Editorials

OAKLAND – Before the sun came up, Grace Manawatao had driven more than 45 minutes to Nancy’s home in East Oakland. She donned rubber gloves almost as soon as she walked through the door, and went to work stripping the bed linens and scrubbing the floors with disinfectant. 

While Manawatao bustled around the small bungalow, Nancy, who asked that her real name not be used, sat in an armchair eating the heaping portion of sliced hotdogs and green beans Grace cooked for her the night before.  

“Mmm, Grace you sure are a good cook,” Nancy called out as she cleaned her plate. “Sometimes she even makes me Filipino noodles.” 

“They are called pansit, I told you,” Manawatao yelled from the kitchen. 

“Well, without her around I would have to eat cold peanut butter or bologna sandwiches,” Nancy said. 

At $7.82 an hour, Manawatao’s job is one of millions of minimum-wage jobs that exist at the margins of the booming economy: they’re more stable because of the tight job market, but wages have yet to rise and health benefits are still only promises. But it’s hard to imagine Nancy’s world without Manawatao. 

Nancy, 62, is disabled by arthritis in her legs and hip and has not left her house for over a year. She is diabetic, has a heart condition, and is medically obese. She said that she shuns contact with friends and family because she is so embarrassed by how she and the house look. After her adult son decided he didn’t have time to both work and look after her, Nancy has gone through a string of health care workers.  

Most only lasted only a few weeks after they realized how much dirty work was involved, she said.  

“I can’t cope by myself at all, I need someone here two times a day to change my bedding or else I have to lie in my own wet,” said Nancy, who is incontinent. “I used to cry myself to sleep at night asking for the Lord to send someone to help me.” 

Then, the county’s health care workers union sent Manawatao.  

The 49-year old said that she cares for Nancy in two daily shifts, and often calls her at the end of the day to make sure she remembered to wash and take her medicine. Twice a week she also works for an 80-year old woman suffering from Alzheimer’s. And three days and two nights every week she earns $8 an hour on call for Rapid Response, a replacement service for home health care attendants who can’t make it to work.  

If her work schedule seems tight, Karen Orlando, a union organizer for Local Service Employees International Union 616, says that Manawatao is actually one of the lucky providers of home health care.  

“There is a 50 percent turnover rate for home care workers. A lot of these people are very marginal,” Orlando said. “Grace is a very skilled and educated worker. Most of them are living on the fringes. One late check and they’re homeless.”  

Manawatao, who is single and rents an apartment in Alameda, has been working in the health care industry since she arrived in the United States from the Philippines in her late twenties. Her first job was in a convalescent home, earning $1.99 an hour to care for more than 17 patients at a time. She worked the night shift and went to school at Hayward State University during the day, studying to become a dietitian. Eventually the stress became too much, and she decided to earn 

a medical assistant certificate and devote herself to caring for the elderly and the disabled. 

“I’ve been cleaning up after other people since I was a girl, helping my mother with my nine siblings,“ she says as she dumps soiled sheets into a washing machine and folds and sorts clean clothes. “In the Philippines, there are no convalescent homes. We don’t isolate our old or sick people. My mother took care of my grandparents, and I helped her to do it,” she said. “That’s why this work is familiar to me and I enjoy it.” 

Manawatao’s only complaint is the lack of health benefits. More than 7,500 unionized home health care workers in Alameda work in the homes of an estimated 8,500 low-income patients. They have been battling the county for a benefits package and pay raise for years. Gov. Gray Davis made something of a breakthrough last month when he agreed to pay $7 million to cover a portion of the benefits long as the county came up with $1.5 million out of its own funds. 

Where this money will come from is unclear. Orlando said that the tobacco settlement is a likely source, but the union has to compete with many different kinds of health programs to get a piece of it. She does not expect any results until at least January 2001. 

Meanwhile, Manawatao, the union secretary, continues to cross her fingers and hope she doesn’t catch anything serious. 

“With our new contract I make more money than I used to, but I still can’t afford my own health insurance,” she said. “When I get sick I have to take time off work to go to Highland Hospital, and that takes all day because the lines are so long.” But despite the low pay and lack of health care, Manawatao said she would not do anything else.  

“With this kind of job, your patient tells you when you do it well. That is invaluable. There is no price for that feeling that they need me and love me. I feel like I belong here,” she said.