The Potential of Faith-based organisations for social change. Contribution of Christian organisations to Elderly and Dementia care

Table of Content

a. Dedication

b. Acknowledgement

c. Acronyms

Chapter 1 Faith-Based Organisation and Social Change
1.1. Introduction
1.2. Definition and theories of social change
1.3. Importance of social change to Human society
1.4. Definition and function of Faith-Based Organisations (FBOs)
1.5. Role of Faith-Based Organisations in the social change

Chapter 2 Dementia: The Journey of Aging
2.1. Dementia, dependence and burden
2.2. Different types and caurses of dementia
2.3. Dementia as a social issue that needs to be addressed

Chapter 3 Faith-Based Organisations as agents of Social Change
3.1. Faith-based organisations and their capability to effectuate social change regarding the case of the elderly and dementia in Europe
3.2. The situation of the elderly in Cameroon
3.3. The socio- political situation of Cameroon
3.4. The religious situation and the role of the churches in Cameroon
3.5. Contribution of Faith-based organisations to (elderly care) dementia in Cameroon
3.6. Similarities and differences to Europe regarding the situation of the elderly in Cameroon
3.7. Similarities and differences to Europe regarding the socio-political situation in Cameroon
3.8. Similarities and differences to Europe regarding the religious situation and the role of Churches in Cameroon
3.9. Feasible goals and measures for such care for the elderly and dementia patients in Cameroon
3.10. Cultural and political setting of Cameroon
3.11. Fitting the religious context and the role of churches, especially the Roman Catholic Church

Chapter 4 Final Thought
4.0. Conclusion
5.0. References

Dedication:

This work is dedicated to my beloved parents; Mr/Mrs (BA) John Ndasi Sama Fokum. My little way of saying thank you for your tireless efforts, prayers and kind words of love and encouragement they gave me.

Acknowledgement:

I will like to appreciate the efforts of my supervisor Prof. Dr. Eberhard Hauschildt, who gave me useful guide lines and resources that were instrumental to the success of my work, and also to Prof. Dr. Michael Wolters my second examiner, both of them from the Evangelisch Theologische Fakultät Universität Bonn Germany. I also wish to thank the Master of Ecumenical Studies (Mest) crew for their support during my study period. A lots of thanks to Imke Scheib, who took time to edit most of my papers, making useful suggestions, corrections and comments which were very help and contributed to my success.

Finally I want to say thank you to my kids and my better half Mr. Ekomenzoge Metuge, for always being there for me and for the family, providing the support and encouragement that was necessary for my success. For my siblings and friends, I wish to say your prayers and kind words contributed in many ways to effectuate this happy end, to all of you I say thank you, and may the good lord richly reward you all.

Acronyms

illustration not visible in this excerpt

Chapter 1 Faith-Based Organisation and Social Change

1.1 Introduction

In this paper, I will explore the capabilities that Faith-Based Organisations have to change; behaviours, beliefs and the environment, especially regarding care of (elderly) and people with dementia in Cameroon. As far as taking care of the needy and the marginalized is concerned, Faith-Based Organisations in most parts of the world are very instrumental. Reason behind their interest in caring for the needy and marginalized I suggest, is the preservation of human dignity and promotion of well-being which is an idea supported by their different doctrines. FBOs have collaborated with governments, CSOs and CBOs to provide material and immaterial support and services geared towards addressing problems plaguing individual, families and communities, thereby contributing to, and promoting well- being through a change in their behaviours, environment, and beliefs. This social change goes a long way to enhance human dignity, giving people the opportunity to live a better life. FBOs are endowed with spiritual potentials as religious institutions, which give them credibility and legitimacy as an altruistic institution, and makes it easy for them to hire volunteers and win the hearts of donors who donate generously to support their projects, knowing that their donations will be judiciously used. The presence of FBOs in grassroots gives them that advantage of knowing the needs of the people and tailoring their services and projects to address these needs. With all these potentials at their disposal, I will argue that FBOs more than secular organisations, are capable and able to bring social change.

Looking at situation of elderly and Dementia Care in Cameroon, I will argue that, mainstream Churches such as Roman Catholic Church of Cameroon (RCC), Presbyterian Church of Cameroon (PCC) and Cameroon Baptist Convention (CBC), acting as FBOs in Cameroon are able to bring change in this domain. I can argue based on the premises that, major Churches in Cameroon, have provided and are still providing significant welfare services in Cameroon that has and is still changing life, such as; upholding, promoting and preserving moral values through their preaching and teachings (i.e. doctrines), which protect and promote human dignity, and in a way has contributed to the relative peace and stability that reigns in Cameroon, a country suffering from poverty, corruption and political dissent. FBOs or mainstream churches in Cameroon, act as a prophetic voice, They encourage the government to stand up to its responsibility, and speaks against corruption and government malpractices. FBOs in Cameroon are very active in providing education, hospitals, and other safety nets or social welfare services to Cameroonians¹, it is therefore reasonable to argue that FBOs can bring about change in the situation of elderly and people with dementia in Cameroon. The elderly, people with dementia and their caregivers in Cameroon, desire support services such as; information, education, training and respite services etc., to help improve on the already existing informal or traditional way of giving care in Cameroon. Such support services if made available, will enable care-receivers enjoy quality care, and help caregivers cope with the burdensome role of caregiving.

Since Churches in Cameroon already know the situation underground, and have existing medical facilities as well as the financial capability, I will contend with the fact that FBOs are better placed, than secular organisations, to introduce and promote elderly and dementia care and support services, which resonates with their objectives of promoting and preserving human dignity and well-being. The feasible goals of FBOs towards elderly and dementia care in Cameroon will be to preserve human dignity by providing support services to already existing informal system of care, human dignity is lost with intellectual impairment caused by dementia. A loss of cognition therefore means a loss of the abilities that gives our life Value, Productivity and independence, qualities attributed to selfhood, and man as image of God². Man is helpless without these qualities, and needs support to be able to live well and maintain his/her dignity. Another feasible goal will be to give hope, and bring God’s unconditional love to mankind, through spiritual, pastoral care or counseling services, as well as show of kindness, patience and concern which brings relief and reassurance to the elderly, and people living with dementia and their caregivers.

The next goal will be to create a stigma free community of faith, love, and support, through information, and education about dementia, which will enable people to accommodate those living with dementia. “The perception that religious traditions combine a commitment to community with a commitment to the inherent worth of individuals provided a focal point for increasing attention paid to the role of religiously based human and social services”.³ Even in Cameroon religious based social services has complemented, as well as substituted many government provided social services. The services that FBOs provide, are very helpful and relevant considering the fact that they are of good quality, efficient, and accessible even in remote places where government services does not exist, or are yet to exist⁴. The presence of religiously based human services in Cameroon, like in most parts of the world has really improved the lives of the poor and needy in societies, and society as a whole, since these FBOs services are not limited only to the poor and needy but spills over to serve the whole nation. Their religious inclination, beliefs and spiritually make FBOs capable and very able to bring change in some aspects of human life and in human society. These Changes can be political, economic and social. Politically, by acting as the voice of the voiceless, and seeing that the state lives up to its responsibility towards citizens, as well as in promoting and maintaining human dignity. Economically, FBOs carry out projects that enhance economic activities which help alleviate poverty, e.g. they create jobs, offer employment that goes to improve living conditions and livelihood of people in the society and change their lives for the better. Socially FBOs improve the lives of people by empowering them through education, training and support of various kinds, that goes to change the life of people and promote their well-being.

Though political and economic changes are also very important for the well-being of mankind, I will at this juncture focus on social change, which happens to be my next topic of discussion.

1.2. Definition and theories of social change

Social change refers to any significant alteration over time in behaviour pattern, cultural values and norms. There are three basic theories of social change on which sociologist rely namely; evolutionary, functionalist and conflict theories of change.⁵ According to evolutionary sociologist , society moves from specific directions, Functionalist sociologist emphasises on what maintain society and not what changes it, while conflict theory maintains that because a society is wealthy and powerful, it ensure the atmosphere in which social practice and institutions favourable to them continue. Change plays a very important role to remedying social inequalities and injustice. Through evolution or change a person can move from one point in life to another, for example through education and hard work a person can move from a disadvantage class in society to a higher class and change the life of his family, so change is a very important concept in human existence, be it physical economic, political or social.

Social change theories are to some degree theories about history, Social change is part of human institution, and human history is very much intertwined with social change. Without social change I am convinced that, human institutions would have been static and there would have been no room for innovations, advancement and developments, both in human lives and institutions. Therefore, social change is very important for human and societal development. Therefore, a change in behaviour, cultures and way of life that is detrimental to human advancement or human society is very necessary if there is to be development in human societies.

