HIVAN/WCRP Forum

Traditional vs Western Medicine

Speakers at the HIVAN/WCRP Forum

The October HIVAN/WCRP Religious Leaders? and HIV/AIDS Researchers? Forum addressed current trends in HIV prevention, treatment and care towards the complementary use of both traditional and alternative health forms. The forum was attended by approximately 70 people and chaired by Paddy Meskin.

Speakers included: Ms. Bongi Gwala and Ms. Queen Ntuli, from the eThekwini Traditional Healers? Council, and a variety of speakers from UKZN including Dr. Nceba Gqaleni, Traditional Healing Programme, Dr. James Hartzell, Co-ordinator ? Traditional, Complementary and Alternative Medicine (TCAM) Project, Dr. Rajen Cooppan, Ayurvedic Medicine, Mrs. Anne Hutchings, Indigenous Herbal Preparations, and Dr. Mohamed Solwa (IMA), Western Medicine.

Ms Gwala and Ms Ntuli spoke of their divinational healing powers. As per the history of traditional healers, when a member of the family who is a traditional healer passes on, then the gift is passed on to another member of the same family. Traditional healing is seen as a sacred profession with rules to ensure that the healer is clean and spiritual.
The medicines prescribed in traditional healing vary ? some have long shelf life and some are fresh depending on the diagnosed illness. Sometimes it is necessary to use the bones of animals. Traditional healers do not only treat a single person, they have access to the whole family. There is always communication from the traditional healers and they are very approachable.

Dr Nceba Gqaleni noted that we are fortunate to have so many traditional healers based in Durban. Research has been done to understand how the plants used by healers work. The medical school has been meeting the holders of this knowledge and has since partnered with them. There are areas where the traditional healers invite training. Dr Gqaleni?s department has moved past work-shopping and has developed a program to add value to traditional healing.

Dr James Hartzell highlighted the TCAM project, which interacts with many traditional healers. He voiced support for the legacy of traditional healing, while acknowledging that science alone cannot explain what traditional healers do. Dr Hartzell himself was told to speak to his ancestors about certain situations, which were then resolved.

Dr Rajen Cooppen spoke more on the principles of ayurvedic medicine. He said that the science of life is a system of study based on the laws of nature, spirit, mentality, sensuality and physical being. Laws of nature apply to all. Medicine treats symptoms. However, the ayurvedic diagnostic approach is comprehensive. Biological uniqueness means no two people will respond to the same medicine in the same way. The belief is that no doctor can heal - only nature can heal. Dr Cooppen noted that there are two herbs that have been associated with the reversal of discomfit in AIDS patients.

Mrs Anne Hutchings of Indigenous Herbal Preparations noted that an HIV /AIDS support clinic was started at Ngwelezane Hospital in 1997 by Dr Peter Haselau. The clinic had the objectives of providing support and clinical care, as well as identifying affordable effective management protocols for people living with HIV/AIDS. In 1999 Mrs Hutchings was invited by Dr Haselau to collaborate in the management of patients on the basis of the observed effects of two creams she had developed, using locally grown plants, for the treatment of skin problems commonly encountered in the area.

In consultation with Dr Nigel Gericke, she was also able to advise on and dispense herbal remedies for the relief of other opportunistic complications such as candidiasis, headaches and various respiratory complaints. The remedies include fresh plant material harvested from her garden and the medicinal plant garden that she has developed at the University of Zululand. The numbers of people attending the clinic and electing to see and be treated by her have grown from the eleven in November 1999 to over 400 by October 2002 [and over 800 by December 2003].

Sutherlandia tablets made from dried leaves are taken by all patients attending the clinic and are associated with observed improvements in weight, energy levels and general well being. Toxicity tests on the leaves from the chemo-type grown for PhytoNova were recently conducted by the MRC on vervet monkeys and indicated safety in all the variables tested. There are many anecdotes available on its efficacy, including evidence of raised CD4 counts and lowered viral loads. Many patients report rapid improvements in appetite and strength.

