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HIV/AIDS researchers reduced to tears
Liz Clarke & Lynne Altenroxel. 15 January 2003. Republished courtesy of Independent Newspapers (Pty) Ltd.
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A nightmarish horror story of life in the poorest HIV-infected families shows that poverty in South Africa is spilling over into wholesale destitution.
As households become more desperate, basic assets are being sold off to support the sick and the dying. In extreme cases, children's school clothes and shoes are being sold to help pay for family expenses. Almost half of stricken households had insufficient food and children are going hungry.
"The electricity we take for nothing. When I cook I boil the water with no mealie meal until the children fall asleep." These were the words of a starving woman which left researchers investigating the impact of HIV/AIDS in tears.
The 49-year-old grandmother who uttered them was one of the people interviewed in nearly 800 South African homes affected by the HIV/AIDS epidemic in 2001 and 2002. This scale of human suffering was highlighted in a Kaiser Foundation report published this week entitled "Hitting Home", which showed how households in four provinces were coping with the impact of the HIV/AIDS epidemic.
The 49-year-old woman, desperate enough to con her grandchildren into thinking there would be food on the table, was a typical case. She was looking after 16 people, including six grandchildren. She had no money to visit two of her children who were sick in hospital.
"Life here is very painful," she said. "We only get food from the mercy of our neighbours and food parcels."
Stories like hers describing extreme poverty and hardship were told many times to the researchers, who were attempting to document the way in which HIV/AIDS exacerbated poverty.
The Foundation warned that if the situation was not addressed there would be:
- Deepening poverty among the already poor;
- Disruption and premature termination of schooling for children, especially girls;
- Increasing early childhood malnutrition;
- Increasing strain on extended family networks.
Coming in the same week as the government's own audit confirming grim statistics that 150 000 South African families were starving, it underlined the growing need for emergency interventions to stem the levels of misery and suffering.
The Kaiser Foundation survey included 771 HIV/AIDS-affected households in rural and urban areas of Gauteng, Mpumalanga and the Free State and in two sites (one urban and one rural) in KwaZulu-Natal - the province with the highest HIV prevalence (36,2 percent in 2000) with more than five thousand family members taking part in the research initiative.
One of the most horrifying aspects of the research was that one in six of those affected by HIV/AIDS were unable to control their bowel movements and about the same number could not control their bladders. About 20 percent could not wash without assistance.
The health and contamination risks were exacerbated, said the report, by the fact that only 43 percent had a tap in the dwelling, a quarter had no toilet at all, and no proper facilities for the safe disposal of faecal matter.
The findings showed that 22 percent of all children under the age of 15 in the households surveyed had lost a parent, while 64 percent of the HIV/AIDS-sick were female, on average 33 years old.
The loss of regular income was a major contributor to the plight of many households. In 337 of the 728 households surveyed, the individual with HIV/AIDS had been contributing to family income before becoming ill.
About half of the families were surviving on less than R1 000 a month, with a third of the money (34 percent) spent on medical-related expenses. The national average household expenditure on health care was four percent a year.
More than half of the households had paid for funerals in the past year, on average spending four times the total household monthly income on a funeral. The survey found that twice as many girls as boys were out of school, the primary reason being lack of money for school fees, uniforms or books.
Denial of their HIV/AIDS status was a major factor. Only half of those surveyed said that the sick person they were caring for had HIV/AIDS. However, where people had revealed the
HIV/AIDS-related cause of their illness, families tended to be supportive. Hostility from family members was rare, but the community at large was less understanding.
Local clinics were used by 80 percent of households, most of which said they were happy with the service, but the same could not be said of public hospitals, which only had a 25 percent
rating.
Only 10 percent of households were using government welfare service. Nearly a third were being helped by churches. Less than half were getting direct assistance from home-based care organisations of any kind.
In conclusion, the report stated that the Kaiser Foundation findings showed that the public health services were not able to "satisfy the needs of HIV/AIDS-sick patients, while home-based care services were virtually non-existent and government grants were not getting through". |
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