My work will focus on possible changes that can be brought about by FBOs, which can alter behaviours, culture and life style of people in societies, making them more, exposed, informed, educated, trained and accommodating, to the poor, and the needy in their communities, especially to the elderly and people with dementia. A kind of change which I think is possible because of the resources at the disposal of FBOs.

However, with government welfare systems falling apart, and becoming more and more incapable and inefficient in executing their duties, there are, and will be an increase in the number of calls for help which will continue to increase the demand for the Christian communities to step forward and provide an alternative to the welfare system that will enhance life changing altitude within communities⁶. This life changing altitude will help people to understand, accept, accommodate, and support those in need, especially the elderly and people with dementia and their caregivers. Caregivers are very instrument to the welfare of people with dementia, support for dementia patients and their caregiver by Faith-Based Organisations or religious institutions, will go a long way to change the life of both the caregivers and the care-receivers, relieving caregivers from the burden of Care, and paving the way for them to provide quality care to their care- receiver. Informing and educating people about this disease as well as training and provision of other social service support such as: respite service, adult day care, meals on wheel etc., will change behaviours, for example, changing the altitude of society towards people with dementia and their caregivers, making society to accept dementia patients for who and for what they are, instead of stigmatizing and isolating them. It will also challenge certain cultures and notions about this disease and encourage communities to support caregivers, in order to enable them provide quality care for people living with this terminal disease. By doing this, they will improve the lives of both the caregiver and the care-receiver tremendously, as well as alter the behaviour and cultural mind set, bringing about change in the entire society.

Furthermore, in order to bring about social change, FBOs and the civil societies must be willing to change existing policies and practices as well as develop innovative approaches to the provision of community support services that are really sustainable, flexible, and responsive to the needs of individual caregiver and care-receivers⁷, which will help improve on well-being and promote human dignity.

1.3. The importance of social change to human society

Change is an important phenomenon in human life and in human history; change takes place at different levels of human life, even human development is an experience of change in that, human beings evolve from stage to stage, i.e. from conception to maturity, the human person keeps changing, and human beings stop experiencing change the day they die. Even nature changes it seasons etc. This is mentioned, to emphasise the importance of change to human beings, and to human society. As social beings therefore, change is very necessary for human beings to development and move forward, change brings innovations that help to advance human life and provides for human needs, therefore social and cultural, as well as economic and political changes are very necessary for human development. Because these changes help propel man from one stage to another, socially it might help to push man from one behaviour that kept him from progressing, to a behaviour that supports and enhance growth, and success in every aspect of life, e.g. primitive, barbaric or Ancient traditions or beliefs, that hindered progress and development, e.g. the idea that that refused girl children in some countries in Africa from going to school in preference of boys, saying women are meant to get married and make a families, such ideas are detrimental to development, and a change in such traditions, beliefs and custom, is therefore necessary for development and well-being to be achieved and promoted.

Social change even though necessary, is not without its own shortcomings, some aspects of social change are detrimental to certain culture and beliefs, and some also flourish at the expense of the poor and needy in the society, for example expensive development projects like road and buildings which are not very pressing though necessary, in place of school and hospital, that go to serve the immediate needs of the poor in society and society in general. It takes only institutions such as FBOs to set in, and help fight social injustice and change the life of the needy and marginalised in the society.

1.4. Definition and Functions of Faith-Based Organisations (FBOs)

The question of Faith-based social services emerged as a major policy debate in the twentieth century. The debate started as part of the Clinton administration's efforts to reform the social welfare system in mid-1990s, this discussion became stronger during the 2000 presidential campaign. The Bush administration eventually put in place a number of initiatives to further highlight and support the role of religious organizations in social welfare provision⁸, this religious social welfare organisations became known as Faith-Based Organisations, a term which originated from the United States of America, and has being used to refer to religious organisation social welfare services.

FBOs have been, and are still playing important and leading roles in providing welfare services all over the world today. It is believed that hurting people cannot often receive the Gospel message until their needs are addressed, and that Christ was conscious of those needs for people, and went about ministering to the needs of the people,⁹ in order to emulate Christ’s example, and follow what the Scripture says “many organizational documents invoke the biblical calling “let your light shine”. A phrase which is based on the notion that by doing good deeds you are making others aware of the unconditional love of Christ and thereby creating an opportunity for, and encouraging others to get to, or want to know Christ¹⁰.

The definitions of FBOs are many and varied; the Science and theology news equates the term Faith-based group with “civic associations loosely connected with faith groups”. According to the 2003 AmeriCorps Guidance’s definition for Faith-Based Organizations: It is a nonprofit organization founded by a religious congregation or religiously-motivated incorporators and board members that clearly states in its name, incorporation, or mission statement that it is a religiously motivated institution.¹¹

Another school of thought defines FBOs thus: at a minimum, FBOs must be connected with an organized faith community. These connections are possible when an FBO is based on a particular religious ideology and draws its staff, volunteers, or leadership from a particular religious group. Furthermore, religiously oriented mission statements, the receipt of substantial support from a religious organisation, or the initiation by a religious institution¹² are other factors or traits that qualify an organisation as “Faith-Based”. (Robert Wuthnow, 2000).

In his book, The Newer Deal: Social Work and Religion in Partnership, (Columbia University Press, 1999), Ram A. Cnaan, associate Dean for Research, Professor, and Chair of the Doctoral Program in Social Welfare, also the Director of the Program for Religion, and Social Policy Research, defines six categories of religious service organisations namely; 1) local congregations or houses of worship,2) interfaith agencies and ecumenical coalitions,3) citywide or region-wide Sectarian agencies,4) national projects and organizations under religious auspices, 5) Para denominational advocacy and relief organizations, and 6) religiously affiliated international organizations¹³. Among these six categories, the kind of religious service organisation which exists in Cameroon is the first type. This is so because mainstream churches in Cameroon, such as the Roman Catholic Church of Cameroon (RCC), The Presbyterian Church of Cameroon (PCC) and Cameroon Baptist Convention (CBC), are providing safety nets, as well as providing for the needy in their different congregations and communities all over Cameroon. Through their out-reach activities, FBOs (Churches) in Cameroon, and CBOs (Community -Based Organisation Services) address shortcomings on state delivery of basic needs; the lack of education, jobs, and social security¹⁴. This has made them important agents of civil society, agents which work tirelessly to preserve and promote the well-being of humanity.

The role played by FBOs in providing health care and social services in most parts of the world today cannot be gainsaid, and funding to these FBOs are being increased by major donor because of the trust that these donor have in FBOs, as moral institutions. Donors give more to FBOs as oppose to secular organisations, with the conviction that their gifts will go to serve the purpose for which it is intended. Also, the fact that FBOs can have unique credibility and legitimacy with local populations which can help to increase acceptability and use of health care and other services, is an additional feather on their cap, or simply put, an added advantage for FBOs. However, there are concerns that FBOs’ religious ideology may hinder the delivery of certain health care and other services, in that, it may seek to convert people as well as play divisive role.

Social change refers to any significant alteration over time in behaviour pattern, cultural values and norms. There are three basic theories of social change on which sociologist rely namely; evolutionary, functionalist and conflict theories of change. According to evolutionary sociologist, society moves from specific directions, Functionalist sociologist emphasizes on what maintain society and not what changes it, while conflict theory maintains that because a society is wealthy and powerful, it ensure the atmosphere in which social practice and institutions favourable to them continue. Change plays a very important role to remedying social inequalities and injustice. Social change theories are to some degree theories about history, Social change is part of human institution, and human history is very much intertwined with social change. Without social change I am convinced that, human institutions will be static and there will be no room for innovations and advancement, both in human lives and in human institutions. Therefore human history is incomplete without social change, social change is very important for the welfare of human beings. A change in behaviour, cultures and way of life that is, or can be detrimental to human advancement or human society is very necessary, if there is to be development or advancement in human society and welfare.

My work therefore, will focus on change that can alter behaviours; culture and life style of people in societies, changes that can make people to be more exposed to new and useful ideas, be educated, informed and trained to take care of the poor and the needy in their communities, especially the elderly and people with dementia. A kind of change which I think can be affected by FBOs, because of the resources at their disposal.

However, with the government welfare systems falling apart, and becoming more and more incapable and inefficient in executing their duties, there are, and will be an increase in the number of calls for help which will continue to increase the demand for the Christian communities to step forward and provide an alternative to the welfare system that will enhance life changing altitude within communities.

