Home care: A woman who creates her own chance – Bavaria

Susannah Strack should actually have been dead for 16 years. At least that’s what the doctors had predicted for her. But now she is 61 years old and still quite alive. “The doors open here at the push of a button,” she says, while using a joystick to ram her wheelchair against the front door with a little momentum, which causes it to swing open. “I am the button.”

Strack suffers from progressive muscular dystrophy. Step by step, your muscles will recede. She has been in a wheelchair since 1994. She now needs 24/7 help. Her mother lives two wheelchair minutes away, but she hardly ever leaves the house, says Strack. Even a few meters can be a damn long distance. Eating, drinking, going to the toilet, raising your arms or turning over in bed, they no longer have the strength for all of that. But Susannah Strack can continue, because there are people who help her with all these things and run her household. Their names are Adonay Haile, Ukubay Baramichael and Luel Tadese. And they also have a long way to go.

In Schongau, about 70 kilometers southeast of Munich, the men are sitting around the small wooden table in Strack’s kitchen. Haile, Baramichael and Tadese are from Eritrea and have successively fled the Red Sea dictatorship over the past nine years. Via the Sudan, Libya, the Mediterranean to Upper Bavaria. At home, says Luel Tadese, he was in the military for 18 years. “All young people have to do military service. Endless,” he says with a cautious smile. Not a trace of military rigor. Tadese is 48 years old and the oldest of the three. He has been working for Susannah Strack for a year and a half, but only full-time since January. The handles are recorded. After he finishes his sentence, he gently slides her foot, which had slipped down, back onto the wheelchair’s footboard.

“I had a work permit after two years and was able to start with Susannah Strack, but I waited three years for my residence permit,” says Ukubay Baramichael in shaky German. He wears open sneakers, beige leather jacket and smiles most of the time. Of the three men from Eritrea, he was the first to take care of the 61-year-old. Like his two colleagues, he has neither received any training in Eritrea nor thought about becoming a nurse. And yet he has been employed by Strack since 2016 as a nursing and household help. The fact that this is possible is what distinguishes the strikingly uncomplicated model from Strack.

For people who come to Germany without papers, qualifications or a recognized school-leaving certificate, the classic route into the healthcare sector is possible, but tedious. “Germany is complicated,” says Adonay Haile. After a preparatory internship and often up to one year of introductory qualification, there is the possibility of training as a nursing assistant – the basic qualification in nursing – even without a school leaving certificate. In some cases in Germany it is also possible to catch up on school-leaving qualifications as part of an apprenticeship as a geriatric nurse. The three men from Eritrea learn written and spoken German from Susannah Strack. The road to becoming a nursing assistant is still a long one for her. In the house of the 61-year-olds, they can also work without qualifications.

This is because Strack took the personnel situation into his own hands. She fought for three foster jobs at the Ministry of Social Affairs because she no longer felt like “abusing the life of a single 24-hour worker” who had to be there for her around the clock. As she was involved in relief efforts for refugees in Schongau, she met Ukubay Baramichael in 2016. The other two joined him in recent years through his contacts in the lively Eritrean community in Upper Bavaria. But such a flexible recruiting model only works because Strack is mentally and physically fit enough for it.

She gives German lessons, explains to her carers in the early days how devices, handles and processes work and even compiles the shift schedules herself in endless Excel lists. Now and then Strack urges the men to continue speaking when they are struggling with the German words. Sometimes she completes one of her sentences when a term is searched for. Sometimes she’s a teacher, sometimes she’s the boss and she always needs help. Once she looks up and asks, “Can one of you fill my cup again? Thanks.” Shortly thereafter, the tankard with tea is in front of her again. The metal straw she uses to drink rattles against the china.

Susannah Strack’s three helpers are divided into early and late shifts. The early starts at 7 a.m., the late ends at 9 p.m. Then there’s a night watch from the ambulance. All three get the 14.21 euros per hour approved by the office. A few cents more than the collective agreement for nursing assistants. According to the nursing care funds, the “customary regional fees” for nursing assistants in Bavaria, even without training, are a little more than 17 euros. In nursing services and homes, either the officially recognized collective agreement or the “customary regional” wage applies in accordance with the Nursing Wages Act. In some institutions, Haile, Baramichael and Tadese would earn a little more, but at Strack they can have a say when it comes to the roster and they are well acquainted. As unskilled, they are not allowed to carry out many of the work steps in a facility that they take for granted here, for example operating the breathing pump or administering certain medications. This is possible at Strack because the employer is the 61-year-old herself. Self-confident, almost a little defiant, she says: “Mistakes that could arise are just my bad luck.”

Can that go well, such a model? A call to Ute Haas. She is a specialist coordinator at the German Nursing Council and has herself worked with paraplegic patients for many years. Such models can sometimes be observed in patients who are only physically but not mentally handicapped, says Haas. She calls it a “special case”. In some constellations, a model like that of Susannah Strack works excellently, in others it doesn’t work at all. It is important that the person in need of care is able to take care of the organizational and technical aspects. “You really have to be a manager,” she says. However, the model cannot replace qualified specialists who are able to assess a situation themselves.

Open detailed view

Bernhard Emunds is even more cautious with his assessment. The head of the Nell Breuning Institute writes, among other things, about care in private households. With such employment models, he is concerned about the well-being of the employees. On the one hand, the “argument that the responsibility is too high” also applies to the caregivers. It is important not to overwhelm them, which happens quickly with demanding care services. On the other hand, there is always the risk that people who have a bad bargaining position on the labor market will be exploited in such circumstances. This can often be observed using the example of Eastern European nursing and household workers. The reality of home care and German employment law often clash, and Susannah Strack has also experienced this.

A connecting element

It was a coincidence that Baramichael, Haile and Tadese ended up in Upper Bavaria. But now they want to stay. A return to Eritrea is not an option for them. President Isaias Afwerki has been in office there for 30 years and keeps the state going primarily by making large parts of the population forced laborers and military personnel. There is no end in sight to his dictatorial rule. In addition, according to the Federal Foreign Office, the livelihoods of 23 million people in the Horn of Africa are threatened by persistent droughts. The three men have their own apartments in Schongau and neighboring Peißenberg. Haile’s wife and children are also in the region. Tadese and Baramichael wish nothing more than to be able to get their families as soon as possible.

The Bavarian state government is making intensive efforts to guide nursing staff from abroad to the Free State. The Ministry of Health currently counts 580,000 people in need of care. According to forecasts, this number could rise to one million by 2050. Meanwhile, Susannah Streck is taken care of by three people who otherwise have a hard time on the German job market. At first glance, the four paint an uneven picture. But Susannah Strack says there is something deeply connecting. For example, everyone in this house knows very well what it feels like to have to live with the feeling of powerlessness.