We have 200 beneficiaries who are cared for at home during temporary, chronic or terminal illness. The cost is just £3.75 per week for each old person cared for in their own homes.

This home care project was the very first to receive part-funding from the Romanian government - a sign of how good a model for future practice it is viewed as being.

The need

Background to the Project

Current Project



State Involvement


Transition to a free market economy has left Romania a staggering 8 times poorer than 10 years ago with 44% of Romanians living in poverty. But the North East area where we work is much more deprived than the average and poverty rises to 80% in the rural parts.

Aid intervention in Romania over the past ten years has largely focused on children and orphans. The elderly have been mostly forgotten and excluded from NGO initiatives in social and health care.

There is no community based social care network in Romania.

Hundreds of thousands of old people suffer chronic illness alone at home in terrible conditions. As one ill old lady said "I'll have to go to the hospital with the white crosses" - seeing the graveyard as the only option open to her.

Recent health reforms that have produced fund-holding GP's have done nothing to address the needs of the elderly sick, particularly in rural areas where the few scattered GP's cannot reach patients in outlying villages.

Added to all this, greater poverty has significantly increased the suffering of the elderly sick and their capacity to afford even the basic necessities.

The "luxuries" of health care or medicines are simply unaffordable. 40% of patient days in acute care hospitals are taken up with elderly social cases.


Our team have set up a project, now in its 5th year, which has received widespread acclaim and provides medical, nursing, shopping, cooking and cleaning services to the poor elderly sick and disabled in their own homes.

We have set up a home loan centre for nursing and rehabilitation aids such as wheelchairs and walking frames. In April this year, we opened a Day Centre for the elderly where they receive counselling, physiotherapy, occupational therapy and social support.

Teams of a doctor, nurses, physiotherapists, occupational therapists, social workers and home carers provide full care and rehabilitation for elderly people suffering chronic illnesses including:

Stroke victims
Parkinson's Disease
Multiple sclerosis
Terminal illness
Burns and trauma victims
Heart failure
Alzheimer's disease


We provide a unique home care service for old people so that they can stay in their own homes during temporary, chronic or terminal illness.

Our teams care for 200 homebound people in 4 areas of Bacau county, NE Romania. By having a referral centre and social worker in the local district hospital, an equipment loan service, home care teams and a Day Centre, we are able to provide continuity of care from hospital discharge through to recovery.

For the chronically or terminally ill, where recovery is not possible, we offer the highest standards of care.

The project beneficiaries are targeted by needs assessment criteria and these are reviewed regularly. In this way, the project is able to adapt the therapy and rehabilitation plan as necessary and discharge clients from its service when they are able to live independently.

The project delivers:

A meals on wheels service

Regular training courses in home care for state and charitable sector employees

An informal national network of organisations involved in providing elderly care

Regular regional and national stakeholder conferences

A manual and guidelines for elderly home care

Volunteer assistance in the project from local nursing, social work and physiotherapy schools

Liaison with and support to the district geriatrician



Bacau is in the north-east of Romania in an area known as Moldova - a particularly poor area even by Romanian standards.

In rural areas, inhabitants live in small villages often isolated from each other and the outside world. Transport is mainly by cow cart on dirt tracks or unmade roads. Some houses have electricity, few have running water, a village well being common.

"Agriculture is largely subsistence and the population elderly as the younger people leave for employment in the towns. It is certainly an area of great need, even within a Romanian context"

(EU Phare report on our work in the area in 2001)



The project is important in its own right in that it provides home care for 200 dependent elderly sick, disabled or terminally ill patients to a high standard.

However, the wider impact of the work is what makes it really significant in Romania.

Our model acts as a seed-corn pilot project for communities to develop their own projects which can be paid for by the state.

There has been no precedent for this and communities need to be shown how it can be done.



Our three year project from January 2003 proposes to extend our Home Care of the Elderly project in NE Romania.

We will use three new rural projects to promote rural councils to set up further satellite projects employing local women as carers whom we will train.

We will oversee all projects until they are fully established and funded by local authorities.

The funding of home carers will eventually be paid by local councils but a transition period is necessary so that budgets can be applied for based on a cost analysis of start-up projects (because mayors cannot request a "theoretical" budget).



Our clients' needs vary from very high to low dependency.

We've got some case histories to give you an idea of the services provided. The average cost per week is a mere £3.75 per beneficiary.



Fundatia de Sprijin Comunitar - FSC (Community Support Foundation ) is an independent, registered Romanian Charity set up by former Relief Fund for Romania key personnel.

FSC is our largest operational partner in Romania. They also have projects delivering services to children, therapeutic arts in institutions and rural health care.


Testimonials on our partners:

"Bearing in mind the enormous changes demanded by the altered situation, the project has been very well implemented … what has been delivered is a programme of integrated rural development that has crossed sectors and responsibilities and produced a model of service delivery that is … being adopted and funded by the local authorities themselves"

Phare-Tacis LIEN monitoring report

"…an effective, professional organisation leading NGO development in its region and with good operating models, including its training programmes … I was very impressed by this organization and its operating style"

Dr John Chandler, PhD British Executive Services Overseas monitoring report 2000


The project undergoes continuous internal monitoring. It is assessed monthly by the local city council and annually by us - the Relief Fund for Romania. Monthly financial and quarterly narrative reports are supplied to us.

A recent external evaluation stated - "FSC is a key player in the local community and a role model for other NGOs on how to develop services in a poor community…the service provision is carried out in a professional manner…with good training, planning and monitoring of services…"

( 'Opportunity Associates' the lead Romanian NGO training and evaluation service, May 2002)


The Relief Fund has provided continuous funding with the help of grants from:

- The Community Fund (previously National Lottery Charities Board UK )

- The Phare Lien Romania programme

- The Open Society Foundation (Soros)

- United States Agency for International Development (USAID)/ World Learning

- Romanian National Government funding (Ministry of Labour and Social Security)

- Bacau city council

- Racaciuni village local council

- The Phare Access '99 programme

We are also able to access central government funding for our poorest clients for food and incontinence materials.


Over the past 5 years, we have continuously lobbied for government funding for home care services to the elderly sick. We have presented homecare/hospital care cost comparisons, case histories and data to local and national government bodies.

Our research studies showed that home care is more than three times cheaper than institutional care - hospitals or long stay institutions.

These activities resulted in our project being the very first in Romania to receive local council funding for home carers.

We then demonstrated to local rural mayors that government funding can be obtained for the payment of home carers.

Over the next 3 years, we will be spreading this project to 3 large rural communities. Local mayors will then spread the project themselves to up to 19 satellite villages in each rural district.

We will provide the know-how, the training and supervision. The funds for rural spread will come from local council budgets, from local businesses and specific grant funding.


Read the personal stories of some of our beneficiaries


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