Mail & Guardian (Johannesburg) - May 5, 2004
Mmanaledi Mataboge

I call the national Department of Health's Aids toll-free line and ask the counsellor where I should go for a test. The first counsellor I speak to says I should go to my local clinic. I tell him there isn't one in my neighbourhood and he asks me to hold while he looks it up. Four minutes later I am still holding. Another counsellor comes on the line and advises me to go to Helen Joseph hospital.

10.40am: I arrive at the casualty information desk and ask the nurse where I should go for an HIV test. She doesn't make eye contact, but continues to inspect her fingernails and tells me to go to the poly clinic.

10.44am: I get to the help desk at the poly clinic, but there is no one behind the counter and no one to show me where to go. I go to a counter marked "patients' files for first visits". The man behind the counter tells me I should have gone to the triage section first, in order have a file opened as I don't have a doctor's letter referring me to the hospital.

11.01am: I join the queue to see a doctor in the triage section. I still have no idea what triage means.

11.48am: Still waiting. The doctor leaves because his shift is over, but tells the nurse to call another doctor. Twenty minutes later another doctor appears. She sees one patient but gets into an argument with the second one. She tells the patient that he should have gone to Mayfair clinic first to get a referral and that she can't treat him without it. He looks visibly ill and tells her he has been waiting for several hours. He says he can't go back to Mayfair and wait in another queue only to be referred back to the hospital. He is unemployed and doesn't have money for transport. She gets angry, says she doesn't have time to argue with patients and storms out. The nurse tells us to wait as she will have to call another doctor.

1.10pm: The new doctor arrives. He sees me 20 minutes later and fills in a triage form for me. I go back to the poly clinic to have my file opened. I queue for another 20 minutes to get my file and am told to go to the voluntary counselling and testing (VCT) clinic.

1.57pm: I join the queue, which only has about six people in it. The counsellor, Fred, is also sitting in the waiting room and says he can't continue with his work as there are no counselling forms. Some patients who already have Aids symptoms are waiting to collect medication or to attend a support group. Many of them look really ill, and I'm tempted to run away. Perhaps ignorance is bliss after all.

2.35pm: A nurse appears with one form, and luckily it is my turn next. I follow Fred into the counselling room. He tells me that the file, which took me three hours to open, is not necessary for a voluntary HIV test. There is a woman sitting at the table. I stop Fred and ask why there is someone else in the room, as this is supposed to be a confidential process. He says she is a colleague and I shouldn't worry about it.

He asks if I know what HIV is and explains that if I am positive I could live without symptoms for up to 10 years. He asks if I know how to use a condom and I say yes. He looks sceptical and says "you people are the ones who tear condoms all the time. If you use it properly, a condom will not be torn."

He asks why I want to take a test and asks if I am sick or have any symptoms. He doesn't seem to believe me when I say I just want to know my status. He starts asking questions about my sexual history and I ask him why it is relevant. He says he needs to know if I am at risk.

After 15 minutes of counselling he calls a doctor who will perform the "rapid test", which will give me a result within 10 minutes.The doctor pricks my finger, smears a few drops of blood on a slide and leaves. I feel uncomfortable because I'm worried that my HIV status will be known by two people instead of just the counsellor. We all wait silently, staring at the slide which will show my status. Four minutes later the slide shows a result.

3.11pm: I leave the clinic feeling exhausted and angry, not understanding why I spent most of the day at hospital for a process that should have taken less than 30 minutes.

Of all the hospital staff I encountered the security guard and the doctor were the friendliest. The nurses were the worst, they seemed uninterested and spent most of the time chatting to each other. The counsellor seemed uncomfortable with the topic of HIV and failed to put me at ease.

If the health department wants to encourage voluntary testing, the process needs to be made more efficient and nurses and counsellors need to be more supportive.

Readers who would like to tell us about their experiences of service delivery can contact us at bathopele@mg.co.za

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