This life changing altitude will help people to understand, accept, accommodate, and support those in need, especially people with dementia and caregivers, who are very instrument to the welfare of people with dementia. Support for dementia patients and their caregiver by Faith- Based Organisations or religious institutions, will go a long way to change the life of both the caregivers and the care-receivers, relieving caregivers from the burden of Care, and paving the way for them to provide quality care to their care- receiver. Informing and educating people about this disease as well as training, and other social service support such as respite service, adult day care, meals on wheel etc., will change behaviours, i.e., changing the altitude of society towards people with dementia and their caregivers making society to accept dementia patients for who and for what they are, instead of stigmatizing and isolating them, it will also challenge certain cultures and notions about this disease and encourage communities to support caregivers in order to enable them provide quality care, for people living with this terminal disease. This new way of seeing things will improve the lives of both the caregivers and the care-receiver tremendously, as well as alter the behaviour and cultural mind set bringing about change in the entire society.

Furthermore, in order to bring about social change, FBOs and the civil societies must be willing to change existing policies and practices as well as develop innovative approaches to the provision of community support services that are really sustainable, flexible, and responsive to the needs of individual caregiver and care-receivers

1.5. Roles of Faith-Based Organisations in promoting social change.

Given that FBOs are the CBOs found in many countries, as well as the fact that they are closer to the grassroots or the poor, they are said to make a positive and outstanding contribution to the achievement of poverty reduction, which brings changes to lives and the societies.

Moreover, their image as a prophetic voice, and an altruistic institution that propound and execute moral values, have made people to trust in them and encouraged donors and volunteers to give their resources and manpower respectively to FBOs knowing that their financial and physical support will go serve the needy, thereby helping to improve and change behaviours, cultures, and beliefs, that stood as a bulwark to human development and human dignity, subsequently bring about necessary change in the society.

Again FBOs, have comparative advantage in societies where religion is important here; they can easily use their spiritual endowment and charitable gestures, to effectuate change in society. A good example of social change during the colonial period in Cameroon was evident with the advent of Missionaries and the opening of schools in this country. History holds that, this brought political, economic and social benefits, i.e. opening of schools, and other services, it brought significant changes; both political, economic and social, which altered beliefs, behaviours and the society as a whole¹⁵. Furthermore, the fact that Faith-Based Communities are more in cooperating than secular organisations, helps FBOs to win support, as well as the contribution of the population in execution of projects which of general interest.

Faith-based organisations can act as a stepping stone for those interested in getting involved in the development sector, because of their links with communities. FBOs it is worth mentioning often share common bases with the communities in which they operate,¹⁶ which implies, it knows how the community functions and is aware of their struggle, with this in mind, FBOs tailors their programme to suit the needs of the community, thereby avoiding waste, and duplication of projects.

Faith-based organizations are very important because, they come in to close certain gaps and fill in loophole left by the state¹⁷. They are very relevant in the community because they facilitate community activities by offering services that goes to serve general interest, this lines from Prof. Cnaan, goes to support that fact: without congregations children currently in day care centers would have no place to go. Without Nursery schools to look after children of working parents, it would have being difficult for such parents to go to work, this I suggest would have been a hindrance to parents who will have to stay away from work to look after their children. Absenting from work will have economic and social impact on the families concerned and society as a whole in that; parents will not be able to pay for necessary goods and services, which will in turn have an impact on their life style, and on taxes which goes to sponsor state projects. But with the help of Faith based or Community based organisations such needs are met, and people can work and have the possibility to live their lives, evolve and also be able to pay taxes needed by the state to be able to run its affairs.

Again there is this believe that people thrive when they are drawn into a Faith community, where they grew spiritually by helping others as well as being helped. The principal of subsidiarity is also very helpful; it encourages and promotes well-being of the poor and marginalized. Religion acts as a motivating factor in that FBOs, Churches and congregation even individuals, are all encourage by their Faith to do good works.

From the above mentioned points, it is obvious that Faith-based organisations play very important roles in bringing change in human societies. The impact of Faith-based organisations can be felt in every aspect of human society, be it in the political, economic and social sphere. Politically FBOs work to see that governments meet their responsibilities towards citizens. As a prophetic voice, it speaks out on the behalf of the voiceless in society and sought to maintain human dignity. Economically, FBOs are offering employment, education and training, which empower people financially, helping them to evolve both economically and socially. Looking at the social aspect, FBOs provides both material and immaterial support to the needy and marginalized in society, enabling them to improve and live a better life.

Besides playing important roles, FBOs also have their own negative aspects, such as being too doctrine conscious, attaching denominational doctrine to service provided, will send away people of different denominational background, thereby discouraging them from using available services. Furthermore, the idea that FBOs often want to employ only people from their own religious background, sends a wrong message to people of other faith, who frown against such approach, and term it to be discriminatory. Too much doctrinal rituals in the running of day to day services, might keep many people from participating in FBOs projects, and hinder them from utilising their services. Furthermore, FBOs lack expertise and enough funding to carry out projects effectively since they rely most often on donations. It means if donation no long drip in, there is going to be a problem on how to complete already existing projects.

However, what I will like to suggest here, is that FBOs while trying to maintain their doctrines, should not let it be the focal point or in the certain of their services and projects, they should seek to be neutral in their services, They should let their services to society be a herald of their mission, which is to extend God’s love and care to humanity. By Caring for the spiritual, and the physical well-being FBOs can bring wholeness in human beings which is what God wants man to enjoy. Their services should act as a message of God’s infinite love to humanity, not a bait to persuade and lull converts into their denomination.

Chapter 2 Dementia: The Journey of Aging

2.1 Dementia, dependence and burden

This chapter will dwell on Dementia, an illness associated to a greater extent to aging, its symptoms, causes, and consequences such as: “dependence and burden”. (Dementia is a disease which cannot be treated), but can only be accommodated by patience and kindness. Furthermore, I will also examine, why this disease among other diseases common to the elderly, is a social issue that needs to be addressed.

The definitions of Dementia are many and varied, but all of them share one thing in common, which is the idea that this ailment, leaves an individual intellectually impaired and dependent on external help in order to be able to cope with routines of daily life. Routines which this individual carried out single handedly prior to his/her ailment.

Dementia has been defined as “an acquired syndrome of intellectual impairment produced by brain dysfunction…which compromises in at least three of the following spheres of mental activity: language, memory, visuospatial skills, emotion or personality, and cognition (abstraction, calculation, judgement and executive Function)”¹⁸ it is also used to describe a group of symptoms that generally include: loss of memory, poor judgement and reasoning as well as changes in an individual’s mood or behaviour.

Dementia has also being defined as a loss of mental ability severe enough to interfere with normal activities of daily living¹⁹, (ADL). Dementia, I will like to add, has to do with the loss of orientation; to time, space, towards one’s self and towards others. This means people suffering from this disease very often cannot locate themselves in time and space. They are disoriented and do not know who they are, and can hardly or sparingly recognise or remember their love ones, talk less of taking care of themselves. This makes the role of care- givers very important; if people suffering from this disease are to enjoy quality life and maintain their God given dignity they need the services or the help of caregivers.

From the definitions above, it is obvious that dementia, is a threat to our identity as selves, and our role as productive, contributing members of the community.²⁰ People suffering from Dementia become a burden to their family and friends because they can no longer carry out their activities of daily living, (ADL) single handedly as they use to do, they have to depend on someone else for everything, This is why Caregivers of people living with dementia are very important, and should be given support, information, education, training, and spiritual help such as; counseling and prayers, by FBOs who are endowed with these resources. Caregivers need support to help them cope with their role as caregivers. This support will enable them provide quality care to their care-receivers, thereby enhancing their dignity even in their present circumstance.

Talking about Treatment of dementia, it has no cure. Dementia is a terminal disease which can be treated by treating the disease that causes it, i.e. for reversible dementia, but for the irreversible type, it cannot be treated. The only treatment that makes sense is patience, kindness and love from family, friends and the community. Only these things can comfort and reassure people living with dementia, that they are loved and cherished in their society.

Moreover, the fact that this disease takes away one’s independence and makes patients to dependent on others, (on caregivers), makes support for caregivers of persons with dementia very important. Support for caregivers of elderly and people living with dementia, have been regarded as a prerequisite to obtaining quality care for such patients. Caregiving is often considered a burden because, it robs caregivers of many things including: their health, free time, jobs, family and finances, therefore in order to have a healthy and productive society, caregivers have to be supported in a way that enable them to maintain their life style and enhance their positive contribution to the society, while giving quality care to their care- receivers.

