AIDS Clinic cuts back as patients increase and funds dwindle

Johannesburg Hospital’€™s AIDS Clinic is able to only see about 70 patients per week, while the country is being ravaged by an epidemic that infects 1 600 South Africans every day.

Even more distressing is that new (first time) patients are subjected to a waiting list of three to four months, a situation that may prove to be too little too late for a patient seeking treatment for a life-threatening condition such as pneumonia or thrush.

The clinic currently only operates on Tuesdays.

Dr Clive Evian, a top AIDS consultant and part-time doctor at the clinic, said the facility has for a long time now continued to restrict significantly the number of patients it is able to treat.

Health-e reported in March that the clinic had virtually stopped seeing new patients, referring most cases to primary health care clinics, ill equipped in dealing with HIV/AIDS-related illnesses.

This appears to still be the case.

But Dr Laetitia Rispel, head of hospital services in the province said they would be extending home based care and step down bed facilities in the new year.

Step down bed facilities are similar to hospice type services.

“We hope this will relieve the pressure on the tertiary hospitals,” she said.

Evian said the Gauteng Health Department kept telling the staff that they were severely constrained financially.

“The clinic needs more funds and perhaps the (National) AIDS directorate could prioritise this service,’€™ Evian said.

“There are currently no permanent posts and the clinic operates thanks to part-timers who do it out of the goodness of their hearts.

“It is clear that the clinic is no major priority within the hospital which has no overall plan for the clinic.

Evian believed that the hospital would “probably do more if they have the funds to do so”.

“I think the hospital authorities would like to help, but their hands are tied. Also, they really need to reduce some other services and increase the HIV/AIDS one. This is always difficult to do and needs some tough decisions to be made, but I have hardly ever seen the hospital superintendents, the Gauteng AIDS co-ordinator or any high ranking official even visit the clinic and talk to staff and patients about the issues,” Evian said.

He said it was also problematic that the clinic was currently headed by a hospital infection control officer (microbiologist) who was never at the clinic.

“For me, the clinic is a huge disappointment, it is a sad reflection on the hospital’€™s commitment to people living with HIV/AIDS and the people of Johannesburg,” he said.

“There is no official record of HIV/AIDS cases in the hospital and no readily available data on HIV cases, AIDS, AIDS deaths or costs. There seems no real plan or contingency for managing terminally ill or hospice cases within the hospital.”

Evian said it was correct for the Department of Health to want to decentralise the patients to the outpatients section, but that the clinic should then be developed into a specialist centre.

Treatment Action Campaign spokesperson Nathan Geffen said the situation was untenable.

“Government must increase the health care budget immediately to address this situation instead of unnecessary military expenditure,” he said.

Geffen, however, appealed to doctors to directly involve activists to ensure that the government’s policy of “rigorously treating opportunistic infections” became a reality and improved services to people with HIV/AIDS.

Several attempts to get Johannesburg Hospital management to respond failed.


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