"We are the ones who get into every household concerned without notice" – Aranka Szabóné Kurucz, a health visitor, always puts the child first
"I am the one who protects the children", says Aranka Szabóné Kurucz, who has been helping the everyday life of families for three decades. As she talks about her job it is clear that, despite the difficult stories, she is still enthusiastic about what she does. This unwavering dedication may also have contributed to the fact that her service as a health visitor has been honoured by the Mária Steller Award this year.
Tell me a bit about the village of Tokodaltáró! What does your district look like? I can see that you drive, even though I imagined you on a bicycle. Are there dangerous roads, stray dogs, or drug dens around here?
Next year I will have been working here for thirty years. When I came here, I had to apply for the job. The population was completely different then. Tokodaltáró started out as a mining settlement, and the council at the time built 'six-flats' for the families of the settling miners. Each of these houses has six flats, one and a half rooms each. Later, the Esztergom municipality bought most of these flats and the inhabitants of a former Roma slum moved in. Four streets are now made up of those 'six flats', the most difficult part of the village for me. Tokodaltáró is still a peaceful little village close to nature, and although I loved the hustle and bustle of Pest when I was younger, it is now this place where I feel at home. Our only claim to fame used to be the so-called 'Polish Market', which still functions as a local market. There are many factories around us, and everyone who wants a job can find one here. I like the fact that the town is so pleasantly 'in one', with no disconnected, separate parts. This is reflected in the atmosphere, too.
Why did you choose this career? What attracted you to it, what did you see in it?
I come from a religious family, there were always lots of related children running around in our home, and as a young girl, I could bond with them. I couldn't be a nursery school teacher, because at my time it was a requirement to play some sort of musical instrument to be admitted into the college for nursery school teachers. Our health visitor in my village was my role model and I talked to her a lot, so I chose this profession. Since then, I have had three sons and seven grandchildren, we live close to one another, so I still spend my life with children. My husband and I are always open to our grandchildren, we never say no to having them. Sometimes we go away for 2 or 3 days alone, just the two of us, and then we are a bit unavailable, but when we are at home, we are very busy every day.
I'm also a volunteer firefighter in our village, but it's also a "family business", where I'm in charge of event organization.
That's what I feel comfortable with.
How did you gain respect as a health visitor? Did you struggle with this initially, or is it more of a partnership between you and the families you are responsible for?
When I first came here, the good thing was that I was the same age as the pregnant mums at the time. But now the advantage I have is that I have children and grandchildren of my own, and I have a lot of experience both as a mother and as a health visitor. There are rules for official case management in the work of a health visitor, such as how many times I notify someone of a vaccination or when I send a reminder letter. I prefer to discuss these things, to resolve them in a nice way, that's what I am like. In some cases, threats are not the best way to achieve success, and building and maintaining trust is a better tool. Trust then makes it possible to discuss why someone did not come in, or what was holding them back. In the end, I always managed to find a way to get them to come in. If a mother tells me that there are no shoes or bed linen in the house, we work it out together, I have a good relationship with the family support service and the local Red Cross. I never felt I had to fight for respect, I hope my visits are also opportunities.
Being a health visitor is a colourful, multi-layered profession, combining health care, child welfare, and social services. How do you balance this?
There are some families where, unfortunately, the child is in danger of being removed from the home, where my role of monitoring and controlling is more important. This is a difficult role. I reinforce in myself that it is the child who is important, that they are the essential ones. It is not the child's fault if the parent treats them miserably or does not provide them with opportunities. Usually, these parents don't realize that they are doing their child harm. My motto is that I am here to protect the child and I am the one who protects the child's best interests. Fortunately, I am no longer the one to suggest a removal, but I do have a duty to report the circumstances.
Twenty years after such removal, a now grown-up boy sent me a friend request on Facebook and showed me the kind of life he had been given a chance for.
Today, he is in a happy relationship, in a good financial situation, has a job, and has good values. I often think of that.
What does a typical day of yours look like? Which part do you like best?
Not all my days are the same, and I'm happy to be the one to manage my time. I have fixed consulting hours, but I am relatively free to move around. Since Covid, we have kept the habit of people coming to me by appointment and I let them know if I go out to visit a family, unless I stop by someone's house unexpectedly for a reason. The health visitor status checks are time-consuming, but it's worth taking the time and not putting the next baby on hold. Of course, what I like best is when I have success. I once helped with an adoption, which was a great joy for everyone. It also gives me pleasure when a screening test leads to a baby getting to early development sessions or receiving timely medical treatment.
What are parents and mothers asking for help with today? What problems are they facing?
Even with all the information available on the internet, there are still a lot of questions, and I'm happy to be asked. We always talk about the birth, what to take to the hospital, and the physiological effects after the birth, and I try to prepare them for what they will have at home. Is it possible to have a normal birth after a C-section? What effect can pregnancy have on different illnesses? When to set off for the hospital, or when to call an ambulance? Do I need to bring a marriage certificate to the hospital? How much bleeding should I expect? When will the paediatrician come to see the baby? There are so many questions that the books don't answer.
The role and methodology of a health visitor have changed during your time in the field. How do you relate baby-lead weaning (BLW), carried babies, or Elimination communication (EC)?
Nowadays, health visitor care is more personalised, we don't visit every family with the same frequency, since not all families need close care. Our methodology has changed as scientific knowledge has changed, for example, about the principles of feeding. There didn't use to be so many food allergies and intolerances, and the know-how of childcare is responding to that. I can be flexible with new trends, and my family keeps me up to date on that. My daughter-in-law is doing BLW with my granddaughter, I did some research and found it to be professionally recommended. I have seen it work in practice. I also like the EC, my granddaughter grew up with that with no problems.
Did you have any requests from your clients in the course of your career, such as a baby club, a safe start nursery or a music club? Have you added such activities to your portfolio?
Yes, because it is important for mums to have a community. We started a mum and baby club at the initiative of the health visitor, and I was very involved in that, and friendships were formed in the club, and it was a real success story. But families have changed a lot since then, they are more afraid of catching something since Covid.
The expectations have also changed, and recently I have seen mothers scrolling on their phones during the club sessions, thinking that the organizers are looking after their children.
But that’s not what it should be about.
Have you ever thought that baby care could be a school subject? How much do mothers learn from home?
I have even found a name for it, "family life education". For example, recognizing abusive situations, contraception, sex life, and baby care – these are areas where there is a lot of ambiguity, while children know the formula for quadratic equations. I did what I could here, locally, and whenever I had the opportunity.
How do you reach fathers? Are they target audiences for you, too?
Nowadays, fathers are also attending antenatal consultations, more and more fathers are present at births, and more and more often I have visits where the father tries to attend. I praise them very much, although I think we shouldn't expect the dad who works all day to take the baby to the health care consultation sessions while the mum is at the nail salon.
The network of health visitors is an incredibly well-organized institution. What else do you think it could be used for?
I think that we are the ones who get into every household with young children without notice, and that is an important, albeit humbling, privilege. It is a huge opportunity for children, for parents, and for the whole family. When I visit a home, every member of the extended family comes to me with their health and social issues, as I thoroughly know the care system. I also think that the opportunities for community building are very important, and I would like to strengthen that as well.
Established in 2020 by Three Princes, Three Princesses Foundation, and the National Center for Public Health, the Mária Steller Award recognizes dedicated health visitors who have supported families with young children through their outstanding professional work. The award is given to one health visitor from each county and the capital.
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