Amar Astha: Solving the caregiver crisis

On the night of October 10, 58-year old Rawshan Ara Khanam tested positive for the novel coronavirus. The next morning her oxygen level dropped alarmingly and her daughter Mahmuda Rahman rushed her to Kurmitola General Hospital. 

Doctors put Rawshan Ara on oxygen and told Mahmuda that her mother needs to get admitted to the hospital. Mahmuda did as she was told. 

At the hospital, she found herself in a fix. She was required to stay at the hospital as an attendant, but she also had a family – her husband, two sons and her father - to look after back home.  

"It was extremely difficult for me to care for my mother under the circumstances. All-day long I was with her, but kept thinking what will happen to her as there was nobody to look after her in my absence," Mahmuda recalled. 

One night, another patient's attendee told her about Amar Astha, a startup that is providing caregiving service for Covid-19 patients. He also provided a phone number. 

"I called the number and requested an attendant. A woman arrived within an hour," Mahmuda said, adding that the woman stayed at the hospital for 18 days till Rawshan Ara was discharged. 

Like Mahmuda, many people who badly needed caregivers for their Covid-19 infected family members relied on Amar Astha, a technology-enabled company that is providing caregiving services.

To care for a Covid-19 patient, a client must hire the attendant for at least 15 days and pay Tk37,000. The attendant will serve the sick person 24 hours a day, irrespective of whether it is at the patient's home or at the hospital.   

However, for a non-Covid-19 patient, a 24/7 caregiver's charge would be between Tk 30,000-40,000 for a month. Both male and female caregivers are available. 

 
The company also provides babysitters and nannies, home diagnostic services, oxygen cylinder for rent and physiotherapy, occupational and speech therapy at the client's home.    

To access the services, a person can use the Amar Astha app, their website or hotline number. 

Amar Astha started its journey in December 2018, with two services: babysitter and caregivers. In its second year, until the outbreak of the novel coronavirus in Bangladesh, the company was seeing high growth. 

"Every day we were getting four to five requests for babysitters. At the same time, the number of job requests was also increasing. Many young people were reaching out to us for jobs," said Shariat Rahman, chief executive officer of Amar Astha. 

How it all started? 

After graduating from BUET in industrial engineering, Shariat Rahman went to Germany to study bionics. 

Returning in 2016, Shariat joined hands with a doctor from Dhaka Medical College Hospital to make medical software applications. He soon found it tough to work with him.   
     
He quit the project and decided to do something on his own. An alumni, Javed Iqbal from BUET, gave him the idea of launching caregiving services and soon after, Amar Astha was born.  

"My senior told me that there is a high demand for babysitters and caregivers in the country," Shariat said. 

He opened a Facebook page and started advertising online to get clients and potential service providers. The first order came from one of his friends for a caregiver to look after his mother.  

"At the time, I had no office. One day in December 2018, a woman from Demra reached out to me after seeing my post on Facebook. She needed work and I needed someone to care for my friend's mother," Shariat recalled. 

"I spoke to her and also verified her documents. Then I recommended her as an attendant to my friend's home as a caregiver. She is still working for my friend's mother. My friend still sends me a commission every month," said Shariat. 

Currently, more than 100 people are working with the company to provide caregiving services.  

"We send nurses at the patient's home to provide services like injection, dressing, catheterisation and canula," said the company officials. 

Babysitters, nannies, psychotherapists, occupational therapists and speech therapists work for Amar Astha as freelancers. The company takes a commission from the client. Nurses and attendants work as the employee of the company on a monthly salary. 

The monthly package for a babysitter is Tk11,500, for taking care of one child.  

The company pays a babysitter Tk10,000 a month and it takes a commission of Tk1500 from the client.    

"If they have to take care of two children, the client will pay Tk13,000. The company will get Tk1,500 as commission. The rest of the money will go to a babysitter or nanny," said Shariat.    

"The demand to become a babysitter and nanny is high. They mainly come from two sectors, those who worked for daycare centres and who came from middle-eastern countries like Saudi Arabia. They are very skilled. The age range for babysitters is 20-40, and they must be married," Shariat said. 

The minimum qualification for a babysitter is Class VIII graduate, and they have to know proper etiquette and good manners. 
 
"It needs patience to be a babysitter," said Shariat, adding that seventy babysitters were working before the pandemic. Now there are around 20 babysitters available.    

Shariat said they emphasise on the security of the client and the caregiver. Hence, they stress on the identification of the service providers. The company officials look into every NID and cross-check the authenticity of the documents. They also visit the caregiver's address. 

On the other hand, the company asks the client to make sure that the caregivers, especially babysitters are not alone in a house. Someone from the family has to be present at the house when the caregiver/babysitter is providing services.

The minimum qualification for becoming a caregiver is SSC graduate, and nurses will have to have a medical assistant and community paramedics, diploma doctor and diploma nurses' courses for the job.

"If someone wants to work as a caregiver, we train them for two months. All the expenses of the training has to be borne by them," said Shariat.

The company also provides home diagnostic service. It has a partnership with Thyrocare Bangladesh Limited, a Mumbai-based chain of diagnostic and preventive care laboratories. 

They collect urine and blood samples from home. After diagnosis, it sends test reports through email or home delivery. 

The company also provides medical oxygen cylinders for patients at home on a 15-day and monthly rental basis.