‘Caregiving is often a solitary journey, characterized by burden, responsibility, isolation and commitment’²¹, in order to make this burden light and enable caregivers give quality care to persons suffering from dementia, whose quality of life depends on the services of caregivers, caregivers need to be supported, and I suggest FBOs has that potential, given their religious roots, their quest to achieve wholeness in human beings, their quest for preservation of human dignity, and the confidence that FBOs have won with donors, volunteers, and the grassroots, who all trust in FBOs, as altruistic institutions and work with them to ensure success of FBOs projects and services. The fact that FBOs acts as intermediaries between man and man, as well as between man and God, Allah, or Yahweh, as might be referred to by the denomination in question, gives it the power that it takes to provide better support services which will go to enhance human dignity.

A look at some symptoms of Dementia will be of great importance, since these symptoms are indications of the presence of dementia, or announce the advent of the disease in a person. Some of the symptoms are: short term memory loss, and difficulties in retaining new information, this are early indicators of dementia,²² coupled with poor judgement and reasoning, as well as changes in behaviour. Besides, Lewy body dementia symptoms are similar to symptoms of Alzheimer’s (AD) which includes: fluctuations between confusion and clear thinking (lucidity), visual hallucinations, and tremor and rigidity²³ (Parkinsonism):

Finally, dementia can be said to be an illness that needs attention, because it touches not just the person directly concerned, but spills over onto family and friends, bringing with it Financial, emotional and physical consequences on both primary and secondary care givers. With increase in the rate of dementia as time passes, if it is not addressed it is going to bankrupt healthcare systems. Therefore to arrest the situation, prompt intervene is necessary. That is why early diagnosis is important, early diagnosis can help people with dementia get the right treatment and support, and help family and friends to prepare and plan for the future. With treatment and support, many people are able to lead active, fulfilled lives²⁴ in this condition. The only way in which dementia can be accommodated since medications can only calm down the spread or progression of this disease, and provide relief; is through patience and kindness’²⁵.

2.2 Different types and causes of Dementia

Alzheimer Disease is the primary cause of dementia, and till date it continues to be the greatest risk factor for dementia. It is a disease that is progressive and irreversible. While Vascular Dementia occurs when brain cells are deprived of oxygen, and blood streaming into the brain is interrupted. Stroke is said to be a common cause. Frontal-temporal dementia, on the other hand involves changes in personality and behaviour with little memory, as an early sign. Lewy body dementia is another type of dementia; which becomes more common as age increases, Lewy bodies are abnormal clumps of protein that have been found in the brains of people with Lewy body dementia, Alzheimer's disease, and Parkinson's disease.²⁶.Lewy body dementia symptoms are similar to symptoms of AD; its unique features include fluctuations between confusion and clear thinking (lucidity), visual hallucinations, and tremor and rigidity (Parkinsonism).

There are so many known causes of dementia which include; Parkinson, pick’s disease, Huntington disease, brain tumor, multiple sclerosis, prolonged alcohol abuse, deficiency in vitamin; thiamin, niacin, or B12, head trauma, Aids, and hypothyroidism²⁷, to name just a few. There are also rare causes of dementia such as: Creutzfeldt-Jakob disease (CJD) and Binswinger’s Disease. CJD is identified by death brain cells, creating a spongy appearance, while Binswanger’s Disease is caused by damage to blood vessels deep in the brain’s “white matter”²⁸ with high blood pressure being the primary cause. As far as dementia is concerned, most types are progressive and cannot be cured. However surgical intervention can help treat some of these causes for example, some brain tumours, excess fluid on the brain (hydrocephalus) or head injury. For neurodegenerative types of dementia, it is important to prevent additional damage by modifying risk factors, such as treating high blood pressure, high cholesterol, type “1” diabetes, and stopping smoking. For the Alzheimer’s disease, which is an incurable type of dementia, medicines can be prescribed that may prevent symptoms getting worse for a period of time. These medications are generally prescribed to people in the early and middle stages of the disease. It is fairly common for people with dementia to have depression as well. There are many treatments for this. Some doctors may prescribe antidepressant medication, or consult a Geriatric psychiatry, or psychiatry of old age, but the best way to treat dementia is through support and care²⁹.

After everything is said and done, the most important type of treatment perhaps is support and care, because our caring love enfolds these people and makes up for the cognitive loss which they suffer.

2.3 Dementia as social issue that needs to be addressed

Dementia is a disease which is irreversible, but which can be accommodated with patience, kindness, support and care. Looking at what caregiving to people with dementia entails, and the consequence of this care on caregivers both emotionally, financially and socially, as well as its effect on the society as a whole, one see the necessity to address this illness. Dementia is a devastating disease not just for patients, but for their families and friends too. And as more people live longer, it is fast becoming one of the biggest social and healthcare challenges. There is an increasing strain on budgets of primary caregivers (i.e. families and friends), as well as on healthcare systems and communities. Something needs to be done to improve on research, diagnosis and treatment of the disease, because of its social and economic impact on those concerned and their family, friends, and to a larger extent their communities³⁰ (David Cameroon, England’s prime Minister).

Caregiving for someone with dementia has significant implications for caregiver’s psychological health, and is a burden.³¹ This burden can as well be physical, emotional, and financial. Apart of the different kinds of burdens listed above, several studies have link care giving to people with dementia to depression or repressive symptoms.

Considering the impact of this disease on the care-receiver, (i.e. intellectual impairment), and the vulnerability that they are being exposed to as a result of this illness, I will argue that addressing this situation by providing support services, information, education, and training³², to care-givers and the public, will help both caregivers and society as a whole to be patient and kind to those living with dementia.³³ Other consequences on caregivers such as: isolation, insufficient energy, worries about the patient while at work, loss of freedom, loss of friends, sleep disruption, and family conflicts,³⁴ can lead to a break down in the health of primary caregivers, and even cripple the healthcare system, if something is not done to put things under control. Therefore considering the effect of caregiving on caregivers, and the fact that dementia is slowly but steadily affecting more people with the passage of time, something has to be done to control it, if not will ground the health machineries to a standstill,³⁵ in that, too many caregivers, may also become patients, and this will have a negative impact, not only on individuals, their family and friends, it will affect the healthcare system, and the economy as a whole. In order to avoid such predicaments and maintain human dignity, something has to be done to address the question of dementia in the world. Premised on the fact that this disease is slowly but steadily taking its toll on the elderly and their caregivers, coupled with the fact that the world’s population is aging dementia research should be an important focal point on the agenda of many countries.

Chapter 3 Faith-Based Organisations as agents Social of Change

This chapter will look at the potentials that Faith-based organisations have, which enables them to provide quality and better services to the needy, and the entire society, especially to the elderly and people living with dementia. I will also explore services by FBOs which help in the promotion of human dignity, as well as talk on what these organisations are doing to help people living with dementia, and their caregivers in Europe (Germany as my example), and compare it with the situation in Cameroon (Africa).

Furthermore, I will examine the politico-social, cultural, as well as look at the religious situation and the role of churches in Cameroon. I will also point out some similarities and different regarding the socio political situation in Germany (Europe) and that of (Cameroon) Africa. I will talk about the religious context and the rule of the churches especially the Roman Catholic Church of Cameroon, which is a major player in the area of social welfare provision and care of the needy in society. Finally I will make possible suggestions as to what FBOs can do to bring about change in the situation of the elderly and people living with Dementia in Cameroon.

3.1 Faith-based organisations and their capability to effectuate social change regarding the case of the elderly and dementia in Europe.

{A}: Looking at the case of the elderly and people with dementia in Europe, I will say FBOs have done much to bring about social change in many European countries. In Europe, precisely in Germany, FBOs have put all their resources into use, in order to be able to come up with support services that have changed lives, and given people living with this disease quality care, hope and the courage to live on in dignity even with dementia. FBOS are doing a great job as far as Elderly care, and care of people with dementia in Germany are concerned. There are many intervention and support services which go to lighten the burden of caregiving, and enable caregivers to give quality care to people with dementia.

In Cameroon the situation is different, most people do not get proper diagnosis in case of dementia, therefore people do not even know what they are suffering form, caregivers are neither informed, educated on the disease, nor trained, they work through instinct. One can argue here that, although FBOs have done well in some countries in the area of welfare service provision and care for dementia and elderly; elderly and dementia care, in other countries like Cameroon, is yet to be taken seriously by FBOs. I want to argue here that this is a case of negligence on the part of FBOs in Cameroon; because they are in the grassroots and am very convinced that they are aware and familiar with this situation, which is very present in communities. FBOs in Cameroon have being in the health care business for long, to have realise the importance of including care of the elderly and dementia patients, in their curriculum. Mainstream Churches who are major provider of welfare services, have provided healthcare services without considering the plight of the elderly and people with dementia in their communities which is not fair. Some research needs to be done in order to understand, the reason for the absent of elderly and dementia care in Cameroon till now. People with dementia in Cameroon, are still left at the mercy of their primary caregivers (i.e. Family and friends), with no support of any kind from anywhere. Primary caregivers have little or no knowledge about dementia and how to care for people suffering from the disease, most often they are financially incapable and overwhelmed with the situation, but with no alternative insight, they have to bear the burden of care giving with its devastating consequences on all aspects of their lives, which makes the situation of even worst. Therefore FBOs or mainstream Churches in Cameroon, still need to extend their healthcare system to include elderly care, and care of people with dementia, this will help change lives, behaviours and promote well-being and human dignity.