The herbal treatment offered in the clinic addresses many problems experienced by HIV/AIDS sufferers and is attributed to a significant improvement in quality of life in both non-wasted and terminal patients. It is appropriate for further development in home-based care and in hospital and industrial clinics. A formal pilot study to confirm their observations of therapeutic benefits and anecdotal evidence of raised CD4 counts in patients taking Sutherlandia, reported by Dr Gericke is urgently needed. This would serve to promote the use of this valuable resource more widely.
She further noted:

?In rural areas where there is little access to clinics and care facilities are limited, training of health workers and care givers and the development of home or community growing would have a beneficial impact.
? Protocols need to be developed for training purposes
? Lack of compliance and adequate nutrition are problems related to the poverty experienced by the majority of our patients. Other social problems needing to be addressed include stigmatisation and lack of education.

Dr Mohamed Solwa, Western Medicine, was impressed with the integration of knowledge. He commented that we must keep our minds open to the various methods available and look at people holistically, the way that Greek and Arab medicine was practised in a holistic manner. They used all herbs available in the 9th and 12th century and this treatment excelled. Subsequently medicine started dividing. Conventional medicine was encouraged and not traditional. This is changing and again traditional medicine is being looked at. The disease, alone cannot be treated. Traditional and complimentary medicine should be documented with respect to successes and failures, just like western medicine. Medication is expensive, so we need to look at local treatment.

Most people were pleased by the discussions and felt that rather than working against each other there has been an integration of Western and alternative medicine.

?The best way to deal with our orphans is to keep their mothers alive.?

From left: Jacqui Joshua, Debbie Heustice, Cati Vawda,
Paddy Meskin & Saydoon Sayed

The Religious Leaders? and HIV/AIDS Researchers? Forum was held on Wednesday, 24 November 2004. Speakers included Ms. Kati Vawda (Children?s Rights Centre) and Jackie Joshua (Youth Peace Forum). Further to the International World AIDS Day theme, ?women, girls and HIV/AIDS?, the
speakers addressed the topic: ?The best way to deal with our orphans is to keep their mothers alive.?

The Programme included:

? a video entitled ?The youngest adult?, which told the story of four orphans
? a presentation on a recently-published book entitled ?Babiza?s Story?, and
? a presentation from the Children?s Rights Centre.

Paddy Meskin opened the event by challenging those present with statistics indicating that there are in excess of 14 million orphans internationally. She said this fact compels every religious organisation to establish an HIV/AIDS desk. She commended those faith-based communities already dealing with HIV/AIDS, which activities generally include home-based care.

Paddy emphasised that religious leaders have a role to play in changing the values of communities. A question to be raised is ?Why should a just society with the best constitution in the world accept the extent of orphaned children?? We are all challenged to act to save mothers who are dying prematurely and leaving their children orphaned.

Paddy ended by reading the following poem by Salim Waseen, a seven-year old boy dying of Aids. He has already lost his Father, Mother and brother.

Aids has left me this way, Where is my Mother?

Jacqui Joshua who represents the Youth Peace Forum read a short extract from Babiza?s Story which is Siphelele Ndlovu?s account of precious moments he has spent with his mother, who is living with HIV.

?Sometimes Mum will come home with plastic bags. If I ask what is in there, she will say: ?It is nothing.? Then I will go to the bedroom and see her covered by the blanket and I will hear crunching! And I find her eating chips maybe. When she is eating chips I will get in the bed with her and we will eat chips together and then we will just talk. I like my mother?s bedroom because it smells nice and that?s also where I was healed when I was sick and had pneumonia. I slept in my mother?s bedroom after I was discharged from hospital.?

?The Youngest Adult?, a story of four orphans, was then screened. The central message of the documentary is: ?You can?t parachute solutions in from the outside ? the solution has to come from within the community.? The Hope for African Children Initiative (HACI) uses the strength of communities to reduce stigma, improve health systems, ensure schooling, and lobby for review of inheritance laws. The video highlights the need for child-focused interventions and that despite the suffering they endure, children have dreams for the future ? like those of being a teacher; being a doctor and helping people, who are sick, especially those who suffer from HIV; being a nurse, and studying body systems, being a driver ?like a boss?.

