Your daily Selection of IRIN Africa PlusNews reports, 1/7/2005

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U N I T E D N A T I O N S

Office for the Coordination of Humanitarian Affairs

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[These reports do not necessarily reflect the views of the United Nations]

CONTENT:

1 - SOUTH AFRICA: Too poor to access free AIDS drugs

1 - SOUTH AFRICA: Too poor to access free AIDS drugs

MNINI, 7 January (PLUSNEWS) - Twenty-one-year-old Nonhlanhla Zuma (not her

real name) lies on a mattress on the stone kitchen floor. Her bony, almost

childlike body, weakened by HIV, makes standing up a major effort.

The mattress is next to the door of the tiny family kitchen. Relatives

bustling in and out to tend a pot of maize cobs boiling on the stove

prevent her from getting the rest she urgently needs; her child, not yet a

year old, is sleeping naked next to her.

Over the past few months she has developed full-blown AIDS and is unable

to work. Her mother takes care of her and her child, as well as other

family members, some of whom are also sick. Only a few days ago Nonhlanhla

lost one of her sisters to AIDS.

She and her family live in Mnini, a rural area in KwaZulu-Natal on South

Africa's east coast, largely cut off from healthcare services. Nonhlanhla

is too weak to walk to the local clinic to get basic medication like

painkillers, and her house - like many homes in the area - is not

accessible by car. If her mother wants to move Nonhlanhla, she has to haul

her in a wheelbarrow.

The closest AIDS treatment site is Prince Mshiyeni Hospital in Durban, a

good 35 km from Mnini. As most patients are too weak to use public

transport, they have to hire a taxi to get there, at a cost of R400 (US

$66): an amount very few in this poverty-stricken community can afford.

Mnini used to be a lively community, farming sugarcane next to the once

flourishing Umgababa seaside resort. But the community sank into

destitution after years of faction fighting in the 1980s and 1990s and

today the majority of its inhabitants are unemployed.

Because Mnini's sick and poor are cut off from public health services,

their only help is a group of volunteer women trained as home-based care

counsellors. The group is run by Zanele Sithole, a traditional healer and

former teacher.

The organisation, called Hlangabeza Home-Based Care and Women's Co-op, is

a consortium of 25 voluntary helpers who each visit an average of 200

houses in the Mnini area. In these 5,000 homes they generally find at

least one family member infected with the HI virus. Sithole reckons that

in Mnini, with a population of about 40,000 people, close to 70 percent

are HIV positive - more than double the 33 percent prevalence rate in the

rest of the province.

The Hlangabeza volunteers received training in home-based care from the

South African Department of Health, but get no stipends to pay for

materials or their expenses. The group has been waiting since the middle

of last year for the department to train them in administering

antiretroviral (ARV) drugs, Sithole said.

The only support they receive is a few bags of rice and beans every month

from a partner organisation, an AIDS hospice in the Valley of a Thousand

Hills, which struggles to get funding but nevertheless shares some of its

clothing and toy donations with the sick in Mnini.

Despite being poor themselves, the Hlangabeza voluntary carers pay for

soap, Vaseline and food for patients out of their own pockets.

Transport is an almost insurmountable problem, and it has been impossible

for those in Mnini with full-blown AIDS to enrol on the government's free

ARV treatment programme. Being part of the programme means the patient has

to visit the treatment site to receive the drugs and undergo monitoring

and health check-ups on a regular basis.

" Not a single one of our patients [in Mnini] is on ARVs, " Sithole told

PlusNews, adding that, due to poverty, is was hardly likely that they

would be able to enrol for ARV treatment in the near future.

From Sithole's perspective, people in rural areas could only be properly

helped if health professionals started visiting communities, rather than

expecting people from rural areas to go to them. " We need doctors, nurses

and social workers to accompany us volunteers on home visits, " she

stressed.

Home-based carers also needed to be better trained. " Carers need to be

authorised to administer painkillers and other basic medicines. They need

to learn how to take down a patient's medical history so that they are

permitted to receive medication at the clinics for those patients who are

unable to go there themselves, " she explained.

The number of problems the Hhlangabeza volunteers have to face continually

grows. One of the core issues is the rising number of AIDS orphans in the

Mnini community. Thus far, the carers have found more than 450 orphans in

the homes they visit, many living in child-headed households.

" As it is, we can hardly handle the number of AIDS patients. We have no

time and resources to help the orphans, " said Sithole. " Many orphans have

stopped going to school, and we fear that many will become criminals. "

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