Finding help for health ?

All of us in South Africa are living with HIV and AIDS, and we know the effects of the epidemic on our neighbourhoods, workplaces, communities, provinces and country. Some of us know our status as being HIV-positive; others have friends, family members, workmates, teachers or employees who are either infected or affected by the virus.

There is no cure for HIV infection. However, as the Treatment Action Campaign (TAC) message runs:

• HIV can be prevented.
• AIDS can be treated.
• So, hope is possible through action, and HIV infection can be managed.

Sondela, in keeping with the theme of ?2004 - A Year of Healing? connects readers with the information, people and organisations that can help you and your loved ones to survive HIV and AIDS. As far as treatment is concerned, there is good news: the roll-out of national government?s Operational Plan for Comprehensive HIV and AIDS Care is well under way and its goal is to ensure that anti-retroviral drugs (ARVs) will be available in every health district within a year.

In May, interfaith leaders, medical researchers and community members in and around Durban joined together for a one-day workshop to share knowledge about anti-retroviral drug treatment and the roll-out of the ARV treatment programme in KZN. Hosted by partners HIVAN and the World Conference on Religion and Peace (WCRP), the gathering focused on how religious groups could help people living with HIV and AIDS, the facts about how ARVs work, and how local health structures are targeting the most vulnerable patients for medication.

Many FBOs are already deeply involved in helping their members with HIV/AIDS counselling as well as the practice of and training in home-based care for terminally ill patients. Faith-leaders, health facilities and community members can form groups to share the basic facts about ARVs and to reduce stigma, while encouraging people to know their HIV status. Working as partners, they can also achieve easier access to social grants, help patients take their drugs safely and effectively, and assist hospitals, clinics and volunteers with the running of ARV services and providing extended care and counselling.

It is crucial that everyone in our society becomes involved in Voluntary Counselling and Testing (VCT), empowering women and families with information, and supporting ongoing prevention and awareness programmes.

So far, the ARV service points in KZN are: King Edward VIII and Addington Hospitals in Durban, Mahatma Gandhi in Phoenix, the Church of Scotland Hospital at Umzinyathi in northern KZN, Stanger Hospital, Empangeni?s Ngwelezane Hospital, the Benedictine Hospital in North-eastern KZN, E G Usher Hospital at Sisonke, Kokstad, and Edendale Hospital in Umgungundlovu. Sixteen more sites are being prepared for accreditation, and in all, 32 sites will recruit patients for the first phase of the programme roll-out.

Much work is involved in preparing these sites for the accredited dispensing of ARVs. Service points have to be resourced with additional teams of trained doctors, nurses, dieticians, counsellors and other healthcare workers. Each member of these specialist teams is crucial to the successful care of patients enrolled on the programme. Standard facilities such as a laboratory, a pharmacy, consulting rooms, and specialist equipment are needed for testing, medical examinations and monitoring patients? progress in the safe and regular use of the medicines.

The key points about usage of and access to ARV treatment are:

• Anti-retroviral drugs enter the cells in the body that the HIV has turned into ?HIV-factories?, and slows down this HIV activity so that the Virus cannot spread further through the patient?s system.
• Vitamin support, nutritional advice and traditional remedies will also form part of the comprehensive treatment care and support programme.
• Not everyone qualifies to enrol in the public sector programme ? only those with ?Stage Four? (advanced) symptoms of AIDS-defining illnesses and those with CD4 cell counts of 200 and below will be assigned for treatment.
• Patients must produce a valid South African Identity Document ? this essential for the ongoing tracking of patients who might move from place to place regularly; registering their ID bar-codes on the national ARV database enables them to obtain medical care and their ARV pill supplies at any service point in the country.
• Two Rapid HIV Tests are taken - the first test screens for an HIV-positive or HIV-negative result, and the second for confirmation of this outcome; these are finger-prick blood tests and take only a few minutes. Only if the two results do not match will the ELISA test be done, sending a full tube of blood to the laboratory for analysis, which takes a week or so; there is a charge for the ELISA test.
• Patients must be willing to disclose their HIV status and attend three or more scheduled visits to the service point the programme involves each patient having a ?treatment partner?, someone known to and trusted by patient, who would help him or her to take their tablets regularly (with food and water as required), to keep their medical appointments and to provide emotional support.
• The correct number of tablets have to be taken every day, on time, for the rest of the patient?s life. If the patient stops taking the treatment or misses too many doses, the pills would no longer be effective in fighting the HIV in his or her body, and the Virus will not only become stronger, making the patient very weak and ill, but will also not respond to anti-retroviral drugs. For the first six months of ARV treatment, some of the drugs can have side-effects which also make the patient feel sick and uncomfortable ? this is why it is so important for one to receive ongoing advice from a doctor and to have a trusted ?treatment buddy? to help one stay with the programme. For most people, the side-effects can be managed and the treatment is very effective in halting HIV within the body.

For more information and free materials, contact:

1. The Treatment Action Campaign (TAC)
   National Office: 34 Main Road, Muizenberg, Cape Town 7945
   KZN Office: Unit A, 3rd Floor, Doone House,
   379 Smith Street, Durban 4001
   Tel: 031 304 3673
   Fax: 031 361 7051
2. The Provincial AIDS Action Unit (PAAU), which offers the
   AIDS toll-free Help-Line = 0800 012 322
3. The Red Ribbon Resource Centre: (011) 880-0405 for free booklets on ARVs.

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