The audio is in isiZulu. See the English summary below.

MABUTHO: Ngaphambi kokufika kwama anti-retroviral drugs okuqala ngoJune wangonyaka ka 2005 esibhedlela saseMadwaleni, eMbashe ngaphandle kwaseMthatha, ukuya kulesisibhedlela bekusho ukuyolindela usuku lokufa kulabo abebeguliswa izifo ezihambisana negciwane le HIV.  Lokhu  kungenxa yokuthi beyingekho into ebingenziwa ukubasiza, kwazise ama ARVs abengakabibikho. USister Nokulunga Willie ungomunye wabaphethe i HIV/AIDS outreach programme kulesisibhedlela saseMadwaleni. Uqale ukusebenza kumnyango ophathelene ne HIV/AIDS walesisibhedlela ngonyaka ka 1999. Uthi ngalesosikhathi ngenxa yokuthi abengekho ama ARVs umsebenzi wabo ububanzima ngoba bebengakwazi ukusiza labo abaguliswa izifo ezihambisana negciwane le HIV.

SISTER WILLIE: Kwakunzima kakhulu… ngoba kwakuthiwa kalokhu abantu mabaze ngaphambili then sibanike ibactrims, zingekho iARVs and abantu beshona sibajongile. Kuthe ngo 2005 apho ke ngoku zafika izi ARVs ngo June esibhedlela eMadwaleni. Hhayi ke ngoko sabhinqa uba mfishane’€¦ saxelela abantu ukuba mabeze bazotesta ngoba ukutesta oku indlela yokungena kuyoyonke iprogrammes zaka HIV. Uba ngabe awutestanga awunakube umfumane uPMTCT, uba ngabe awutestanga awuzukwazi ukuzifumana iziARVs, uba ngabe awutestanga awuzukwazi ukufumana iinkonzo edibaniselana no HIV kanye no AIDS program.

MABUTHO:UNoma Vinjwa ungumphathi walesisibhedlela saseMadwaleni. Uqale ukusebenza kusona njengo nurse ngo 1971 ngaphambi kokuba anikezwe isikhundla sokuba ngumphathi weso ngonyaka ka   2000. Naye uthi akangabazi nakancane ukuthi ukufika kwama ARVs ngo June ka 2005 kulesisibhedlela saseMadwaleni kudale omkhulu umehluko.

NOMA VINJWA: Kube irelief engummangaliso ukufika kwezi ARVs. Kusinike ububheteri kakhulu, abantu bayancedakala kakhulu siyababona bephuma apha ezibhedini beyayatheka okwenene bephuma nezi ARVs. And bayazisebenzisa nasemakhaya bayalandelelwa kakhulu iteam le yase ARV clinic.

MABUTHO: Khonamanjalo sixoxisane nabanye babantu abanegciwane le HIV abasizwe ukufika kwama ARVs kulesisibhedlela saseMadwaleni. UNondiphiwe Magqwetha ugule isikhathi eside ehamba izindawo ezihlukene efuna usizo ngaphambi kokuba aze athole ukuthi unegciwane le HIV maphakathi nonyaka ka 2005, emva kokutesta kulesisibhedlela saseMadwaleni. Uthi uzizwa ethokoze kakhulu ukuthi kuthe ngesikhathi ezithola ukuthi unegciwane le HIV wakwazi ukuthola ama ARVs ngoba abanye ebebegula ngaphambi kokufika kwawo kulesisibhedlela bebeshona.

NONDIPHIWE MAGQWETHA: Ewe bebeshona abantu kuqala kuba bebelungekho uncendo. Thina ke ngoku sigule sekukhona lezizinto okuthiwa zi ARVs. And ke umuntu ofayo ngoku ngumtu ongazinonophalanga empilweni yakhe ngoba usenokuzinikwa eziphilisi uzibeke kokwenu. Uba uzibeke kokwenu indaba yakho. Kukuwe ukuba uzitshe okanye ungazitshi.

MABUTHO: UChristina Kopano usebenza njenge HIV counsellor kulesisibhedlela saseMadwaleni. Uthi waqala ukuzithola ukuthi unegciwane ngonyaka ka 2000 nathi bekuyisikhathi esinzima kubantu abaphila negciwane le HIV ngenxa yokuthi abengekho ama ARVs ngalesosikhathi.

CHRISTINA KOPANO: Abantu kudala bebesifa nyani and imost yabantu baswelekile bengazi ukuthi babulewe intoni. But uthi xa uzicingela uthi ‘€˜he! inoba uZibanibani wayenayo iHIV. Ndingasho nje ukuthi isimo asisafani nakuqala. Kuqala bekungekho nama ARVs, kungekho support groups, kungekho ntoni. Umuntu if uzincamile wayotesta, wazifumana ukuba uHIV-positive, ufumanise ukuba akukho ncedo angalifumana.

