By Sibusiso Mdlalose
NEWCASTLE, KwaZulu-Natal – Alex is among hundreds of HIV-positive patients in Newcastle, KwaZulu-Natal, who have stopped taking ARVs despite knowing about health risks due to different reasons, including stigma, lack of nutrition and alleged bad attitudes from health workers.
Speaking to OgeneAfrican from his home in Blaauwbosch village in Newcastle, Alex who was diagnosed with HIV in 2009, said he stopped collecting his medication because he cannot afford nutritious food as he is unemployed and living in poverty.
A 38-year-old father of one who lives alone in his four-roomed house that he shared with his late grandparents and mother (also the late), dropped out of primary school in Standard 5 (Grade 7) and tries to make ends meet by doing odd jobs.
“I was not academically inclined thus I dropped out of primary school in Standard 5, and had to look for a any kind of job because of my lack education. I once got a job at the coal mine in Utrecht, but seven years later the mine had to close down and many of us lost our jobs.
When I was still employed at the mine I was able to support my child and help at home. But since losing a job at the coal mine I have never been able to find another proper job.
It was better when my grandparents were still alive because their old pension grants made a huge difference. My grandfather died in 2009, while grandmother died in 2016, and my mother died in 2014. Since then life has been difficult for me,’’ said Alex, who stopped taking ARV treatment in August 2017.
“I know that I need to take my ARV treatment to stay healthy, but the problem is that I’m unemployed and am struggling to make ends meet, so I can’t afford food as I used to before. It’s so difficult to get work in this area of Newcastle, there is a high rate of unemployment and poverty especially in this our rural village (Blaauwbosch), even those who have educational qualifications struggle to get employment. Then what about us with only Standard 5?
At times I sleep on empty stomach, because I don’t want to be a nuisance to my neighbours, begging for food everyday. When I happen to get that odd job, I buy basic food like mealie meal, potatoes or cabbage and cooking oil, as I can’t afford nutritious food because I’m poor.
ARVs makes you hungry, and you need food everyday when you take them, so it’s difficult when one is unemployed.”
“HIV stigma is still one of the big problems especially in our rural villages. Some fellow rural villagers still lack information about the virus, because they still mainly associate HIV with promiscuity, and some of those who are open about their status in the community experience some sort of discrimination. Which is why most of the people living with the virus are not open about their status in most our rural villages.
But, I’m planning to approach the local non-profit organisation which gives relief to people are HIV-positive and find out if I can be assisted with food parcels that are usually provided for poor HIV-positive people like me. Because I really need to resume my ARV treatment before it’s too late, as I have witnessed deaths of the fellow HIV-positive individuals in the area as a result of defaulting,’’ added Alex.
Faith of Osizweni township who was diagnosed with HIV in May 2017, is an albino woman who has admitted that she has been at the receiving end of bad treatment from some of the health workers, which consequently prompted her to stop collecting medication at the local clinic.
“I stopped taking ARVs last year in October because I had had enough of the bad treatment from some of the nurses at the local clinic. Maybe they are offended with the fact that I’m an albino, I don’t know, because they have always made rude comments to me as if I deserve to get sick. It has been depressing and humiliating, and I couldn’t take it anymore,’’ lamented a 35-year-old mother of two who said she was now looking for help from a local albinism organisation to assist her to get ARVs.
According to some of the HIV/Aids counsellors at the local clinics in Osizweni and Blaauwbosch – who asked not to be named as they are not allowed to speak to the media – there is a high rate of ARV defaulters in the Newcastle area and Amajuba district as large.
Senzeni Ndawo, secretary of Qaphelani Community Outreach Project, a non-profit organisation which basically gives relief to the people living with HIV/AIDS and orphans in Newcastle and Amajuba district, said they are aware of the fact that there are some people who have defaulted on their ARV treatment, and that is a concern for them.
“As an organisation we do all we can to encourage HIV-positive to stick to their treatment, because it a health risk and equal to be suicidal to abandon one’s treatment. Our volunteers who operate as care givers spend their time giving counselling, cleaning and feeding those who are terminally ill. Through donations from various business people and good Samaritans, we provide needy HIV/AIDS people and child-headed families through our identification programme with food parcels sporadically.
But, we mainly promote one home one garden, so that those who take ARV treatment will have something to eat instead of relying solely on food parcels,” said Ndawo.
Spokesperson for KwaZulu-Natal Department of Health, Noluthando Nkosi: “The Department can confirm that the average loss to follow up for patients taking anti-retroviral drugs in Amajuba district improved from a 36% loss (April-June 2018) to 32. 99% (October-December 2018). The province as a whole improved from a 33.2% to 27% during the same intervals.
Although we are aware that this number is still higher than we want it to be, the Department wishes to recognise the efforts of partners and healthworkers who have contributed to this improvement. Community health workers have integral part of this. They trace both HIV and TB clients lost in care and they achieve this by adhering to weekly targets to trace and link back to care at least 3 HIV/TB clients. The interventions is monitored weekly in high volume sites through weekly meeting with all district directors and their teams.
“Ethekwini, King Cetshwayo and Ugu districts, in partnership with some of the department’s partners, have set up call centres to track and trace patients that have defaulted in HIV and TB treatment. The department plans to establish these call centres in more districts.
With regards to ill-treatment; the department urges victims of abuse at the hand of healthworkers to report them immediately to their superiors and if dissatisfied, elevate the matters to the district director. Minister Nomagugu Simelane-Zulu has made all District Directors and hospital CEO cellphone numbers publicly available. And any healthworker who discriminates against or verbally abuses any patient because of his or her medical condition, religion, race or any other factors violating the Constitution must be dealt with.” (Nkosi, provincial health spokesperson replied through email)
According to UNAids’s
update report which was launched in
Eshowe, KwaZulu-Natal, on 16 July this year (2019), by UNAids executive
director Gunilla Carlson together with SA’s deputy president David Mabuza, South
Africa is making huge advances in the fight against HIV/Aids epidemic. But the
global body warned that there was a long way to go in eastern and southern
Africa, the region most affected by HIV.
In 2014, UNAids launched 90-90-90 targets with the aim to diagnose 90% of all HIV-positive persons, provide antiretroviral therapy for 90% of those diagnosed and achieve viral suppression for 90% of those treated by 2020.
Mabuza said statistics showed that poor people had the highest risk. “We acknowledge that unless we deal decisively with the challenges of unemployment, poverty, gender-based violence, substance abuse and poor housing, among others, we will not be able to heal our society,” Mabuza said, quoted by national media.