The New caregivers

On a Sunday afternoon, before rapt onlookers, a Sri Lankan home caregiver struggles with adjusting a wheelchair. “Sister, you can remove the leg step because it is obstructing you,” volunteers a voice from the audience.
 
The caregiver at the centre of attention wraps her friend’s arms around her neck and slides a hand under her friend’s thigh. “Observe your posture. Tummy in, back straight,” a Singaporean nurse cautions.
 
Eventually, the caregiver counts – 1-2-3 – lifts her friend from the mock-bed, and gingerly lowers her into a wheelchair to a thrum of approval from the audience.
 
On Sundays, migrant home caregivers gather at Active Global Specialised Caregivers’ training sessions, which aim to hone caregivers’ skills so that they are well-equipped to work with a variety of patients with different ailments and conditions. 

Ang Man Yun, a local nurse who doubles as a trainer, welcomes the caregivers to a Sunday training session.

​The kicker? The caregivers present, all of whom are professionally trained, have entered Singapore on Work Permits – and they are officially registered as migrant domestic workers.
 
Active Global is the brainchild of Yorelle Kalika, who has established branches in Singapore, Shanghai, and Hong Kong. It aims to provide professional homecare for patients in need of long-term care, such as elderly persons with dementia, stroke, Parkinson’s, cancer, and other ailments, or children with special needs.
 
“Singapore has a world-class acute care system,” Yorelle observes, “but the options after hospital discharge are limited.” 

Bernadith Camedo practices helping to move stroke patients in and out of wheelchairs.

Mohini Therapali (left, standing) and Swaroopa Rani (middle, seated) share a light moment during a training session.

 
Domestic workers tend to be under-qualified and under-supported for serious medical situations, Yorelle says, while hiring a local nurse is often too expensive. Alternatively, the family could send the patient to a nursing home, but this option is costly, unpopular with Singaporeans, and – in land-scarce Singapore – impractical in the long run.  
 
Employers, patients and workers are matched to each other after an intensive screening process. Active Global conducts an interview with the patient’s family, sends a local nurse to the patient’s household to assess the situation, and runs through an extensive questionnaire about the patient’s conditions before shortlisting a few suitable caregivers.
 
Once the agency finds a caregiver whom might be a good fit for the job, the caregiver is trained on-site according to a tailored care plan for the patient before finally joining her patient and his or her family as a live-in caregiver.
 
To keep these services affordable, Active Global recruits nurses and nursing aides trained in countries such as Myanmar, Sri Lanka, India, the Philippines, and Indonesia. A caregiver has, at minimum, a diploma or bachelor’s degree in nursing. Often, she also has experience practising in hospitals in her country of birth. 

Mohini and Swaroopa give advice to the next pair to test their skills.

Ang Man Yun offers tips throughout the practical demonstration.

Active Global adopts an ethical recruitment model by controlling the recruiting chain from start to end. This allows them to ensure that recruited candidates do not pay fees to any middlemen.
 
“It’s not just because we are nice guys,” Yorelle says. “It’s because it makes good business sense. It gives us a real competitive advantage.”  
 
Recruited candidates pay no fees to come to Singapore to work. Instead, Active Global charges the employers of caregivers a one-time fee of SGD $2,000 before the employment relationship begins, which covers all necessary costs.
 
Depending on their level of expertise, caregivers earn between SGD $600-$900 per month. 
 
Active Global’s efforts to recruit and retain its caregivers also hinge on providing a favourable employment experience. They are careful to differentiate caregivers from migrant domestic workers who might not have received similar levels of training.
 
The agency insists on a strict adherence to the caregiver’s job scope. For instance, the caregiver may be expected to change the patient’s bedsheets and clean the patient’s bathroom, but not the rest of the house.
 
Caregivers are also given uniforms to wear during their working hours, as well as a tablet containing 200 hours of training material. The tablet also allows them to stay in touch with a team of experts in case of any trouble with the patient.  

The audience pays close attention to an instructional video about managing patients who have had a stroke.

 
With these measures, the agency’s retention rate is significant: 95% of caregivers whose elderly patients pass on before their employment contracts are completed choose to stay on in Singapore to work.
 
As we experience a demographic shift towards ageing populations in developed countries, there is an intensifying scramble to recruit global healthcare talent. At this juncture when source countries are increasingly reluctant to send unskilled workers abroad, perhaps it is time to heed Active Global’s call for a separate visa category to recognise the importance of professional migrant live-in caregivers to Singapore’s care landscape.
 

Images: Grace Baey
Text: Charmian Goh

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