Health-e (Cape Town)

27 August 2010

South Africa: Strike Threatens Lives of Aids Patients

Photo: Anthony Kaminju/IRIN
Government has sought the help of the army to ensure people had access to health services

People taking life-long antiretroviral therapy have been left stranded and are being forced to skip crucial treatment as the public sector strike continues.

Hospitals and clinics administering anti-retroviral and tuberculosis treatment have been empty this week, with doors being closed on patients needing the medication. Without this life-saving medication they could easily become sick again. A patient who did not want to be named told Health-e News Service that close to 60 patients on ARVs at the Koos Beukes clinic, in Soweto, were turned away earlier this week. She was among that group.

"I was due to fetch my treatment. When I went there it was locked. How can they do that? The nurses always tell us that we should not skip our treatment, now they are the ones' doing this to us, making us skip our medicine for two weeks. What do they expect us to do? They just want money and they don't care about us, they need to help us".

The patient's fear is almost palpable. "I feel very bad. I can't live without my treatment. It will be a draw-back because it means that my CD4 count will reduce. Then, I'll die. I don't want to die. I want to continue living like I am", she says.

Two blood sisters also came for their treatment and could not find it. Luckily, they decided to go to the nearby Chris Hani Baragwanath Hospital's HIV/AIDS unit where they received help, said one of the sisters.

"When we arrived, they told us that they are not working because they are afraid of being threatened by striking nurses since they had been intimidated the day before. They told us to go and didn't even suggest an alternative place to go to. We decided to come here because without the tablets we won't survive. A lot of people didn't get their treatment because only the 3 of us came to Bara. I can only imagine what happened to the others".

The other sister was also relieved that they managed to get their ARV treatment, saying without them the chances of surviving become slim.

"This is very hard because when you skip your treatment, even for one day, it becomes very tough. The experience we had there at the other clinic was not good, especially because no one even advised us of an alternative place. We rely on these pills", she explained.

ARV medication is a life-long intervention. A doctor from the Clinical HIV Research Unit at Helen Joseph Hospital says the effects of defaulting on treatment could be detrimental to ones' life. Dr Francesca Conradie says the danger of skipping treatment may result in making medicines the patients are currently taking useless when they resume taking treatment.

"Antiretroviral therapy reverses the damage done to the immune system. It is a very effective therapy. But because the virus mutates so quickly, you have to make sure that our patients don't miss any tablets. One of the questions asked is: 'Does a day or two make any difference'? It is very possible that it does. Once a person becomes resistant to a drug, you lose it. It cannot be used again. And if the virus starts to replicate, you lose that drug and the immune system damage can occur. The stakes are very high".

Conradie also expressed concern for pregnant women who have to protect their unborn babies from HIV infection.

"The stakes are high for pregnant women because if their virus goes out of control they can transmit their virus to the baby, which is very difficult to treat. I'd say for both her and her unborn baby. We've got good medication in this country and an outstanding ARV programme the biggest in the world very successful and we're going to blow this all into the water by drug interruption", she says.

She has also warned that the strike may have crippling effects on TB patients who may develop drug-resistant tuberculosis if they default on treatment.

"It consists of four 4 medicines for the first two months and two medicines for the next four months. If you don't adhere to that, it's possible that drug resistance will occur and we call those organisms multi-drug resistant TB. This is more expensive and the cure rate is poorer".

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