Integrated Regional Information Networks - October 30, 2006

JOHANNESBURG, 30 October (PLUSNEWS) - For many HIV-positive people in South Africa's Embo area, southwest of the port city of Durban, accessing treatment at public health facilities is as difficult as navigating the steep and muddy paths between their homes.

Pausing briefly to catch his breath up the hill to a patient's house, Leonard Gcabashe, a local pastor and community caregiver, recalled the many times he had tumbled down the paths while carrying people who were too sick to walk.

"My van only goes as far as the paved roads will allow, and then I go the rest of the way by foot, sometimes for distances of 1.5km. It doesn't seem like much, but when you carry a grown man or woman on your back, it can be very tricky," he told IRIN/PlusNews.

Gcabashe, who began volunteering his time after his brother and sister-in-law died from AIDS-related illnesses in 2005, noted that patients were sometimes reluctant to take up his services due to the poor level of care offered at some hospital and clinics. "Some patients are treated so badly, that they choose to stay home until they die."

DEATH OUTPACES TREATMENT

Weakened by AIDS-related tuberculosis (TB), Raymond Hadebe, 48, had decided against his weekly visit to the Hillcrest Hospital Respite Unit about 10km away, where he is monitored for adherence to his TB medication and treated for loss of appetite resulting from his depleted immune system.

He claimed that nurses feigned concern when the unit's doctor was on his rounds, but patients were neglected once the doctor had left for the day.

"Some nurses even get drunk while on duty. We are burdens to them, and those patients with diarrhoea are left to soil ourselves. I would rather die at home with the little pride I have left, instead of putting myself through that," said Hadebe.

Poor infrastructure, as well as health worker shortages, are often described as obstacles to improved care and treatment at government facilities, but a local activist claimed "this excuse is wearing thin".

AIDS lobby group, Treatment Action Campaign (TAC), said it has been at logger-heads with the health department over its slow roll-out of ARVs.

"The problem is not availability of ARVs, but rather a lack of ARV sites, especially in rural and semi-rural areas like Bothas Hill, [of which Embo is a district]. People from these parts usually have to travel distances of up to 25km to access treatment when they can afford to travel to the hard-to-reach and over-crowded sites," TAC provincial organiser, Lihle Dlamini, said.

Between April and June this year more than 31,000 people nationally were on waiting lists for the life-prolonging drugs, according to the public health department. But Dlamini suspected the number was much higher, as 1,371 people were waiting for drugs at Mahatma Ghandi Memorial Hospital alone, just one of more than 50 operational sites in the province.

UNAIDS has estimated that 5.5 million of South Africa's 43 million people were living with HIV by the end of 2005, and almost 1,000 related deaths occurred every day.

"I conduct at least three funerals at my church during the week, and another three or four on any given Saturday - and this is not counting those funerals at the number of other places of worship in the area. It's not said out loud, but I suspect most of them are AIDS-related," Gcabashe said.

In addition to increasing the number of ARV sites across the country, Dlamini recommended that government urgently look at ways of increasing the number of trained staff at its treatment sites.

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IR061059

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