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Ka-Manzi, Faith (2013) HIV clinics battle with overcrowding and shortages . Eye on Civil Society (The Mercury)  : -.

I BELIEVE that I am a law-abiding citizen, but I hate bureaucracy. I dislike political parties because of their rigidity, yet I’m a permanent activist.

I’m still furious about access to Aids medication. Our city has the greatest number of people in the world who are HIV positive. But last year, along with cuts in South Africa’s own national and provincial financing, the US government announced plans to slash funding for its main programme, the President’s Emergency Plan for Aids Relief.

This devastated the patients and caregivers at three major Durban hospitals who had relied on resources from Washington. Even though Barack Obama appears to support the UN Global Fund that addresses Aids, TB and malaria more than his predecessor George W Bush, the combined funding his administration gives to both has been reduced by $220 million (R2 billion).

And that is why I took the bull by the horns when I recently visited an Aids-medicine dispensing centre I had not tried before. Having received superb service at McCord Hospital, I am now a regular in Cato Manor. But to assess how things are elsewhere in Durban, I decided to try Thokomala ARV Clinic based at the Prince Zulu Communicable Diseases Centre in Warwick Triangle, the most convenient clinic for the hundreds of thousands of commuters who come through the taxi rank each day.

I asked the patients about their experiences. Siphokazi (not her real name) has attended this clinic for the past two years.

Overcrowding has been a major hurdle for the whole time she has attended, but it seems to be getting worse.

Today, patients are no longer admitted after 10am. That was the exact time I arrived at Thokomala ARV Clinic. I started counting people waiting to be counselled, have their blood taken and receive their medication: 214.

Some had been at the clinic as early as 6am, but found themselves turned away and told to return the following day.

What if they have no means to come back the following day? What if they had asked for a day off at work? Just imagine the inconvenience to workers, loss of income and stalling of production.

With the budget cuts, with more people coming to Durban from rural areas, with extremely high unemployment, and with what seems to be worsening violence against women, I am not surprised by the overcrowding.

However, more

worryingly, scarcity of medication is also becoming a huge concern. Both Siphokazi and I were told in both our clinics that we would not be given multivitamins. She was not given an explanation, but I was told that it was because there were none from the suppliers.

There were only four nurses consulting these 214 patients: two in the blood section, one to take blood and one to take cards and write down names. There is only one doctor and one person handling urine tests and disposal. Is that sufficient?

Siphokazi usually arrives at the clinic at 8am and leaves at 4pm. She tells me that if you miss your appointment for your medication, you are then marched to a counsellor, who first rebukes you and scribbles something on your card before you get your medicine.

“At first we would receive three months’ treatment – but now it’s only for one month, except for December whenwe were given enough for two months. They say the reason why we are given just a month’s treatment is because of the shortage of medicine.’’

In Cato Manor, where I receive my medicine, murmurs are growing among the patients. One morning, I woke up at 4am and was at the clinic by 6am.

I was already number 30, which irked me because I was thinking, what time do other people wake up then?

The doors were open by 7am, but 45 minutes later, there was still no activity from the clinic staff. Then we started griping. The sister in charge came to address our complaints.

We told her that some of us were still going to work and then she said they don’t work by time: “Some mornings I have to update my staff on new policies regarding treatment and if we operated on time, we won’t be able to treat you.”

Soon I will visit KwaMashu and Umlazi to see how the clinics are managing. But from these first experiences, it seems that if the funding cuts are not reversed, a catastrophe involving overcrowding and scarcity of medicines is looming.

Ka-Manzi works at the UKZN Centre for Civil Society.

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