{B}: The capability of FBOs in bringing social change to people with dementia.

Deuteronomy 15:11, of the Scriptures (Holy Bible), advocates for open handedness towards the poor in our midst. Poverty in this sense is not limited only to financial or economic hardship; it also means opening our arms and hearts in supporting the elderly and people with dementia, as well as other needy people in the society. Faith-Based Organisations, has left their footprints on the sands of time in area of welfare provision worldwide, and this has given FBOs specific potentials such as: ‘credibility and legitimacy’ among other qualities attributed to them, which have accounted for their success in changing behaviour, beliefs and the environment. An example is their ability to create a stigma free environment³⁶ in some communities, where dementia patients feel welcomed and loved; a social change very necessary for their well-being.

Besides credibility and legitimacy, FBOs also have the other qualities, which gives them an edge over similar secular organisations and accounts for their relative success, these qualities are:

The image of FBOs, as moral and altruistic institutions. The simple fact that FBOs are regarded as belonging to, or as a moral and spiritual institutions with ‘altruistic motives’, makes it to win support from donors, who donates, knowing that their gifts will be used for the intended purpose. These altruistic intentions make it possible for FBOs to win the confidence of donors, who donates generously to support their project making them financially fit to carry out their services.

Again FBOs as ‘spiritual and a moral institutions’ has that potential to counsel, pray for, and with people in difficult situations, encouraging them to be hopeful in their present situation, trusting in a superior being, who gives life and livelihood to all men. Every religion has its own name for this great provider; Christians call him God, Muslims Allah, Jews say Yahweh etc.

FBOs has the quality and credibility of ‘staffs and volunteers’, who may see working with these organisations as a way of serving God, Allah, Yahweh etc., which makes a major difference and accounts for the success of FBOs against similar secular organisations.

Furthermore, the closeness of FBOs to grassroots enhances their relation with the local community and builds a relationship of trust, which enables FBOs to win community support. This popular support, contributes to the success of FBOs services or project.

Again operating in the grassroots among local communities, get FBOs acquainted with the urgent needs of the community and tailor their services to meet these needs.

Also the fact that FBOs have existing structures such as buildings and other resources such as: labour and finance, makes it easy for them to provide affordable and quality services. Their motive of preservation of human dignity and promotion of well-being, rather than profit making, makes people to prefer using their services instead of those of similar secular organisation, and this gives FBOs and edge over its secular competitors.

Finally, Faith-based organisations because of the potentials they are endowed with, play powerful role in advocacy and public awareness in society. This gives them the opportunity to be respected by the state, it has been regarded as an agent of civil society with powers to influence policies and affect decisions, concerning the well-being of Humanity.

Looking at the capabilities listed above, one can contend with the fact that FBOs has that potential to effect change in societies, because of the resources at their disposal. FBOS are capable and able to provide quality and efficient services at affordable prices, to the needy in society and bring change in behaviours, beliefs, as well as in the environment. Though capable of bringing about social change, there are some factors which hinder the success of FBOs, such as: unaccountability of some FBOs, dishonesty, mismanagement of funds, coupled with other factors such as: logistics, cultural, human and natural factors, These bulwarks must be taken into consideration and properly handled in order for FBOs to have complete success in their projects in future.

Dementia is regarded most often as a shameful private issue that concerns only immediate family member³⁷, usually people suffering from this disease are isolated, and locked up in homes, for fear of embarrassing behaviours associated with this illness, they suffer stigmatization from the society as well. Congregations and communities in some parts of the world, through the services of FBOs, have rejected stigma on people with dementia and learn to accept and accommodate them with patience and kindness. This has help to bring them out of isolation and remove stigma, making people with dementia to feel wanted and loved by their community or society. To share in friendship with someone with dementia, we need to learn to be present to them emotionally in a ways that comforts them and gives them joy, and freedom from anxiety³⁸. For dementia is: part of the journey of aging for up to half of us, a bitter but realistic truth.

Churches have become a particular kind of resource in Europe, Africa and other parts of the world where they exist. Churches or FBOs in Europe represent certain values and bring certain qualities to the field of welfare³⁹, where Elderly care, and care of people living with dementia are no exception. In Germany, Greece, Norway and Finland, churches remain the major providers of welfare⁴⁰

I will like to be more specific here, and talk on Care of people with dementia by FBOs in Germany. Majority Churches in Germany i.e. Catholic and protestant Churches, are acting as the primary provider of welfare services,⁴¹ with the state subsidising them. These two Churches, under the canopy of Caritas and Diakonie respectively (FBOs), are doing a very commendable job in providing for the needy, as well as caring for the Elderly and people with dementia in Germany, an example worth emulating in other countries especially in Cameroon.

3.2 The situation of the elderly (dementia patients) in Cameroon

Cameroon like most countries in the world today is facing economic hardship, but things are made even worst because of high level of corruption. ‘Sectors like the police, judiciary, education, political parties, military, medical corps, parliament, religious bodies and media have been singled out as the most corrupt in the country’⁴². Corruption coupled with poverty and injustice, has handicapped the government, making it incapable of standing up to its responsibility towards citizens. The elderly in Cameroon and those suffering from dementia are left completely at the mercy of their families who have to struggle amidst, financial, emotional and physical stress, to care for them. There are no such support systems, as is the case in Germany, dementia patients are being taken care of by intuition, or by using person initiative, with no proper diagnosis, no information or assistance of any kind, talk less of education and training geared towards helping caregivers cope. What keeps these caregivers going is the love that exists between the care-receiver and the caregiver (Family bond). The situation of the elderly and people with dementia in Cameroon is a situation worth revisiting both by the government, and FBOs. The FBOs should step in and provide support services, to help caregiver of people with dementia in Cameroon cope, with the burden of care giving. Geriatric nursing is something very new in Cameroon as indicated by the following lines “A new nursing professional orientation is creeping into and gaining fertile roots in Cameroon. It is the nursing care for the elderly called "geriatric nursing".⁴³ I suggest elderly care or geriatric nursing is something to be encouraged and promoted by both the government and FBOs. The elderly with dementia in Cameroon are not being properly taken care of because there exist nothing like support services for elderly with dementia and their caregivers, which can help them cope with this illness and the challenges that come with it.

For instance caregiver intervention, such as therapy, didactic education, management skills, and training techniques of managing specific problems that exist in most part of the developed world, is yet to reach Cameroon, also intervention for the care-receivers like memory retraining, reminiscence activities and therapy, environmental reality and orientation and general ward activities⁴⁴ are not available to people suffering from dementia in Cameroon, more research is needed in order to better understand the situation of dementia.

3.3 The socio-political situation of Cameroon.

Socially, Cameroon has being eaten by the Canker worm of corruption and the situation has being worsened by poverty and injustice, which is dragging the country to its knees. Like I indicated above, almost all sectors of the country including the social welfare system and FBOs are said to be corrupt, and this has affected their abilities to provide social and other necessary services to the population, Cameroon because of its political and social system, is lacking in government provided social welfare services, and what the FBOs are doing, is not enough to meet public demand, never the less, some important services like care of people with dementia which is gaining considerable attention in other parts of the world , is still unknown to the many Cameroonians even with the presence of FBOs (Mainstream Churches in Cameroon with networking possibilities at their disposal), with tentacles spread all over the world. More research is needed to explain the lack of interest by both the Cameroonian Government and FBOs in the area of dementia care and research, which is very important given the consequence of this disease on individuals, families and on healthcare systems of Countries worldwide.

3.4 The religious situation and the role of churches

Religion in Cameroon takes the following format: Christian religion 40%, Muslim 20%, traditional religion and 40%⁴⁵. Most Christian Churches are found in the western and southern parts of Cameroon, while the Muslim religion is concentrated in the northern region of Cameroon. Churches and Mosques in Cameroon operate side by side in almost every part of the country. There is inter- religious communications, which has contributed to peace and stability in the country.

