WOMAN 1: The way I see it we’€™re going to die, some of those who used to come here with us have died. It means we’€™re also going to die ‘€“ because we had hoped that the ARV’€™s would help. (Clip: in isiXhosa)

YOLISA: Like a number of people living with AIDS ‘€“ this woman asks for her name not to be revealed. She fears victimization from her community.

But she insists that her worst fear right now is dying. She is amongst a great number of people who have been referred from surrounding clinics to Mthatha General Hospital for antiretrovirals, BUT here is a long waiting list and she is struggling to actually receive them. This is confirmed by Dr Anele Mani ‘€“ a sessional doctor at this hospital.  

DOCTOR MANI: There are lot of patients who have died. We have got evidence for that. You can go to the clinic and look at the cards of people who have died and find out how many of them have died while waiting for ARVs.

YOLISA: The hospital’€™s superintendent, Dr Linda Mafanya, does not dispute this. She puts the blame on staff shortages.  

SUPERINTENDENT: We 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/she gets the ARV’€™s.      

YOLISA: In fact there are gross staff shortages resulting in a major backlog. Doctor Mani agrees.

DOCTOR MANI: There’€™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 whole month, and the pharmacists will only be able to dispense to 40 patience of that 120, then it means the patients that I have prescribed to in 1 month, he’€™ll be able to dispense to them in 3 months time.

YOLISA: The patients keep coming back ‘€“ hoping they will be put on treatment. I’€™m greeted by a number of these people. They are squeezed into a garage that keeps some of the hospital’€™s medicine. There is no other space.

The backlog and staff shortages are not the only reasons for these long queues. On this particular day that I visit the hospital ‘€“ a number of patients are being told to go home and return the following week. This, they are informed, is because the dispensary is closed. Closed because the provincial pharmacists are on strike…

From January this year ‘€“ this hospital hasn’€™t had a pharmacist to dispense Antiretrovirals for people living with AIDS. They finally managed to secure the services of one pharmacist. But only a day into his duties ‘€“ he has to join the strike.

On his return he is faced with thousands of people waiting for ARVs.

DOCTOR MANI: There was one pharmacist for 39 patients in 2004. There is till one  pharmacist for 2000 plus patients in 2006. When you look at the number of patients that that single pharmacist is seeing in a day, how do you expect a pharmacist to see 80 ‘€“ 90 patients in one day and give them each ARVs? When you give ARVs it’€™s not like Panado.

YOLISA: Another lady who has just been told to come back next week looks like she might just faint. She says she was referred to Umtata General hospital for ARVs last year October.  

WOMAN 2: I’€™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. (clip in isiXhosa)

YOLISA: And once again she has been told to put her health on hold. There is no guarantee that ‘€“ come the following week ‘€“ she will receive the treatment. She knows this quite well. As she struggles to hold her tears back ‘€“ she looks around for a spot to sit down. She is short of breath.

WOMAN 2: I’€™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.

YOLISA: Unfortunately she will have to keep coming back on her own. She only lives with her elderly mother. She tells me that her mother insisted she use the last R14 for taxi fare – instead of buying something to eat for them. She is unemployed. This R14 is the last money from the government social grant she receives because she’€™s living with AIDS.

She will only receive her grant in three weeks time.

 Mthatha General Hospital is just one health care centre in the Eastern Cape that is struggling to keep up with the dispensation of ARVs.

One by one, people are fading away ‘€“ while waiting for ARVs.

But the Health MEC Bevan Goqwana claims something else is killing these people.

MEC:   Well I wouldn’€™t say they are dying because what 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 ‘€“ as a result they think ARV’€™s is a cure.

YOLISA: In his policy speech early this year, MEC Gogwana stated that his department aims ‘€“ by the end of THIS month ‘€“ to have a total of 13 500 people on ARV treatment. This is despite the fact that by June last year, more than 30 000 patients were already eligible for treatment.

So does the hospital superintendent have a plan to address this?

SUPERINTENDENT MAFANYA: There is a master plan which is in place Yolisa ‘€“ to try and upgrade the hospital. There will be new management that will be in place with expertise’€¦ the..the the –  so that.. that whole ehh renovation or upgrading is what we call revitalisation programme. We will be on that programme in the financial year 2007/2008.    

YOLISA: Health MEC Goqwana says even though there is only one pharmacist at this hospital to dispense the treatment, other health care professionals are aware of the need to be part of the solution by helping

MEC: Even if there is no pharmacist ‘€“ there can be somebody who knows exactly the pack. That ‘€“ that could be done. What we have done we have quickly made it a point that there’€™s a pharmacist that goes there. Fortunately we have hired one and obviously those people who have not been innovative enough to think what do I need to do when there is this problem ‘€“ there’€™s something that is going to happen to them, we are going to deal with them.

YOLISA: But even those who have been willing to do something innovative like Dr Mani are getting quite frustrated.

DOCTOR: When I decide to quit or get frustrated it’€™s not that I have anything negative against the patients but I’€™m being frustrated by the system and the problem is I cannot talk to anybody because in a place that you have seen, you are going to complain to whom? You can’€™t complain to anybody.  

YOLISA: So, no one is able to alleviate the fear of death of this woman who has been told to come back time and time again. In all likelihood, she will just be part of the statistics of those who simply don’€™t come back. Those who loose the battle while waiting for ARV’€™s.