Do patients default on treatment to get grants?

The audio is in isiZulu. See English summary below.

MABUTHO: Nakuba lungekho ucwaningo oselwenziwe ngabantu okuthiwa babeka izimpilo zabo engcupheni ukuze bathole imali yempesheni yokugula (temporary disability grant), uMarlise Richter owenza iziqu zakhe zobudokotela kwi Public Health enyuvesi yaseWits uthi iyanda lemibiko ekhuluma ngalesisimo. Ngenxa yokuthi impesheni yokugula iyaphela uma ngabe kutholakala ukuthi umuntu oyitholayo usengcono ngokwempilo uthi ngezinye izikhathi, ngenxa yobubha, abantu abaphila negciwane leHIV bazithola besesimweni sokuthatha isinqumo esinzima sokuthi baqhubeke badle ama ARVs izimpilo zabo zibe ngcono okanye bawayeke izimpilo zabo zibe sebucayini kodwa baqhubeke nokuthola imali yempesheni yokugula.

MARLISE RICHTER: Some of the terrible decisions that people have to make will be, where people with HIV might have to choose between going on antiretroviral treatment and loosing their (temporary) disability grant or keeping their disability grant not accessing health care and eventually dying.

MABUTHO: Maqondana nodaba lokuthi kungenzeka ukuthi kukhona nalabo abazibeka engozini yokuthola igciwane lesandulelangculaza ukuze bazoba sohlwini lokuthola lemali yempesheni yokugula uthi akakholwa ukuthi ukhona umuntu ongazibeka kulesosimo. Kodwa uthi kusadingeka ukuthi kekwenziwe ucwaningo olunzulu kulendima.

MARLISE RICHTER: I think for someone to deliberately or carelessly contract HIV/AIDS is quite unlikely. The person’€™s circumstances must be very dire. But once again, we come to the fact that there is not enough research that has been done into this issue.

MABUTHO: Kodwa ukwenyuka kwezibalo zabafaka izicelo zempesheni yokugula eminyangweni wezenhlalakahle kushiya imibizo eminingi engaphenduleki njengoba kuleminyaka embalwa edlulile inyanga nenyanga umnyango wezenhlalakahle uthola izicelo ezilinganiselwa ku 10 000 zabafuna impesheni yokugula. Cishe kungalesisizathu esenza uDimakatso Moutloatse ongumqondisi emkhakheni wezempeshini emnyangweni wezenhlalakahle athi ngenxa yobubha abantu bangenza noma yini ukuze bathole imali yempesheni yokugula.

DIMAKATSO MOUTLOATSE:     The possibility is there. You can never under-estimate the human mind. It is a question of addressing unemployment and poverty. So, people faced with survival issues and the need for food will do anything possible. I haven’€™t come across it in a scientific way that can be supported by research, but there are several anecdotes of people being upset when they are not proved to be positive.

MABUTHO: U Herbert Bholotini usebenza njengomeluleki wezengqondo wabantu abaphila negciwane HIV emtholampilo ozimele esifundazweni saseLimpopo, iNdlovu Medical Centre. UHerbert naye ophila negciwane le HIV osenesikhathi esingaphezulu kweminyaka emithathu esebenza nabantu abaphila negciwane le HIV uthi kuyiqiniso ukuthi ngenxa yobubha abantu benza noma yini ukuze bathole imali yempesheni yokugula.

HERBERT BHOLOTINI: Into ezinjalo ziyenzeka vele njengoba ubheka isimo mfethu ukuswelakala kwemisebenzi into enjalo. But last’€™nyana nje ngike ngezwa omunye usisi ehamba nomntwana wakhe, losisi upositive, ethi umntwana wakhe uma engatesta positive that means bazothola ama grant ayi two. So manje uyayibona lento ukuthi on the other hand ine negative impact ngoba abanye abantu ukuba positive kubanikeza opportunity ukuthi bazothola imali. And of which at the end of the day uthola ukuthi umuntu wakhona akabibikho adherent, akawaphuzi amaphilisi wakhe. At the end of the day uzogcina enze njani? Uzogcina eshonile. So ke asingabi negligent just because sifuna ukuba positive ukuze Sithole imali of which it is not right.

MABUTHO: Nokho okuqaphelekayo ukuthi akulula njengoba abantu becabanga ukuthola imali yempesheni yokugula njengoba kunabantu abanegciwane nabagulayo abangakwazi ukuyithola lemali. UFloyd Mogae wase Zone 1 eMeadowlands ungomunye wabantu abaphila negciwane lesandulelangculaza, kanti njengamanje udla ama ARVs. Uke wayihola lemali yempesheni yokugula, kodwa kuthe ngasekuqaleni kwalonyaka yabe seyimiswa ngezizathu athi naye akaziqondi.