Mainstream churches in Cameroon namely RCC, PCC and CBC are major players in the domain of welfare in Cameroon,⁴⁶ the only problem is that these mainstream Churches have not expanded their welfare programmes to incorporate care for the elderly and people with dementia in Cameroon, a research on this will be necessary to explain the reason behind this dynamics. I see this as negligence on the part of the FBOs, because they have different medical facilities which they run with different services, like I said, more research should be down in this area to be able to explain the reason behind lack of elderly care nursing services in facilities run by FBOs in Cameroon, I think being closer to the grassroots gives FBOs a firsthand view of this pressing problem plaguing some families in their communities and in the societies which needs attention.

Mainstream Churches in Cameroon function as FBOs. In collaboration with other civil society organisations (CSOs), they have provided welfare services that has impacted the lives of Cameroonians, FBOs and CSOs should work to reconcile and rebuild themselves as equal partners, in order to ensure development of the society⁴⁷.

Besides, Mainstream Churches in Cameroon (FBOs)) has played very important roles in providing welfare services in the country. They have filled the gap left by the government in the provision of welfare services, complemented, and even substituted the government in rural areas in Cameroon. Churches therefore, are and remain important players in Cameroonian scene.

3.5. The contribution of Faith-Based Organisations to elderly and dementia care in Cameroon.

Major Churches in Cameroon namely: RCC, PCC, and CBC own hospitals, and employs Nurses and Doctors, this makes it easier for them to introduce or incorporate elderly care nursing in their already existing schedule. Before beginning with this dementia care projects, Churches should try to sensitise people, especially those at the grassroots by giving them useful information about this disease, its symptoms, causes, effects and possible treatment. This will create a certain degree of awareness about this disease, which many people in Cameroon are yet to know about, and might help the population to know how to handle such situation if it ever prop up.

Again FBOs should educate train and provide possible support services, which will help caregivers with dementia, cope with the burden and stress that comes with the diagnosis of this disease.

Since FBOs stand a better Chance in recruiting volunteers, they should recruit and train volunteers who will move around sensitising and educating people about this illness, telling them where to get help in their community. Volunteers should be trained to give respite and community services, to caregivers of dementia, or work in ADS or memory cafes for elderly, which will give the caregiver a bit of time to relax, go for shopping, met with friends or have some quite moment of their own thereby reducing stress and the possibility of depression, and other health risk associated with caregiving.

FBOs in Cameroon should provide community service centers and networking possibility, which will provide useful information and necessary help to people living with dementia.

If these support services can be put in place by Churches in Cameroon (FBOs), the (elderly) and people with dementia in this country will be properly taken care of by their families and care giver, and they will be given care without constrains, thereby assuring quality life for the elderly and people living with dementia.

Churches in Cameroon are called upon to engage in a respectful way in their activities to society and use their influence, resources and power for the good of the society and humanity⁴⁸ because they are regarded as moral institutions and God’s hand in the world.

3.6. Similarities and differences to Europe regarding the situation of the elderly

What is similar in the situation of elderly and dementia care in Cameroon to that of Europe is the fact that, the elderly in both contexts are being taken care of. Families in both contexts see into it that their elderly and family members with dementia are properly cared for according to the means at their disposal. The difference now lies in their approach or the way care is being given. While in Cameroon caregiving to elderly and family member with dementia, is being done informally and considered a private family affair with no support services available; in Europe (Germany), care for the elderly and people with dementia, is done both formally and informally. With the informal caregivers having variety of support services at their disposal. i.e. both material and immaterial, to enable care-receivers and their caregivers cope with this burdensome and stressful situation.

In most parts of Europe, there are alternatives e.g. When primary caregivers find it difficult to cope with their caregiving roles, care-receivers can be sent to a formal care institution, a situation which is not true for Cameroon since such facilities do even not exist. From this stand point I will argue that, while elderly in Europe are well taken care of both informally and formally, Cameroonians are left to struggle helplessly with their elderly or relative with dementia, they are left with no support from the government, their community or from FBOs. While in Europe (Germany) FBOs of Catholic and protestant churches i.e. Caritas and Diakonie respectively, are providing valuable support services to elderly and people living with dementia and their caregiver, permitting them to live quality life.

3.7. Similarities and differences to Europe regarding the socio-political situation

The political and social situation of Europe (Germany) is different from that in Cameroon in that; there is accountability in the German political system, which curbs down on corruption and permits the government to use taxes to develop the country and provide SNNs and other welfare services to the society. In Germany mainstream Churches i.e. Catholic and protestant are primary providers of welfare services, they are being subsidised by the government. In Cameroon the politico-social scenario is ridden by corruption, which makes it very difficult for the government to actually provide effective SNNs and social security to meet public demands. The similarity between the situation of Germany (Europe) and that of Cameroon (Africa) is that; mainstream Churches in both cases, are primary provider of welfare services with the intention of promoting well-being and human dignity. The difference is that in Germany, Churches receive regular subsidies, meanwhile in Cameroon Churches receive irregular, and minimal subventions from the government for welfare services they provide.

3.8. Similarities and differences to Europe regarding the religious situation and the role of Churches

Comparing the religious situation in Cameroon, to that of Europe precisely that of Germany, I will say it is similar in that, in both contexts there is understanding between different religious institutions. People from different denominational background live and work together in both countries, keeping aside religious differences.

Churches in Cameroon have therefore encouraged their followers to cooperate with people of other denominations considering them friends, not rivals. From this perspective, I contend with the fact that Churches in Cameroon enjoy good relationship with one another and can put their resources together to work for the common good. Unlike in other countries where there is disagreement between Christians and Muslims, Sunni and Shites, Hutu and Tutsi, Buddhists and Muslims. In Cameroon Christians, Muslims and people of other faiths live and work together in peace for the interest of the society, a situation similar to the one in German, where religious tolerance is a common practice.

Churches in Germany like the ones in Cameroon play four very important roles namely: Vanguard roles, improver roles, guardian roles, and service provider roles⁴⁹. In their vanguard role, Churches in both countries play a leading role in pointing out areas of need and giving priority to the marginalized. In their improver role, Churches enhance existing welfare services in order to increase different aspects of its quality, in their roles as value-guardian; they act as advocates for various human values such as preservation of human dignity, equality, peace and justice. Lastly in their service providing role, they provide and harness services that support and promote both spiritual and physical well-being, which are the necessary ingredients for wholeness. (i.e. Spiritual and physical wellbeing), which is God’s intention for mankind.

3.9. Possible goals and measures for such care for the elderly and dementia patients in Cameroon

The possible goals for care, for elderly and people living with dementia in Cameroon by FBOs should be: preservation of human dignity. Extending God’s unconditional love to the needy and brokenhearted, supporting caregivers in their difficult caregiving roles, making it possible for caregivers to give proper care without constrain, and ensuring quality service for people living with dementia thereby helping them cope with cognitive loss and the burden of caregiving.

These goals can be obtained through the following measure: given that FBOs or Churches in Cameroon are already involved in the medical field, they can incooperate elderly care nursing in their curriculum, educate and train professionals to carry on with support services. FBOs should promote and encourage proper diagnosis, information, education, networking and a subsequent follow up to dementia support services.

Furthermore, FBOs should hire volunteers who will help in providing services such as respite, e.g. memory cafe and other services like helping out with ADL. FBOs should also create programmes that involve elderly and people dementia, for the more people come in contact with them, the more they become aware that something like dementia exist, thereby creating some kind of awareness about the disease.

Finally, FBOs should improve on the already exiting traditional style of informal care in Cameroon, while trying to convince Cameroonian of the necessity of the formal elderly care system; it should also introduce support services which resonate with the cultural values of Cameroonians, in order to encourage utilisation of such services.

3.10. Cultural and political setting of Cameroon

Cultural and political settings are very important for the success of any project, therefore elderly and dementia programme or services in Cameroon, should meet the cultural expectations of Cameroonian. It will be therefore good for support service provider to do a research on these issues, and come up with concrete and useful information before carrying out support services and other programmes. For example, building a formal care institution in Cameroon at this moment, will be a waste of resources since it will be underutilized or not used at all, because of the tradition in Cameroon, which associate keeping your elderly away from you or your home, to abandonment. This kind of action brings shame and reproach to an entire family. To be successful with formal care in Cameroon, FBOs have first of all to inform, and educate Cameroonians to get this idea off their heads before they can even think of using Formal Care facilities. Our tradition encourages us to personally take care of our elderly, or relative with dementia. Again, moving your old or sick parent of relative to an elderly care facility will be frowned at even by non-family members as well as members of your community, because it is something that our tradition does not encourage.

Politically FBOs needs to consult with the government, in order to be able to prioritise areas of needs and avoid duplication and waste of projects and services.

