For the past month, no new patients have been started on antiretroviral medication as the hospital is battling to cope with the 11,000 patients it already has on ARVs.

Hospital staff, speaking to Health-e on condition of anonymity, confirmed that the hospital had informed the district health officials last November that they needed urgent help ‘€“  particularly to address the shortage of pharmacists, doctors and space to dispense medicine and examine patients.

However, nothing was done to address the problem and the hospital reached a stage last month where it could no longer admit new patients without compromising the care of patients already on ARVs ‘€“ some of whom have been unable to get their monthly medication because of the shortage of pharmacists.

At present, some 650 people are now on the waiting list for ARVS, including 30 children.  It will take at least three months to address this backlog and staff members say they know that people are dying while waiting for treatment.

Zakhele Ndlovu*, a 38-year-old security guard from Imbali, said he had gone through his ARV readiness training late last year then waited for four months to get onto ARVs.

‘€œI started getting opportunistic infections and had spots on my face. I was very weak and I thought I was going to die,’€ said Ndlovu. ‘€œI went to the hospital to ask them when they would put me on the programme but they said that they didn’€™t have enough doctors.’€

Luckily for Ndlovu, a relative arranged for him to get ARVs at RK Khan Hospital in Durban. By this stage, his CD4 count was 114 (those with CD4 counts of 200 and under are eligible for ARVs).

‘€œMy friend who was also waiting with me to get ARVS died while waiting, and I realised that I could have died like him if I hadn’€™t gone to RK Khan,’€ said Ndlovu.

Noluthando Zondi*, 23 years old, seven months pregnant and HIV positive, was also unable to get ARVs despite the fact that she runs the risk of transmitting HIV to her baby. Her CD4 count is a dangerously low 48.

Although Greys Hospital in the city has apparently agreed to take on the pregnant HIV positive women from Edendale and its clinics, when Zondi went to the city hospital, she was told by a nurse there that she could only get ARVs at Edendale.

‘€œI was disappointed that I wasted R32 on transport money to get there for nothing,’€ said the unemployed Zondi. ‘€œI am just waiting for the clinic to tell me if I must go to Greys or Edendale.’€

The ARV programme is currently operating with four doctors, three pharmacists, an intern and two pharmacy assistants. One any given day, 550 patients will line up for the ARVs, which need to be dispensed by pharmacists. The room allocated for the pharmacy is so tiny that it can barely accommodate the staff and  medication.

Meanwhile, the Communicable Diseases Clinic (CDC), which is housed in an old prefabricated building at the back of the hospital, is completely overrun with patients. Doctors are forced to share examination rooms, and patients are called in two at a time.

When Health-e visited the clinic this week, some 70 people were crammed into a small turquoise room outside the CDC getting their weight taken. When new patients are being initiated, this room also serves as the drug readiness   training room.

A further 60 patients were crammed into the poorly ventilated CDC waiting room, spilling down the passage and outside in the winter cold.

Many of these patients are co-infected with TB (including the drug-resistant form) and other infectious diseases, which they can easily pass on to other immune-compromised patients in the queues.

The provincial health department denied that the ARV rollout had been suspended, claiming that ‘€œdue to space shortages and the high numbers of patients enrolled in the [ARV] programme, the hospital has been compelled to reduce the daily intake of patients per day’€.

The hospital had planned to reach 8 500 patients by 2010 but already had almost 11 000, said spokesperson Leon Mbangwa.

He added that the hospital ‘€œhas vacancies that it cannot fill’€, and that ‘€œit is failing to recruit pharmacists for permanent and sessional employment’€.

However, the pharmacy was being extended and ‘€œwe are hoping that the construction would be completed by the end of the month,’€ said Mbangwa.

Stable patients who had been on ARVs for at least three months were also being ‘€œdown-referred’€ to clinics, he added.  This would ease congestion at the 55-year-old hospital.

However, hospital sources said that the moratorium on the employment of new staff, and the policy of freezing posts that became vacant, had made the situation of employing necessary staff very difficult. The situation at Edendale was further compounded by the fact that the hospital has neither a CEO nor a medical manager.

However, the province has apparently approved posts for three senior pharmacists have been approved, as well as a senior doctor and two junior doctors.   A locum pharmacist started at the hospital this week. ‘€“ Health-e News Service.

* Names changed at patients’€™ request.