Gauteng trying to come to grips with an epidemic threatening to overwhelm the hospitals

Faced with the daunting task of trying to manage an AIDS epidemic which has the potential “to overwhelm our services”, care givers, doctors, nurses and management from the Gauteng Health Department recently met in Johannesburg, hoping to find answers.

“Government alone does not have enough resources to offer care to all, but we need to let people know that there is life beyond HIV infection,” Gauteng Health MEC Dr Gwen Ramokgopa told the delegates.

Dr Anthony Kinghorn of ABT Associates said South Africa was still early on in the AIDS epidemic with about 20 000 people dying of AIDS-related diseases in Gauteng last year.

This figure was expected to increase five-fold within the next decade.

Kinghorn estimated that about one million bed days were used last year to treat AIDS-related illnesses in Gauteng hospitals. An estimated five million bed days would be needed in 10 year’€™s time.

He said a study carried out among employees of the Gauteng Provincial Department revealed an HIV prevalence rate of about 12%.

“Next year AIDS deaths will overtake all other causes of death in the province,” Kinghorn said. About 20% of the workforce was expected to die by 2010.

Dr Liz Floyd, head of the province’€™s AIDS programme, said they were already losing people prematurely.

“Good, fast treatment could have avoided that,” she said.

Floyd said difficult decisions would have to be taken on the limits of treatment available to AIDS patients.

“There is a strong case for people who are HIV-well to be managed at primary health care level. HIV-ill people should be top priority in the health service with AIDS patients being referred to palliative and home based care centres.”

Floyd said they were aware of the fact that home based or palliative care would not decrease the need for hospice beds.

“But our first choice would always have to be family care,” she said.

Dr Warrick Sive, medical superintendent at Johannesburg Hospital, added that there shouldn’€™t be a need to differentiate between AIDS/HIV and health care.

Dr Alan Kaerstadt, who headed a service analysis at Chris Hani Baragwanath Hospital in Soweto, found that 31% of adult medical admissions at the hospital had tested positive for HIV last year. This was in comparison to 25% in 1997.

He said hospitals should have the capability to treat pneumonia, tuberculosis (TB) and bronchitis.

Kaerstadt also revealed that the admission of an AIDS patient was not more expensive that that of a non-HIV related admission.

“The cost of hospitalisation is related to the length of stay.”- Health-e news service.

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