Health-e (Cape Town)

30 October 2012

South Africa: Surviving On an Empty Stomach

OurHealth - Nombulelo Manala Lubhelu (45) of Lusikisiki-kwaGqwarhu location has taken the tough decision of declining lifesaving antiretrovirals (ARVs) because she is simply too poor to buy food and does not want to take her medication on an empty stomach.

After several days of falling asleep without eating, Lubhelu informed clinic staff that she did not want to start treatment on an empty stomach.

She described to OurHealth how she had to depend on the goodwill of neighbours for food and the hope of a small job.

Lubhelu tested HIV-positive in 2009. Tested at Xurana Clinic, her CD4 count at the time was 717. Clinic staff monitored her condition on monthly basis and she was supplied with vitamin supplements.

However, her condition took a turn for the worse in September when she was struck by lightning.

She now suffers from chronic diarrhoea and lower abdominal pain. Her CD4 count has dropped dramatically to 357, and she weighs 37 kg.

Lubhelu has already completed the ARV readiness programme at the clinic, which means she has been prepared and counseled to initiate ARV treatment.

However, Lubhelu has informed the sister-in-charge and her adherence counselor that she cannot start her treatment.

“How can I start ARVs on an empty stomach and while I rely on other people for food,” she asked when OurHealth interviewed her.

Lubhelu has received counseling and was given two packets containing a food supplement, however her concern remains that she needs a sustainable solution.

Clinic staff are treating her diarrhoea, but have warned that the water source is contaminated.

“I will shout out for help from any good Samaritan until my health condition gets better,” a distressed Lubhelu said.

Lubhelu lives in Ward 13 and claims she has approached her Ward Councillor who told her there was a long waiting list for food parcels, but promised to add her name to the list. He allegedly sent her home with a small packet of maize meal and rice.

Lubhelu has started a tiny vegetable garden and tries to sell some of her produce.

“I now only depend on the income of the veggies and looking forward to enlarging it so that I can make a living. I am willing and ready to start my treatment as soon as I receive support system,” she said.

Treatment Action Campaign community mobiliser Nosizwe Mbebe said they have assessed Lubhelu’s socio-economic situation, but warned that she needs urgent intervention and that she has to be initiated onto ARV treatment.

OurHealth has alerted the Department of Social Development (DSD) and the area manager has given the assurance that a crew will visit Lubhelu and supply her with food parcels.

"The social worker will visit her to do a situation analysis so that she can be supported with food parcels even though this will be for only three months. There needs to be a long term plan as she has to take life long treatment," said the DSD official.

Poverty is hitting communities hard because of the high rate of unemployment and Lubhelu’s story is not unique.

Vinjwa is the OurHealth Citizen Journalist reporting from the OR Tambo district in the Eastern Cape

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