For 11 and a half months, for 24 hours a day, every day, we had a paid carer in our home. I travelled a bit for work, and Louise and I went away for a weekend when our friend Sharon Kleintjes, who herself has cared for many people in her family, insisted that she move in for the two days so we could have a break. Apart from that, we had carers in the house. The first thing that needs to be said about this, and it's really important that it is said, is that we were enormously privileged to have these carers. The vast majority of families in the world who care for sick and dying people do not have any help at all in the home. A not insubstantial number of women in these families will work as carers for wealthier families, and after a full day's work will return home to start caring for their own relatives.

In a huge and growing international industry, some women will travel across the world to wealthier countries to look after sick, disabled and dying people, leaving their own sick, disabled and dying families at home. Tied up with their care of rich people is their abandonment of their families; tied up with their abandonment of their families is often the best way they can care for those families – by earning in a strong currency and sending remittances home. The layers of this are obvious, and why, with all the international concern about human rights, we are not more concerned about this is something that troubles me.

While I was writing this book, the popular and well-regarded author Deborah Moggach published a novel titled The Carer. I have not seen a bad review of this book, and I have seen many very favourable ones in good publications. I must be the only reader who found it brittle, formulaic and, though funny and well written, ever so slightly sanctimonious. But then, I have skin (and a lot of it) in the game. The third paragraph of the book reads, in its entirety: