Today’s picket by the AIDS Consortium and trade unions outside the Johannesburg Hospital HIV clinic is the culmination of many attempts by doctors, AIDS workers and activists to draw attention to the poor management of a facility that has been forced to sporadically turn away desperate patients for many years.  

The HIV Clinic, which has been running since 1985, has ceased to take in new patients due to staff shortages and is apparently redirecting patients to Helen Joseph Hospital. Currently, the clinic has about 3000 patient files, according to Dr Clive Evian, who has been working at the clinic since 1989, initially as a volunteer doctor and later as a formal sessional medical officer.

In a letter last month to Dr Rams Saloojee, chairperson of Gauteng’s Standing Committee on Health, Evian said the clinic has received very little support from the hospital and has essentially been staffed and run by volunteer doctors and other health care personnel, “often in opposition to the will of the hospital administration”.  

Evian said that at present the clinic was grossly neglected, unsupported and on the brink of collapse.

“The staffing is inadequate, inappropriate and unstable, the patient demands are growing and the need for teaching and research is more than ever.”

Evian said the clinic should function to provide:  

• A referral clinic for the hospital, peripheral clinics and for specialist HIV consultations, care and advice.  
• A training and teaching facility to be used by Wits University and other institutions of learning such as the nursing school, technikon and hospices.  
• A centre for appropriate clinical research.  

Evian said the hospital did not seem to have any strategy or plan as to how it will manage HIV patients in general, other than through its usual process, “however, HIV does demand some extra attention and some creative thinking”.

The clinic, which currently only runs on a Tuesday morning and has a morning patient load of 75 to 100 patients, is staffed by a single four hour session doctor.

Evian said the so-called “head of the clinic”, a Dr Sacho, is the hospital’s infectious diseases control officer (microbiologist), who does not do any clinical work at the clinic and “in fact is never ever seen at the clinic”.

Evian said the university and the hospital departments were not in the least bit interested in the clinic.  

“The situation is frankly a disgrace and suggests that the authorities do not care much for people with HIV and will not take the necessary steps to remedy the situation,” Evian said in his letter to Saloojee.

Clinic staff reported in December already that new (first time) patients were 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.

Health-e reported in March last year 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.

But Dr Laetitia Rispel, Chief of Operations in the province said at the time that 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.

Various AIDS organisations, doctors, health care workers and students will gather on the corner of Jan Smuts and Empire Roads at 11am.  

A memorandum addressed to Johannesburg Hospital, the University of the Witwatersrand, the Gauteng MEC for Health and the province’s AIDS Directorate will be handed over at the Johannesburg Hospital’s main entrance by National Education and Allied Workers Union president Vusi Nhlapo.