This week, Helen Joseph Hospital’s Themba Lethu HIV/AIDS Clinic celebrated the enrolment of their 6000th patient on ARV therapy with a little party for patients.
Dr Dennis Rubel, the medical director of the clinic, says the clinic already had many AIDS patients when the health department accredited it as an ARV treatment site in April 2004.
‘We literally had people dying for treatment, so we started with a bang with a couple of hundred people,’ says Rubel.
On any weekday, the waiting rooms of the clinic are crammed with people mostly in their 20s and 30s, the majority of whom look too healthy to be in a hospital.
‘We have grown without doing any advertising. It’s just been word-of-mouth,’ says Rubel.
Thandi* has been coming to the clinic for the past two years. She discovered that she was HIV positive while pregnant almost three years ago.
Then, her CD4 count (which measures the level of immunity in the blood) was 178 and she was suffering from persistent thrush and herpes.
‘Since I started the ARVs, I never had any problems. I am just fine, not sick,’ says the 25-year-old.
‘Adherence is the most important thing. Don’t mix ARVs with traditional medicine and don’t waste your money on immune boosters. These ARVs are very very helpful, but you must also have good nutrition, avoid alcohol and don’t have sex without a condom,’ says Thandi.
Her CD4 count has more than doubled since starting treatment. She no longer suffers from thrush or herpes outbreaks and ‘ best of all ‘ she recently managed to find herself a job.
Thandi’s recovery is one of the thousands of the clinic’s success stories ‘ and the reason that the doctors love working at Themba Lethu.
‘In the 28 years that I practiced medicine before coming here, no one ever said that I had saved their life. Now people tell me this weekly,’ says Rubel. ‘There is such a dramatic illustration of people getting better, as opposed to dying within weeks without the medicince.’
Word of how the ARVs are working is also spreading in the communities that the patients come from.
A year ago, women patients outnumbered the men by three to one, and most had discovered that they had HIV while pregnant. But now more and more men are coming to the clinic and Rubel believes this is because they have seen the ARVs working on their partners.
‘We have won the ideological battle against rival modalities. We are now seeing semi-literate taxi drivers from KwaZulu-Natal coming in and saying that they want treatment ‘ something that would never have happened a year ago,’ says Rubel.
Lively young Portia Baloyi became a volunteer counsellor at the clinic two years ago, after seeing her uncle and aunt dying of AIDS.
‘Some of the patients I counselled in 2004 were in wheelchairs, or not walking by themselves. I have seen such a huge difference as they have become normal just like everyone else. Last year, the one lady I counselled was bedridden. But after about three months of taking the ARVs, she can come here by herself,’ says Baloyi.
But as the battle against the virus is being won, so new challenges are emerging.
Patients with CD4 counts below 200 are eligible for a disability grant, so once the ARVs take effect and their immune systems start to heal, they have to give up their grants.
‘This makes people want to not take their pills properly so they can keep their grant,’ says Baloyi. ‘I have to tell them ‘don’t let yourself down for money. If you are well, you can get a job’.’
‘Many of our patients had been preparing to die,’ adds Rubel. ‘It was as if they had been facing a firing squad and then, all of a sudden, the firing squad had walked away.
‘Now they have to find a place in society. But most are unemployed and semi-skilled. What my patients really need now are jobs.’
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