Antiretroviral drugs are being dispensed so slowly at Mthatha Hospital that patients on the waiting list are dying long before they get the medication.

‘€œThere’€™s a huge backlog. We prescribe for patients day in day out, but our pharmacist can only dispense for 10 new patients per week. Now if I prescribe for 120 patients in January, the pharmacist will only be able to dispense to 40 patients of that 120,’€ says Dr Anele Mani, a sessional doctor at this hospital.

‘€œThere are a lot of patients who have died,’€ he adds. ‘€œYou can go to the clinic and look at the cards of people who have died while waiting for ARVs.’€

Cindi (not her real name) said she had been waiting for ARVs since last October, and was getting weaker and weaker.

‘€œI’€™ve been told to keep coming back. We were first told to come back last December but when we got here we were told the nurses are toyi toying so we must come back in March,’€ Cindi said faintly, while struggling to hold her tears back.

Now she has been told to come back next week as provincial pharmacists are on strike.

‘€œI’€™m not okay, I can feel it. Even my weight keeps going down. This is too much on me. I wish there was someone who could help me and keep coming here for me.’€

But Cindi lives with her elderly mother who insisted that she used their last R14 on taxi fare to the hospital. It will be another three weeks before Cindi gets her grant again.

The hospital’€™s superintendent, Dr Linda Mafanya, blames staff shortages for the long waiting list.  

‘€œWe don’€™t have enough people to dispense these drugs. There is a backlog in terms of the patients who are ready to start the drugs but are not yet on drugs. It does not make us feel good when a patient dies before he or she gets the ARV’€™s,’€ says Mafanya.

Each week, patients keep coming back in the hope that they will be put on treatment. They squeeze into a garage storeroom as there is no other space for them.

This month, a pharmacist was finally appointed to dispense ARVs, but he has a huge task.

‘€œThere was one pharmacist for 39 patients in 2004. There is still one pharmacist but now for 2000-plus patients in 2006,’€ says Mani.

‘€œHow do you expect a pharmacist to see 80 to 90 patients in one day and give them each ARVs? When you give ARVs, it’€™s not like Panado.’€

The hospital superintendent says there is a ‘€œmaster plan’€ to address Mthatha’€™s problems, but it is likely to be too late for Cindi.

‘€œThere will be new management that will be in place with expertise. And we will be on a revitalisation programme in the financial year 2007/2008,’€ says Mfanya.

Meanwhile, Health MEC Bevan Goqwana says patients are not dying because they cannot get ARVs.

‘€œWhat kills them is not really the HIV but it’€™s the depression and the lack of psychological assessment that we do. Because some of them, you find that they have not been counselled well and as a result they think ARV’€™s is a cure,’€ says Goqwana.

In a parliamentary speech early this year, Goqwana stated that his department aims to have a total of 13 500 people on ARV treatment by the end of this month. However, by last June more than 30 000 patients were already eligible for treatment.

Goqwana says one of the possibilities to address the shortage of a pharmacist is to get someone other than the pharmacist to prepare the ARV packs

‘€œEven if there is no pharmacist, there can be somebody who knows exactly the pack. That could be done.’€

But even those who have been willing to do something innovative like Dr Mani are getting worn out.

‘€œWhen I decide to quit or get frustrated, it’€™s not that I have anything negative against the patients,’€ says Mani. ‘€œBut I’€™m being frustrated by the system and the problem is, I cannot talk to anybody because in the place that you have seen, you can’€™t complain to anybody.’€ ‘€“ Health-e News Service.


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