3.11. Fitting the religious context and the role of churches, especially the Roman Catholic Church

Cameroon is a country with religious freedom and there is interdenominational cooperation which can be argued contributes to the relative peace and stability reigning in the country today. Like I already mentioned in section 3.8, Churches in Cameroon like churches worldwide play four roles namely: Vanguard roles, improver roles, guardian roles, and service provider roles, all these roles are directed towards promoting and preserving human dignity.

The Roman Catholic Church of Cameroon is a major player, present in almost all aspects of Cameroonian society. Its influence is felt in nearly every sphere of life in this society such as: political, economic and social. The RCC more than other Churches, has stood out very tall in the provision of welfare services in Cameroon, RCC has the potential to reach a wider audience since it is involves a larger part of the population, something that a Pentecostal church cannot do because it is geared towards a small group of people. A kin look at the compendium of 2004 published by the pontifical council of justice and peace at the Vatican, identifies four area of Catholic social doctrine which are as follows: the principle of Human dignity, the Common good, the principle of subsidiarity, and the lastly the principle of solidarity⁵⁰. The Catholic Church in Cameroon therefore works according to this Catholic social doctrine, the aim of all these Catholic social doctrine is to preserve spiritual and physical well-being of humanity. But the principle of solidarity is often presented as the hallmark of Catholic doctrine clearly stated in many Catholic official documents,⁵¹ this principle is based on the idea that society is stratified, therefore; those at the top are obliged to offer help (subsidium) to those at the bottom,⁵² This principle it is evident, falls in line with the Scriptures in the book of Deuteronomy 15:11, which advocates for open handedness towards the poor in our midst, a principle which the Catholic Church in Cameroon is really applying. I say this, premised on personal experience from my local parish, Where People use to give things such as clothes and other necessities to the parish, which in turn gives it to the needy in the community. Also people, who have no one to care for them are being helped by the parish; in that the parish gives money to Christians who are willing to take up responsibility of caring for such persons, a token sufficient just for the up keep of these people, an example that can be improved and developed to a valuable support system by FBOs in Cameroon. Such support activities and other welfare services mostly takes place in parishes or in rural areas. The Catholic Church in German also offer similar support services, but in a more organise and advanced manner through Caritas; a Catholic Faith-Based Organisation. The other mainstream churches, such as PCC and CBC are also doing a commendable job as far as providing for the needy is concerned. I therefore contend with the fact that Churches in Cameroon are very instrumental for the spiritual and physical well-being of Cameroonians, and the preservation of human dignity.

Chapter 4 Final Thought

4.1 Conclusion

Finally, I will like to conclude that Faith-based organisations are very important in our societies today, because of the service they provide to humanity which help preserve human dignity and promote well-being. I will argue that FBOs has not been completely successful in social welfare provision, because their services are under utilised, also the fact that it is directed toward people of a particular denominations stops people from other religious background from using it, furthermore, too much religiosity involved in the services of some FBOs stop some people from using their services, at times services of FBOs become more expensive than government provided service, people instead turn to prefer government services than those of FBOs. In spite of these weaknesses, I can say beyond every reasonable doubt that, FBOs have contributed in preservation of human dignity and promotion of well- Being, through it services. It has changed behaviours, beliefs and the environment, making people to live a better, healthier and more fulfilled life.

A Comparison of what FBOS are doing in Germany (Europe), to what they are doing in Cameroon, (Africa), in the domain of elderly care and dementia leaves one in a dry mouth or speechless situation. More research is required in this area, to explain why the Roman Catholic Church, though universal in its policies, are offering good and quality support services to the elderly and people with dementia in some parts of the world (Europe/Germany a good example), while people in similar situation Cameroon (Africa), and in other part of the world are being neglected. The elderly, people living with dementia and their caregivers in Germany (Europe) are living well and are well taken care of because of the social support services provided by FBOs, while in Cameroon (Africa) where this same FBOs exist, the elderly, people with dementia and their caregivers are left in the cold, with no one to listen to their cry and run to their aid, though FBOs exist right under their nostrils. They are left to bear their burden amidst poverty and economic hardship, this lack of support services is having a negative impact on the primary caregiver, emotionally, physically and economically. I suggest that this issue should be addressed, because it is gradually destabilising individuals, families, communities and society as a whole.

I will furthermore suggest that FBOs make their services open to all, by avoiding activities that attaches it to a particular faith, They should avoid being too religious in their services, so as to encourage others or people with no religion to use their services. FBOs should tailor their programmes to suit the cultural context and situation on the ground in order to avoid conflicting interest. Again, I want to suggest that, FBOs in Cameroon should work together, plan and carry out projects in unison to avoid waste and duplication of services. To be successful FBOs in collaboration with CSOs should be willing to change existing policies and practices, as well as develop innovative approaches to community support service provision, which are really flexible, sustainable and responsive to individual caregiver needs⁵³. Finally I will conclude by saying; though FBOs through their welfare services has given much to societies, that has brought social change, physical and spiritual Well-being and has preserved and promoted human dignity in many societies in Europe and Africa alike, FBOs in Cameroon have to do more, to improve on the situation of elderly and people with dementia in this country. They are to do so, by providing support service both informal and formal that will help change the situation of dementia and elderly care and that of caregivers. Formal service will hardly thrive in Cameroon as of now, because of the cultural context. Tradition in this country demands that people personally take care of their elderly relatives, healthy or sick; it is an obligation, something instinctive one does it happily, without any pressure. Medical attention is very important for all sick persons, but when it comes to assisting with ADL, it is a private and family sphere not open to stranger. The fact that people might not want to share their privacy with stranger is another reason that will put a stumbling block in the formal care system in Cameroon, not leaving out the financial aspect of it. Financially it will be difficult for majority of Cameroonians to afford institutionalisation given financial hardship or level of poverty in the country, coupled with the fact that there is nothing like insurance scheme as it is in Germany to incure part of the cost. My suggestion therefore is that, the only thing that can help Cameroonians in this situation, are support services directed towards informal care for caregivers of people living with dementia, such as proper diagnosis, information, education, training, respite, therapies, counseling and if possible financial support, such as tax reduction on drugs, respite service like (ADS) Center-based adult day care programme services and café for elderly with dementia etc. These support services will help create awareness, improve on the life of care-receivers and caregivers in Cameroon, making the caregiving job not as burdensome as it was before, thus improving on the lives of both caregiver and care-relievers. With such support services available in Cameroon, many Cameroonians may gradually begin to realise the importance of formal elderly care and care of people with dementia, because of the improvement it will bring on the life of both caregiver and care- receiver, and may one day be willing to change their tradition and belief, and accept the formal care system as last resort, when primary caregivers can no longer handle the situation through the tradition informal system. I will contend with the fact that accepting the formal care system or institutionalisation in Cameroon is something that needs time, information, sensitisation and education, for it to materialise. And it will take FBOs which have all the necessary resources, to effectuate social change in the domain of dementia and elderly care in Cameroon (Africa), as it has done in other places, a good example being Germany (Europe).

References

Bäckström, Anders. Davie Grace. Edgardh, Ninna. and Petterson, Per. (2011). Welfare and Religion in 21st century Europe Volume 2. Gendered, Religious and social change, Ashgate publishing limited, Wey court East union road Farnham, Surrey Gu97PT England.

Lochart, Vincent. (1996). Inculturation and Social Change: Among the Savannah Societies of Western Cameroon. New College and University of Edinburg.

McFadden, John. T, Div. (2012). Aging, Dementia and the Faith Community: Continuing the journey of Friendship Wipf and stock publishers 199 W. 8th Ave., Suite 3, Eugene, OR 97401.

Queen, Edward L, 11. (2000). Serving Those in Need. A Handbook for managing FaithBased Human Service Organizations. copywrite@2000. by Jossey-Boss inc.publishers, 350 Sansomestr, San Francisco, California 94104.

L, Sherry. Dupuis. Epp, Tim. Smale, Bryan. (2004). Caregivers of persons with Dementia: Role, Experiences, support and coping. A Literature Review, Murray Alzheimer Research and Education Program University of waterloo.

www.clas-pages.uncc.edu/scott-fitzgerald/files/2011/05/Fitzgerald-2009.pdf. Accessed, 03.07.13.

www.arcworld.org/downloads/cameroon-pcc-summary-sept2011.pdf. Accessed 20.07.13

www.nationalserviceresources.org/filemanager/download/196/F_Definitions.pdf. Accessed 14.08.13.

