On the Road and on their Own: Autonomy and giving in home health care in Quebec

The reorganization of health care in Quebec, as in the rest of Canada, has helped reinforce inequities based on gender, race, ethnic status, etc. in employment in this field. Home health care workers in Quebec, called auxiliaires, are mostly women, frequently immigrants, and often immigrant women of colour. Their jobs are low status and badly paid, yet auxiliaires express a high degree of attachment to the work and find it highly rewarding. We suggest this is largely due to the worker's mobility and physical distance from the institutions that employ them; this allows them considerable autonomy and gives them the freedom to provide service beyond the requirements of the job. Drawing on recent analyses of Mauss' notion of the gift, as well as Tronto and others, we look at 'giving' in home health care, and its implications for the workers.