Adela Rubiano Hurtado does not feel there was a point when she made the decision to care for her granddaughter. It was just that when Rubiano’s daughter became pregnant at 15, and could not care for the baby, there was no one else.
“I never considered it a job or a career,” the 67-year-old says from an armchair in her house overlooking the urban sprawl creeping up the mountains of Colombia’s capital, Bogotá. “Who else was going to do it?”
Her granddaughter, Adriana, now 20, has moderate cognitive impairment and has to be cooked and cleaned for, and needs extra support with the work she brings home from the classes she attends at weekends. It is a round-the-clock job, so Rubiano is rarely able to leave the house. At times she feels trapped by her responsibilities.
“I was overwhelmed, frustrated and did not know what path to take,” she says. “There was no one else to talk to about it, either. Sometimes, I just wanted to run away from it all.”
In recent months, however, there is a new palpable sense of optimism in her home. Rubiano is no longer alone. A pioneering project, focused on transforming unpaid care work, has improved her mental health and reframed her love and dedication.
“I can see a different way of doing things now. It’s like the house is in harmony,” Rubiano says.
In Colombia, like most societies, unpaid caregiving falls disproportionately on women. Few choose to dedicate their life to caring for the young, the old or the sick and most carers have no training, financial assistance or recognition. In 2010 Colombia became the first country in the world to introduce a law that requires the contributions of the invisible care economy to be documented.
When Bogotá’s local government studied unpaid care workers in 2018 they found around one in three women in the city – about 1.5 million people – were labouring with little recognition for their dedication, 90% of them living in poverty. Most had no formal education, one in five had a diagnosed illness and 14% were housebound because of the needs of those they care for.
In response, Bogotá’s first female mayor, Claudia López, proposed an innovative programme which then beat 630 other applicants to win the Mayors Challenge prize, securing $1m in funding from Bloomberg Philanthropies in January 2022. One of those coordinating the project is Sandra Milena Blanco.
“Most of the time carers have little support or do not know how to access it, which sadly means they have a lot of mental health issues, due to the massive burden they carry,” she says. “Sometimes they have to care for two or three people alone and it is not uncommon that the carers themselves are old and need help, they are just too busy caring for others.”
The plan involves 23 care blocks strategically dotted around Bogotá’s deprived neighbourhoods. Carers can stop by to chat to a therapist, receive legal advice from a lawyer around government support, join workshops or yoga classes, swim, learn computer skills, or just drop off dirty washing. They can also bring the people they care for to get some respite.
“There is a strong focus on gender so that these women feel heard and valued,” says Claudia Mirta Luna, who oversees implementation. “It’s not just about reducing the load on them but making sure they realise the importance of their work, they value themselves and realise that ‘I can care for others but while still caring for myself.’”
The mayor’s office sends specialists into homes, once a week for 12 weeks, to tailor strategies for carers.
Sipping at a mug of sweet black coffee, Rubiano recalls her two decades of experience as a carer as Adriana paints with the educational specialist Karen Espejo.
“You see the change as soon as you arrive,” Espejo says. “Often, we are the only person these carers have to talk to, so just by us being here you see the carers suddenly become a lot lighter.”
Espejo has been assessing ways to improve Adriana’s development, particularly with her least favourite subjects.
“I don’t like numbers,” Adriana says. “They are really hard. I like animals and plants, and colouring and drawing.”
Using more engaging ways of teaching like painting or plasticine instead of pens and paper have been working, says Espejo, who adds: “We have also spoken a lot about the best way to explain things, with patience and managing emotions, not shouting or arguing.”
Espejo’s support has brought confidence and a new contentment to Adriana and to her grandmother. For the first time in two decades, Rubiano has regular time to herself, to go out, do housework, or just watch television.
In the nine weeks Espejo has been visiting she has taught Adriana to make the bed, dust, wash clothes and prepare food.
“It makes a massive difference,” Rubiano says. “I honestly never thought that all of this was possible,.”
Mirta says these lasting changes are what make the programme so efficient. Carers may only visit for four hours a week for 12 weeks but the result is a new independence.
“Sometimes carers spoon-feed people as they think they are not capable, but it limits possible progress. I had a mother last month tell me that what her daughter is doing now seemed impossible just three months ago,” she says.
Rubiano has used her free time to gain a qualification from Bogotá’s National Training Service, formally recognising her care experience as the city authorities certify the skills of its caregivers, giving them respect and a way into the workforce should they want it. Rubiano currently depends on the monthly stipend (equivalent to about £100) from the state to support Adriana’s learning disabilities and from renting out her spare room. She would like to do more.
“I think I’d like to work with older people,” she says. “They’ve got good stories and great gossip.”
The new Bogotá administration wants to increase the 23 care blocks to 45 by 2035 and has also introduced mobile care centres. The programme has attracted international attention, with interest from Mexico, Chile, the Dominican Republic and Sierra Leone.
“This is a big, ambitious idea to shift the care economy at urban scale.” says James Anderson, head of government innovation at Bloomberg Philanthropies.
“This is the right programme, tackling the right set of challenges, at exactly the right time – and that’s why cities everywhere are watching closely,” Anderson says. “Care blocks may have started in Bogotá but they will inspire and spread far beyond.”