Robert Wuthnow, (2000). www.press.princeton.edu/chapters/s7703.html. Accessed 14.08.13. www.cup.columbia.edu/book/978-0-231-11624-4/. Accessed 20.08.13 www.mayoclinic.com/health/dementia/DS01131/DSECTION=causes. Accessed. 17.08.13 www.press.princeton.edu/chapters/s7703.html. Accessed 20.08.13

www.nhs.uk/Conditions/dementia-guide/Pages/dementia-treatment.aspx. Accessed. 20.08.13

www.crtv.cm/cont/nouvelles/nouvelles_sola_fr.php?idField=12548&table=nouvelles&sub=n ational. Accessed. 20.8.2013.

www.allafrica.com/stories/201209241550.html. Accessed 20.8.2013.

www.csduppsala.uu.se/devnet/CivilSociety/Outlookserien/2012,%20Faith/FCV_Forje.pdf. Accessed 20.08.2013.

www.medicusmundi.org/en/contributions/events/2009/contracting-crisis/04-case-study- cameroon.pdf. Accessed, 23.08.2013.

Recommended for further reading:

Acton, G J. and Kang, J (2001). Interventions to reduce the burden of caregiving for an adult with dementia: A meta-analysis. Research in Nursing Health.

Adkins, Julie. Occipipinki, and Heffernan, Tara. ed. (2010). Not by Faith Alone. Social services, Social justice and Faith-Based Organizations in the United States. Lexington a division of Rowman and Littlefield publishers Inc. 4501 Forbes Boulevard, suite 200, Lanham Maryland 20706.

Ammerman, Nancy T. (2005). Pillars of Faith: America Congregations and Their Partners. University of California press.

Bernstein, Philip. (1983). To Dwell in Unity: The Jewish Federation Movement In America since 1960. Philadelphia: The Jewish Public Society.

Boddie, Stephanie C. Cnaac, Ram A. (2006).Faith-Based social services: Measures Assessments and Effectiveness. The Haworth press Inc. 10 Alice street, Binghamton, NY 13904-1580.

Bougeois, Michelle., and Hickey, Ellen M. (2011). Dementia from diagnosis to managementA Functional Approach. Psychological press. Taylor and Francis group, 270 Madison Avenue, New York. NY 10016.

Jawad, Rana. (2012). Religion and Faith-Based Welfare: From Wellbeing to ways of being. Published by policy press, University of Bristol, Fourth floor beacon House, Queens Road Bristol B581Qu UK.

Miller, Caroline A. (1990). Nursing for Wellness in Older Adults. Fifth edition. Lippincott

Williams., and Wilkens. 530 Walnut Street, Philadelphia PA 19106. Printed in China.

Silverstein, Nina M. Maslow Katie. Ed. (2006). Improving Hospital care for persons with Dementia. Springer publishing company, Inc. 11West 42nd street, 15th floor, New York, NY 10036-8002.

Unruh, Heidi Roland. Sider, Ronald J. (2005).Saving Souls, Serving Society: Understanding the Faith Factor In Church-based Social Ministry. Published by Oxford University Press Inc. 198 Madison Avenue, New York 10016.

[...]

---

¹ www.arcworld.org/downloads/cameroon-pcc-summary-sept2011.pdf.

² John T, McFadden. M, Div. Aging, Dementia and the Faith Community: Continuing the journey of Friendship, Wipf and stock publishers 199 W. 8th Ave., Suite 3, Eugene, OR 97401 2012).p.6

³ Edward L. Queen 11, Serving Those in Need. A Handbook for managing Faith-Based Human Service Organizations,copywrite@2000,by Jossey-Boss inc.,publishers, 350 Sansomestr, San Francisco, California 94104(2000).p.12

⁴ www.medicusmundi.org/en/contributions/events/2009/contracting-crisis/04-case-study-cameroon.pdf.

⁵ http://www.cliffsnotes.com/sciences/sociology/social-change-and-movements/social-change-defined.

⁶ www.clas-pages.uncc.edu/scott-fitzgerald/files/2011/05/Fitzgerald-2009.pdf. p.414

⁷ Sherry, L. Dupuis. Tim, Epp. Bryan, Smale. Caregivers of Persons with Dementia: Role, Experiences, Support and Coping. Murray Alzheimer Research and education program university of waterloo,( Marep 2004).p.74.

⁸ http://press.princeton.edu/chapters/s7703.html..

⁹ www.clas-pages.uncc.edu/scott-fitzgerald/files/2011/05/Fitzgerald-2009.pdf. p.416.

¹⁰ Ibid P.416.

¹¹ https://www.nationalserviceresources.org/filemanager/download/196/F_Definitions.pdf.

¹² http://press.princeton.edu/chapters/s7703.html.

¹³ http://www.cup.columbia.edu/book/978-0-231-11624-4/.

¹⁴ www.csduppsala.uu.se/devnet/CivilSociety/Outlookserien/2012,%20Faith/FCV_Forje.pdf.

¹⁵ Vincent, Lochart. Inculturation and Social Change: among the Savannah Societies of Western Cameroon. (New college, University of Edinburg. 1996). p.49.

¹⁶ Religionanddevelopment.org/resourcemodule/@random454f80f60b3f4/128438599_civicus_rep.

¹⁷ Anders, Bäckström. Grace, Davie. Ninna, Edgardh. and Per, Petterson. Welfare and Religion in 21st century Europe Volume 2. Gendered, Religious and social change. Ashgate publishing limited, Wey court East union road, Farnham,, Surrey Gu97PT England,2011). Pp. 34-37.

¹⁸ Sherry, L. Dupuis. Tim, Epp. Bryan, Smale. Caregivers of persons with Dementia: Role, Experiences, support and coping, A Literature Review, Murray Alzheimer Research and Education Program University of waterloo, 2004) p.1.

¹⁹ www.medical-dictionary.thefreedictionary.com/Dementia

²⁰ John T, McFadden. M, Div., Aging, Dementia and the Faith Community.p.6.

²¹ Sherry, L. Dupuis. Tim, Epp. Bryan, Smale. Caregivers of persons with Dementia. p.56.

²² John, T. McFadden. M, Div., Aging, Dementia and the Faith Community p.15.

²³ Sherry, L. Dupuis. Tim, Epp. Bryan, Smale. Caregivers of persons with Dementia.p. 77.

²⁴ www.nhs.uk/Conditions/dementia-guide/Pages/about-dementia.aspx.

²⁵ John T, McFadden. M, Div., Aging, Dementia and the Faith Community .p. 19.

²⁶ www.mayoclinic.com/health/dementia/DS01131/DSECTION=causes:

²⁷ www.//medical-dictionary.thefreedictionary.com/Dementia.

²⁸ Sherry L, Dupuis, Tim Epp, Bryan Smale, Caregivers of persons with Dementia pp.77-78.

²⁹ www.nhs.uk/Conditions/dementia-guide/Pages/dementia-treatment.aspx.

³⁰ www.gov.uk/government/news/uk-to-use-g8-to-target-global-effort-on-dementia.

³¹ Ibid.p.13.

³² Sherry, L. Dupuis. Tim, Epp. Bryan, Smale. Caregivers of persons with Dementia p.22.

³³ Ibid.p. 15.

³⁴ Ibid. pp.22-27.

³⁵ Mcfadden.p.18.

³⁶ John T, McFadden. M, Div., Aging, Dementia and the Faith Community.p.17.

³⁷ ibid .p14-15.

³⁸ Ibid.p.13

³⁹ Anders, Bäckström. Grace, Davie. Ninna, Edgardh. and Per, Petterson. Welfare and Religion in 21st century Europe Volume 2.p.57-58.

⁴⁰ Ibid.pp.57-58.

⁴¹ Ibid.p.34.

⁴² www.crtv.cm/cont/nouvelles/nouvelles_sola_fr.php?idField=12548&table=nouvelles&sub=national.

⁴³ www.allafrica.com/stories/201209241550.html.

⁴⁴ Sherry L, Dupuis. Tim, Epp. Bryan, Smale. Caregivers of persons with Dementia p. 50.

⁴⁵ www.state.gov/j/drl/rls/irf/2006/71290.htm.

⁴⁶ http://www.medicusmundi.org/en/contributions/events/2009/contracting-crisis/04-case-study- cameroon.pdf.

⁴⁷ www.csduppsala.uu.se/devnet/CivilSociety/Outlookserien/2012,%20Faith/FCV_Forje.pdf.

⁴⁸ Ibid.

⁴⁹ Per, Petterson. Majority Churches as Agents of European Welfare: A sociological Approach .p.33.

⁵⁰ Anders, Bäckström. Grace, Davie. Ninna, Edgardh., and Per Petterson, Welfare and Religion in 21st century Europe Volume 2. PP.111-113.

⁵¹ Ibid.p.113.

⁵² Ibid.p.114.

⁵³ Sherry L, Dupuis. Tim, Epp. Bryan, Smale. Caregivers of persons with Dementia.p.74.