FLOYD MOGASE: So kusho ukuthi bengihola igrant for 12 months bayivala, mabeqeda ukuyivala January ngayirenew April. Kusho ukuthi ngisuka eMeadowlands ngezinyawo ngiye eChiawelo ngiyo renew  i-grant yami. Bangibhalela zonke izinto kwaba right bathi ngiyicheck ePhefeni after three months. Mangifika ePhefeni after three months bathi i-rejected imali yami. Ngisanda kuthola incwadi evela ku SASSA (South African Social Security Agency). ISASSA ithi ngenze iAppeal. So, I don’€™t know how to make iappeal, ngifuna uncedo. Kodwa ke ngibeliever ku Nkulunkulu kogcina kulungile ngoze ngiyi ..(COUGHING), kogcina kulungile.

MABUTHO: Ngokomthetho iSocial Assistance Act wangonyaka ka 2004, ukuba negciwane le HIV okanye isifo sofuba akwanele ukuthi kungaholela ekuthenini umuntu athole impesheni yokugula. Kepha ukuze umuntu abe sohlelo lokuthola lemali yalempesheni kumele kube ngukuthi umbiko kadokotela wesifunda okanye kahulumeni ubonisa ukuthi akakwazi ukuzenzela lutho ngenxa yokugula. Kube ukuthi futhi akahlali esikhungweni sikahulumeni kubalwa isibhedlela kanye ijele. Kodwa ngokombiko wocwaningo lwe Kesho Consulting and Business Solutions ka 2006 obelwenzelwe umnyango wezenhlalakahle kuyavela ukuthi ngenxa yobubha nendlala kugcina sekunesimo lapho abantu sebethola impesheni yokugula ngale kokulandelwa kwezimiso zomthetho iSocial Assistance Act ezigcizelela ukuthi umuntu anganikwa nje lemali ngokuthi uyagula kodwa kube ngukuthi ukugula kwakhe kumenza angakwazi ukuzisebenzela.

English summary

Do patients default on treatment to get grants?

Several anecdotes suggest that patients with HIV, AIDS and TB might be defaulting on their treatment for fear of losing their temporary disability grants should they get better. Some of these anecdotes further allege that some people might even go as far as exposing themselves to the HI virus.

According to Marlise Richter, who is doing her PHD in Public Health at Witwatersrand University in Johannesburg, there is no scientific research that has been conducted on the issue. However, she says hunger and poverty is likely to drive people to do anything possible to get money.

‘€œSome of the terrible decisions that people have to make will be, where people with HIV might have to choose between going on antiretroviral treatment and losing their (temporary) Disability Grants or keeping their disability grant, not accessing health care, and eventually dying,’€ she said.

She, however, does not believe that people can deliberately expose themselves to the life-threatening HI virus just to get a temporary Disability Grant.

‘€œI think for someone to deliberately or carelessly contract HIV/AIDS is quite unlikely. The person’€™s circumstances must be very dire. But once again, we come to the fact that there is not enough research that has been done into this issue,’€ she said.

However, Dimakatso Moutloatse, the Director of social grants at Social Welfare Department holds a different view.

‘€œThe possibility is there. You can never under-estimate the human mind. It is a question of addressing unemployment and poverty. So, people faced with survival issues and the need for food will do anything possible,’€ she said, adding that, ‘€œthere are several anecdotes of people being upset when they are not proved to be positive’€.

Meanwhile, Herbert Bholotini ‘€“ an HIV positive counselor at Ndlovu Medical Centre in the Limpopo province – told Health-e that it is an open secret that some people, due to hunger and poverty, are now comfortable living with the virus because they see it as means of getting a temporary Disability Grant.

‘€œBecause of lack of job opportunities things like that do happen. Not so long ago I met an HIV positive lady who came for counseling with her baby. She told me that if her baby can test positive as well she will be entitled to two grants. So, now you can see that on the other hand this (temporary disability grant) is having a negative impact because some people think that to be positive is another way of making money. And at the end of the day you find out that they don’€™t adhere to the treatment. At the end of the day where is the person going to end? Obviously, that person will end up dead. So let’€™s not be negligent just because we want to be positive just to get money, which is not right,’€ said a concerned Bholotini.

However, not all HIV positive people are lucky enough to get a temporary disability grant. Floyd Mogase from Zone 1 in Meadowlands, Soweto ‘€“ once received it, but is now struggling to get it despite being HIV-positive and visibly ill.

‘€œI got the grant for 12 months, thereafter, they closed it earlier this year. I tried to renew it in April at Chiawelo office. They wrote down everything and told me to check it at Phefeni after three months. I went there after three months, but they told me my application has been rejected. I got the letter from SASSA (South Africa Social Security Agency) telling me that I must make an appeal, but I don’€™t know how to make that appeal I need help. But I believe in God, I will get my money,’€ said  Mogase,his speech interrupted by coughing.

According to the Social Assistance Act of 2004 not everyone who is HIV-positive is qualified to get the government temporary disability grant. There are certain requirements which include, among other things, that the medical report by a government doctor must confirm that a person is unable to support him/herself and that such a person must not live in a government-run institution such as a psychiatric hospital and prison.   However, according to the Kesho Consulting and Business Solutions’€™  research of 2006  , which was commissioned by the National Department of Social Welfare, in some cases  impoverished situations are sometimes used to award disability grants to people who are HIV-positive and those who have other chronic illnesses.

 

 

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