Aids - SA's biggest failing

2004-04-26 15:58
Cape Town - Sindiswa Moya buried her boyfriend when he died of Aids. Now the former policewoman is battling for her own life.

In an open letter to President Thabo Mbeki, Moya made a desperate plea for medicine. "My immune system is weak and I am running out of time," the 34-year-old wrote in the Sunday Times newspaper.

But Health Minister Manto Tshabalala-Msimang has asked South Africans to be patient, saying the government needs time to roll out a treatment programme it promises will be the world's largest and most comprehensive.

In a decade marked by dramatic political and social reform, activists protest the government's slow response to the Aids crisis has been one of its greatest failings.

Ten years after all-race elections ended close to half a century of oppressive white rule, the Aids epidemic is proving deadlier than apartheid at its zenith.

The disease is killing at least 600 people a day, decimating the work force, destroying families' earning power and creating a generation of orphans. No country has as many people infected with HIV - an estimated 5.3 million of 45 million people.

While millions are being spent on HIV prevention, Mbeki's government for years resisted providing life-prolonging, anti-retroviral drugs, citing safety and cost concerns.

Doctors furious

Furious doctors and activists have dubbed his health minister Dr Garlic for preaching the benefits of garlic, olive oil and traditional medicines as remedies against the virus.

"That really caused confusion, pain, paralysis in implementation and policy for five years - at an enormous cost in terms of new infections and a serious death rate," said Zackie Achmat, 41, leader of the Treatment Action Campaign.

Achmat, who has been nominated for a Nobel Peace Prize, found out he was HIV-positive in 1990. But he refused to take anti-retrovirals until last August, in solidarity with the estimated half million with advanced Aids symptoms who can't afford treatment.

Under mounting public pressure, the government approved a plan in November to provide the medicines free to all who need them within five years.

But Tshabalala-Msimang warned Aids sufferers that it could take years to upgrade health facilities neglected under apartheid, hire and train staff, and negotiate contracts to supply the drugs.

By braving the stigma still associated with the virus, the ex-policewoman Moya has found a sponsor to pay for her treatment until it becomes available at her clinic in Soweto.

She is one of the lucky few. Fewer than 3 000 patients have started treatment at a handful of hospitals under the government's programme.

For most in the squalid black townships, the disease remains a death sentence - destroying any hope they once had for a brighter future after apartheid's end.

Waiting for a miracle

On the outskirts of Soweto, a 27-year-old who gave her name only as Phumzile can only hope for a miracle. When her boyfriend died two years ago, she moved into her mother's rusting shack. Weak and emaciated, she spends her time resting on a damp mat on the floor.

Community volunteers bring her food parcels, but her brother usually steals them. She worries about her two young children, the eldest of whom has missed months of school because she couldn't afford the fees.

"I didn't think my life was going to be like this," Phumzile said.

The epidemic is undermining what would have been impressive gains in universal health care.

For decades, most blacks went without basic care in a country that pioneered heart transplants in the 1960s.

Under the new government, more than 900 clinics have been built or upgraded; pregnant women and children under 6 receive free health care; immunisation programmes have slashed such diseases as measles and polio; and pregnancy-related deaths have fallen.

But for all the advances, average life expectancy has dropped from 61.5 years in 1994 to below 50. By 2010, it is expected to slip to just under 40.

Hospital wards are overflowing with patients with pneumonia, tuberculosis, and other Aids-related diseases.

"Health system is like a toy car"

Disillusioned health workers are leaving the country, while an alarmingly high number have Aids viruses - including more than 15% of nurses, according to one survey.

"The health system is like a toy car," said Ed Jarvis, a doctor at Soweto's Baragwanath Hospital. "It looks tough and rigid, but it is going nowhere fast, and the gradient is increasing all the time."

Aids-related complications afflict nearly half the patients admitted at Cape Town's G F Jooste hospital, a bleak, single-story facility serving about 1.5 million people.

With private funding, it can treat some patients with anti-retrovirals.

"People just used to come here to die," said Dr Kevin Rebe. "Now they come to be treated."

Still, the drugs are a drop in the ocean. So far, only 60 of an estimated 15 000 qualifying patients are on treatment. Only one in 10 of the up to 7 000 people who flock to the chaotic casualty unit each month are even admitted, and many of them have to wait for more than 24 hours for a bed.

"A lot of people will die while they are on our waiting list," said Rebe.


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