Save lives: Reduce the waiting period

presented at a consultative meeting last week in the capital – highlighted the challenges faced by people living with HIV in Zimbabwe.
Mr Forster Matyatya who presented the findings said although challenges faced by HIV-positive people during the time of the research were similar, rural folks are in a worse off situation as they travel long distances to collect medicines at the nearest health centres.
In some instances, some people had to camp overnight outside hospitals in order to be served the next morning because of transport challenges.
This made it impossible for people to travel in one day, collect medication and return home.
Married women therefore at times had problems with their spouses and had to rely on others to bring in their medication.
They therefore formed groups and would contribute bus fare and send one person to collect ARVs for the rest of the members.
This worked well but at times when one was ill, they could not make use of the scheme and therefore had to go to the hospital in person.
The distance travelled to health institutions thus remains a major hindrance and this calls for the decentralisation of anti-HIV medication.
Clinics should have trained personnel to dispense ARVs.
User fees charged by hospitals appear minimal, but remain an obstacle to some people living with HIV, according to the forum.
The US$5 charged when one goes for review is not easily obtainable to some people. When one tests HIV positive, there are costs involved as one has to have a CD4 count and a liver function test done.
These are mandatory tests because the doctors have to know if one’s liver can stand the medication and if one does not already have a liver or kidney ailment which must be attended to before one commences ART.
All these tests require money and may delay one’s commencement on ARVs if not done on time.
Not all hospitals can offer these services for free.
When one is ill, he or she has to first get treated for other ailments and this seems to cause confusion in most people if not well explained.
People living with HIV have reported experiencing negative attitudes from some hospital staff when visiting health institutions.
In Murehwa at a monthly meeting organised by the Rozaria Memorial Trust at Mazeyanike Primary School last month, similar sentiments were echoed.
It was pointed out that they are lectured by health personnel instead of having dialogue.
“On visiting health centres, nurses talk to you as if addressing a child and they even have the nerve to tell you why you are ill, yet one would not have defaulted.
“Does it mean an HIV positive person does not fall ill like any other person?” the forum quizzed.
This scenario may not be widespread but since some nurses with attitude problems are permanent staffers at the OI clinic, this makes visits to the hospitals unbearable.
People living positively pointed out that they are treated like minors and it appears the medical people already know why one is ill, a wrong assumption all together.
The delay and the deteriorating health of the patient when one is on the waiting list was noted and ZNNP+ called on responsible authorities to be sensitive and help reduce the waiting period.
But as I have always said, our health institutions are overwhelmed and one needs to know his/her status and start treatment well in time.
If someone is asked to be on the waiting list and is put on prophylaxis when still feeling well, the complaints received are bound to be less.
But I have witnessed cases where patients can barely walk, and are carried into the clinic by relatives who would like to see the health personnel jump out of their seats to attend to them.
When one deteriorates, it is not an overnight thing, it is a process but people still do not want to get tested. Public institutions usually have breakdowns on the used equipment and for a simple process like a CD4 count, the hospital may have to send out samples to other laboratories, which are already overburdened.
Access to treatment, care and support for people living with HIV ought to be prioritised .
Services should be available to all in need.
As known, the waiting list is long in most hospitals and when one is ill it becomes a problem.
There should be increased prevention because it is the starting point.
Speaking on the sidelines of the workshop, Tendai Westerhof said it is imperative that people live with HIV openly associated as it helped shed away the stigma.
“I have found that disclosure helps as one no longer lives in fear or denial,” said Westerhoff.
The former model is one of the few public figures to have disclosed their status.
Today she is a proud mother-in-law and grandmother.
Governments are meeting from June 8 to today at the United Nations in New York for an HIV/Aids Summit.
They are looking at the global response to the epidemic over the next five to 10 years.
People living positively put their hope on the outcome of the meeting and hope for ARVs access as enshrined in the universal access to be sped up.
Science tells us that treating HIV not only saves lives, but also dramatically reduces transmission by 96 percent from an infected to an uninfected person.
Meanwhile, a report released by the international medical humanitarian organisation Médecins Sans Frontières revealed that several countries hardest hit by the Aids epidemic are improving HIV treatment to reduce deaths and illness – but a lack of support from donors prevents many from making vital changes.
This fragile progress needs sustained support, but the two biggest Aids donors, the US and UK, are opposing a critical HIV treatment target ahead this Aids Summit in New York at a time when mounting evidence shows that HIV treatment can also prevent HIV infections.
“Our report shows that there is clear engagement from countries to providing an ambitious response to Aids, by changing their guidelines to put people on treatment earlier and with better drugs,” said Dr Tido von Schoen-Angerer, Executive Director of MSF’s Access Campaign.
He adds: “But because of funding constraints, some of them are unable to put these guidelines into practice, which serves as a reminder of how fragile this progress really is.
“Today, 10 million people are in urgent need of treatment.”
MSF’s new report, ‘Getting Ahead of the Wave’, provides a snapshot of the response to the epidemic today, by looking at the policies put in place in 16 countries that together account for 52 percent of the global HIV/ Aids burden.
Of the 16, 12 have changed their treatment protocols to provide people with treatment earlier in the course of their disease and 14 have changed guidelines to move to better-tolerated drugs.
Both policies are part of the latest recommendations from the World Health Organisation. Several countries, such as Malawi and Zimbabwe, planned to implement improved treatment protocols, but are unable to fully implement it because of funding constraints.
This means keeping people on inferior drugs, or treating people only once their immune systems are weak.
Governments have been asked by Secretary-General Ban Ki-Moon to support a treatment target of putting at least 13 million people on treatment by 2015 – others have called for the number to be 15 million people.
But in closed meetings, the US and some European governments, such as the UK, have so far expressed opposition to support such a target.
Having all governments commit to a treatment target is important if a credible global response is to be mounted to break the back of the epidemic.
Dr Marcella Tomassi of MSF in Swaziland said: “We know so much more from the past decade about how to get treatment to as many people as possible as quickly as possible.
“With the right policies in place, we could triple the number of people on treatment without tripling the costs.
“But if key donor governments do not support a treatment target, they are sending a clear message that they do not intend to ever come to grips with this pandemic.
“We know that HIV treatment saves lives, reduces illness and even dramatically reduces the risk of one person passing the virus to another.
“Now, more than ever, governments need to renew their ambition to fighting the epidemic and put people on treatment.”
MSF began providing antiretroviral therapy (ART) to people living with HIV/ Aids in 2000 and today provides ART to more than 170 000 people in 19 countries in Africa and Asia.
In Zimbabwe they have free clinics in Epworth, Beitbridge and Matabeleland.
We pray the two main donors will listen to other world leaders and together help in charting a way ahead of the wave.
Until then God bless.
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