Lusikisiki, a tiny town in the Eastern Cape, has just celebrated enrolling over 1100 AIDS patients on antiretroviral treatment thus becoming the biggest rural treatment programme in the country.

‘€œThe majority of people in South Africa can’€™t spell Lusikisiki. They just know that it is in the bhundu. If we can achieve this here, the whole country can achieve even more. Let us be a light for others by saving our own lives,’€ Dr TC Thomas, superintendent of the local St Elizabeth Hospital, told the 2000-strong crowd gathered in the town on Friday (28 October).

The Lusikisiki programme was launched two years ago by Nelson Mandela, and is a partnership between the humanitarian organisation, Medicins sans Frontieres (Doctors without Borders), the Eastern Cape health department and the Nelson Mandela Foundation.

An estimated 1 500 people in the area need ARVs, which means that the programme is well on its way to reaching all patients.

For Nozibele Mditshwa, one of the programme’€™s first ARV patients, getting her certificate for treatment adherence marked a personal triumph.

 ‘€œThe treatment has changed my life,’€ said Mditshwa, a mother of three children.

‘€œBefore, I was very weak and sick. I was a skeleton. I weighed only 43kgs. I didn’€™t know what was wrong with me. I went to the clinic and they told me I have HIV. Then, my CD4 count was 24. Today, I am 66kg and my CD4 is 375.’€

A CD4 count is a measure of immunity in the blood, and healthy adults usually have a CD4 count of at least 500.

‘€œARVs have become a political hot potato,’€ Treatment Action Campaign (TAC) general secretary Sipho Mthathi told the crowd. ‘€œSome people say we need nutrition or vitamins or ARVS. But we are saying we want them all.

‘€œThe community of Lusikisiki has proved that ARV treatment works. You are living proof. So when people lkike Dr Matthias Rath want to spread confusion and say ARVs don’€™t work, we are ready for them.’€

Patients wearing white T-shirts emblazoned with ‘€œviral load undetectable’€ sang modified freedom songs with AIDS replacing apartheid as the enemy and ARVs replacing AK47s as weapons of defence.

By early afternoon, rain had started falling and wind buffeted the white marquee, but still patients ‘€“ ranging from pre-school children to middle aged women ‘€“ queued up to give their testimonies and get their certificates.

All patients consented to being named and photographed. Local nurse Zama Mzimela  said that many people were prepared to live openly with HIV now that treatment was available.

Mzimela, who runs a support group at one of the clinics, also praised the TAC for its  community education programmes that had also contributed to breaking down myths about HIV and explaining treatment options.

Meanwhile, Dr Thomas described MSF’€™s arrival at Lusikisiki as a blessing, adding that the hard work of St Elizabeth staff and MSF had ‘€œsurpassed all expectations’€.

Two-thirds of hospital outpatients are HIV positive, while 60% of male and half female patients in the wards had been admitted to hospital for HIV-related illnesses, according to Dr Thomas.

Aside from the hospital, there are 12 clinics to serve approximately 150 000 people and the MSF has ensured that the programme is primarily nurse-driven at clinic level so that it is sustainable when the organisation withdraws from the area at the end of 2006.

Although officials from the national and provincial health department, including the health minister, were invited, none attended the ceremony. ‘€“ Health-e News Service.