigeria. Further study took me to the United Kingdom, where I worked as a care personnel across NHS and homecare settings, from elderly care to learning disability support and mental health. When I returned home and founded a homecare business, I discovered that the biggest barrier to good homecare in Nigeria is not money or medicine. It is mythology. Let me take you into the field and show you what this work actually looks like. Myth One: Homecare Means Hiring a House Help This is the myth I meet most often. A family assumes that caring for Mama after her stroke simply requires getting someone to stay in the house, cook, clean and help her to the bathroom. Then reality arrives. Mama needs her blood pressure monitored and recorded. She needs medications given at the right time and dose, because two of them interact dangerously if mismanaged. She needs turning every two hours so pressure sores do not open on her back. She needs someone who recognises the early signs of another stroke and acts within minutes. That is not housework. That is clinical work. When families discover the difference, it is often after a preventable crisis. My hope is that more of them discover it before. Myth Two: Homecare Is a Luxury for the Rich I understand where this belief comes from. But consider what families already spend when care is unstructured. Repeated emergency admissions. Prolonged hospital stays because there is no safe discharge plan. A relative who abandons her job to become a full-time caregiver, losing an income the household needed. Structured homecare, matched honestly to what a family can afford, frequently costs less than the chaos it replaces. A patient whose surgical wound is properly cared for at home avoids the infection that would send him back to theatre. That is not luxury. That is arithmetic. Myth Three: Using Paid Care Means Abandoning Your Parents This myth carries real moral weight in our culture, and I treat it with respect. We are raised to believe that caring for our elders is a duty of love, and it is. But love is not a clinical skill, and duty does not protect a daughter from burnout. The scale of this burden is documented. The International Labour Organization reports that women perform 76.2 per cent of the world’s unpaid care hours, more than three times the share carried by men. Professional care does not replace a family’s love. It rescues it. When a trained caregiver handles the lifting, the medications and the night shifts, the daughter can go back to being a daughter. The son abroad can hear a proper clinical update instead of vague reassurance. Nobody has been abandoned. Everybody has been relieved. Myth Four: Serious Illness Belongs in Hospital Hospitals are essential, and nothing here diminishes them. But hospitals are built for acute intervention, not for the long middle of illness. Stroke rehabilitation, chronic disease management, recovery after surgery, dementia care and end-of-life care are journeys measured in months and years. No hospital bed can hold them, and no family purse can pay for the attempt. This matters more each year, because Nigeria’s over-60 population is projected to reach about 25.3 million by 2050. Some of the most profound nursing I have ever done happened at home. I have supported patients at the end of life in their own bedrooms, surrounded by their people, their prayers and their music, with pain properly controlled. For much of the illness journey, the home is where care belongs. Myth Five: Anybody Can Do This Work, So Standards Do Not Matter Because homecare in Nigeria is largely informal, families often cannot tell the difference between a trained caregiver and an untrained one until something goes wrong. The difference is everything. It is the difference between a fall prevented and a hip broken, between a medication error and a safe morning, between dignity and neglect behind a closed door. Yet Nigeria has fewer than ten geriatricians, its 2021 National Policy on Ageing remains unimplemented, and the country lacks comprehensive national data on caregiving. This is why I argue in my book, The Homecare Framework, that homecare must be treated as infrastructure. Roads have engineering standards. Water systems have safety standards. The care of our mothers, fathers and children in their own homes deserves nothing less. What the Field Has Taught Me Strip away the myths and homecare in Nigeria looks like this: it is skilled, structured, deeply human work happening in ordinary rooms. It is a daughter sleeping through the night for the first time in a month. It is a father recovering at home instead of returning to hospital. It is a trained caregiver doing quietly heroic work that no policy document has yet fully recognised. The families are already there. The need is already there. What Nigeria must now build is the framework around them, and that conversation continues at The Care Conference, convened by The Purple Global Mission in Lagos on 18 and 19 November 2026. Care is infrastructure for everyday life. It is time we started treating it that way. Abiola Ayilara is a registered nurse, health informaticist, author of The Homecare Framework and founder of The Purple Global Mission, convener of The Care Conference, Lagos, 18 and 19 November 2026.