The clinic that makes people sick

2013-05-26 14:00

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Three tents, no electricity, a single tap that often runs dry and a stinking pit latrine. Welcome to Lusikisiki Village Clinic in the Eastern Cape, where patients are ashamed to be treated. Zinhle Mapumulo visited the clinic with photographer Leon Sadiki

Nomawethu Fica looked around the tent in which she was sitting, surrounded by neighbours and strangers, and decided not to tell the nurse what was really ailing her.

If she did, she thought, she would be mocked. Everyone could hear every word.

But when she realised her infection was getting worse, 38-year-old Fica returned to the tent, grimly determined to tell the truth.

“I was prepared to face the shame and gossip that might come. I don’t care how people see me afterwards, because this is my life,” she says.

This is Lusikisiki Village Clinic, a facility in the Eastern Cape’s OR Tambo district. The district is piloting government’s National Health Insurance (NHI).

Clinics and hospitals that are part of the project are supposed to be clean and well-stocked with medication. Patient safety is one of their priorities and patients must not spend hours in queues.

Lusikisiki’s village clinic fails on all counts.

The trouble started on January 3, when the clinic was evicted from its premises in Lusikisiki’s town centre.

The provincial department of health had allegedly not been paying the rent. Three tents and a mobile unit were set up on a plot of land a few kilometres away. The tents were supposed to be temporary, until the arrival of bigger mobile units.

Eastern Cape health department spokesperson Sizwe Kupelo confirmed they were aware of the situation at the clinic.

Kupelo said no decision had been made about whether a new clinic would be built, or more mobile units would be sent to the current site to replace the tents.

Nearly five months on, the clinic still looks more like a refugee camp than a place of healing.

On Wednesday and Thursday this week, queues snaked from different corners of the three tents. The biggest, in which nurses are stationed, is entirely open-plan. Privacy isn’t an option, so physical examinations are not performed.

There is no electricity and a single tap, which patients say often runs dry.

Nurses and patients share a filthy pit latrine, crawling with maggots.

Boxes of medicine and cabinets jammed with files clutter the small mobile unit, which doubles as a pharmacy and consulting area for pregnant women.

“Clinics are supposed to help sick people get better, but this one makes people get worse,” says Nonzaliseko Ntwana, the branch organiser in Lusikisiki for the Treatment Action Campaign (TAC).

“People are afraid to disclose their medical problems and end up returning home without receiving proper attention.”

Ntwana says the lack of privacy and “forced disclosure” means fewer people are coming to be tested or counselled for HIV.

Nophumzile Nokoweni from Mevana AA in Lusikisiki Village, Eastern Cape, walks more than an hour to Lusikisiki Village Clinic for treatment. She is among many villagers who are forced to disclose their medical problems in front of other patients as there is no privacy. Picture: Leon Sadiki/City Press

The TAC’s small support group has also suffered. It holds meetings on Tuesdays and Thursdays – the first for anyone who wants to attend, the second only for those who are HIV positive.

At the old building, the Thursday meeting was held in a private room. Now it happens in an open space behind one of the tents and attendance has dropped from more than 30 people on Thursdays to about 10.

Ntwana says: “Once other people see you going to the support group, they immediately know your status. So those who have not yet disclosed to their families and the public have stopped coming.”

Medicine shortages are common, which infuriates patients who must return again and again to check whether the drugs they need are in stock.

One such frustrated patient is 24-year-old Nobuntu Mzonyana, who says on Thursday she is returning to the clinic for the third time in two weeks for antibiotics.

“You stand in the queue for hours and when it’s your turn, you are told there are no drugs,” says Mzonyana.

Vaccines are also in short supply. The lack of electricity means vaccines are kept at the Lusikisiki Gateway Clinic about 10km away and a limited number are brought to the village clinic each day in a cooler box jammed with ice packs.

Nolwakhe Qathukile (25) must travel for an hour to reach the clinic.

She says walking such a long distance with her 15-month-old baby, only to be told to return the following day, makes her angry.

Nolwakhe Qathukile walked an hour to the clinic to vaccinate her 15-month-old baby, only to be told to return the following day because the clinic was out of vaccines. Picture: Leon Sadiki/City Press

Some people try their luck at Gateway, but say that when nurses there learn they are usually treated at the village clinic, they are turned away.

Mzonyana says: “Once the nurse sees the card is from the village clinic, they tell us to go back to our clinic as they have their patients to treat. We are caught between a rock and a hard place.”

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