MABUTHO: UChristina uthi into nje emphatha kabi ukuthi nakuba isimo sesingcono njengoba sekukhona ama ARVs abantu abafuni ukuphumela obala bazihlole ukuthi banalo yini igciwane ukuze bezothola ama ARVs uma ngabe iCD4count yabo isingaphansi kuka 200.

CHRISTINA KOPANO: It’€™s just that abantu abafuni ukuza ngaphambili umuntu azozazi kwangethuba intobana umiI kuphi yena ne HIV because into ebalulekileyo intobana uzazi ukuthi wena ume kuphi ne HIV – because it does not mean that xa uHIV-positive kufanele ugule. Ungane CD4count ephansi naku 50 kodwa ufumanise ukuthi kawuguli ndawo.

MABUTHO: Bangu 939 abantu okumanje abathola ama ARVs kulesisibhedlela saseMadwaleni. Kukhona nabanye abangu 1000 aba HIV-positive abangakawadingi ama ARVs abangaphansi kwe Wellness Programme yalesisibhedlela, nalapho belulekwa khona ngendlela abantu abanegciwane le HIV okumele baziphathe ngayo. Inselelo ebhekene nalesisibhedlela ukuthi umphakathi osizwa isona uhlala kude kanti nezinto zokuhamba kazikho ngangokuthi abanye bahamba amahora angaphezulu kwamabili ngezinyawo beya esibhedlela uma bengathukanga bahlangana nemoto eza esibhedlela.

See the English summary below.

The arrival of the first batch of ARVs in June, 2005, at Madwaleni Hospital, in the rural area of Mbashe outside Mthatha, in the Eastern Cape, changed how health-care workers and the community view AIDS.

Before the arrival of anti-retroviral drugs, HIV-positive patients would go to the hospital with very little hope for survival, says Sister Nokulunga Willie, head of an HIV/AIDS outreach programme at Madwaleni Hospital.

‘€œIt was difficult because we had only Bactrims to give to the HIV-positive patients because there were no ARVs at that time. The arrival of the ARVs in 2005 changed things for the better. We then encouraged more people to come forward for an HIV test because it is the only way to have access to  ARVs. If you don’€™t test you won’€™t have access to PMTCT and other HIV/AIDS programs,’€ she said.

Noma Vinjwa is the manager of Madwaleni Hospital. She started working as a professional nurse at the same hospital in 1971 before she was promoted to her current position in 2000. She says prior to the arrival of ARVs, HIV-positive patients were dying in huge numbers because the hospital could not do much to help them. She says the arrival of ARVs played an important role in reducing the high death rate of HIV-positive patients.

‘€œIt has been a relief. It made things much better for us and we see the HIV-positive patients who are on ARVs leaving their hospital beds to continue with their lives at home while on treatment. And luckily, our ARV clinic team is very active in making follow ups on patients who are on ARVs,’€ said Vinjwa.

One of the HIV-positive patients at Madwaleni hospital, Nondiphiwe Magqwetha, told Health-e how grateful she is for having access to ARVs.

‘€œBefore people were dying because there were no ARVs. But fortunately, now we have ARVs. And a person who dies  nowadays is somebody who does not want to take ARVs. If you’€™re supposed to take ARVs and you decide not to, the onus lies with you,’€ said outspoken Magqwetha. Magqwetha got sick for a long time before she was admitted at Madwaleni Hospital where she discovered her HIV-positive status.

Christina Kopano is one of the first the first peer educators to join Madwaleni’€™s HIV programme. She is also HIV-positive and on ARVs. Kopano discovered her HIV status in 1999 when there were no ARVs. She says after discovering her HIV-positive status, she waited for death because she had seen so many people dying of AIDS-related illnesses at that time.

‘€œPeople were dying, but most of them didn’€™t know what killed them. But when you think of it today, you realize that ‘€˜maybe so and so was HIV-positive’€™. But fortunately, nowadays things have changed because we now have ARVs. If you happened to be brave enough to go for an HIV test in the past, and discovered that you are HIV-positive, you would have less hope for surviving,’€ she said.

However, Kopano says despite the relief that has been brought by the arrival of ARVs, she is concerned about the small number of people who come to the hospital for an HIV test in order to have access to ARVs if their CD4count is below 200, as required by AIDS treatment policy.

‘€œPeople don’€™t want to come forward to get tested, whereas we know that it is very important to know your status in order to get help. It does not mean that if you are HIV-positive you will get sick. You can have a CD4 count far below 50 and don’€™t get sick,’€ said Kopano.

The Madwaleni HIV/AIDS program has 939 patients on anti-retrovirals and a further 1000 who are part of the Wellness Program, but not yet in need of the drugs. But the long distance between the Hospital and some of the community remains a challenge as some community members walk more than two hours to go to the hospital.