Katie Vawda started her presentation by asking a few questions. One of the questions was: What is Hope? She noted that part of hope is faith, which guides interaction with HIV/AIDS children. When children?s rights are discussed, we discuss a public area as well as a private area. Children?s rights and realities are very far from each other. At the moment, 40% of South Africans are under the age of 18. There are 250 000 HIV positive children under 15 years of age in South Africa. One to two percent of children are being orphaned annually for different reasons (road accidents, AIDS, etc.) Statistics indicate that by the year 2015, there will be 5.7 million orphaned children.

Parents who are on treatment are able to be better parents as they have quality of life to work and contribute economically to the family. They live longer because of treatment. Treatment literacy and home-based care training at community levels are critical. People need to identify at an early stage, the children that are at risk and families that are in trouble.

Ms Vawda appealed to all faith based organisations to adopt a health clinic and to promote HIV testing. Action is also needed to protect children?s inheritances, and to reduce the costs of dignified funerals. At the Redhill Cemetary on a Saturday, there are four funerals being conducted at the same time. People cannot pray, meditate or sing in an atmosphere of reverence.

Jackie Joshua gave the final address on the issues that youth face today. She spoke about the irony of modern technology and its unlimited potential which still fails to relieve our helplessness in a society increasingly-shattered by HIV/AIDS. She rued the fact that children with dying parents watch helplessly as their parents die slowly, ?seeing their mums or dads, withering away, covered in sores and staring speechlessly at them?. The thrust of her argument was: ?We can barely cope with the numbers of orphans and vulnerable children now ? how will we cope in the future? ?.

Jacqui called for a sense of purpose to counteract mass indecisiveness and vulnerability to random influence. She noted: ?There are regular news stories reporting rapes of two-month old babies; and others? daily reality is characterised by walking long distances through unsafe areas to collect polluted water, sacrificing their schooling, but doing the best that they can. These are not rare instances ? the numbers are overwhelming. Tomorrow will be what we make of it, but we need to make this a purposeful generation.?

HIVAN?s Project Manager, Debbie Heustice, closed the Forum by thanking all the speakers for their challenging and inspiring insights.

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North and South Coast Community Forum Series - November 2004

HIV/AIDS and grants

The final 2004 HIVAN, South and North Coast Communities Fora were held on 16 and 18 November respectively.

The topic for November for both Communities was: ?HIV/AIDS and Grants?.
The guest speakers from the Department of Social Welfare and Population Development, Chatsworth Office were Mr A Reddy ( senior officer, specialising in pension queries) and Ms B Nkabinde (a social worker involved in social development).
Speakers from the Verulam Office were Mr S Perumal (the District Head responsible for the processing of pensions and grants as well as the management of staff) and Mr E Ngwabe (a senior administration clerk, actively involved in community affairs).
The speakers from Chatsworth also gave an overview of the empowerment and capacity building programmes rendered according to welfare objectives (especially in the rural areas, which are most affected by HIV/AIDS). These include:

? Teaching people to plough and farm fruit and vegetables to generate their own income
? Provision of Food parcels
? Youth Programme ? (Pilot Project) - jointly with district offices.
? Grouping together disadvantaged people who want to generate income for themselves.
? Social support to the Elderly
? Integrating the disabled into the community.Social Welfare Assistance is provided in the form of various grants viz.

Speakers at the North Coast Forum with Hemlata Morar
(right) of HIVAN

? Pension/Old Age Grant ? males must be 65 and over whilst females must be 60 and over.
Document required: a bar coded ID.

? Disability Grant ? persons between the ages of 18 and 59 years who are temporarily or permanently disabled can apply. An adult who is temporarily or permanently unable to work due to AIDS related illnesses might apply for this grant.
Document required: bar coded ID, medical report from the doctor treating the person/confirmation of the disability.

? Care Dependency Grant ? awarded to the parent or foster parent of a severely mentally or physically disabled child who needs constant care. The grant may be given to a child who has AIDS and needs constant care.
Documents required: birth document of the child concerned, medical reports and the report of the social worker; the income of the parents is assessed, but not that of the foster parents.

? Foster Care Grant ? this grant applies to children from birth to 18 years of age and who are placed in official foster care through the Children?s Court. Children orphaned through AIDS can be placed in foster care and be awarded the grant for their upkeep.
Documents required: the Children?s Court Order, birth documents of the child/children, bar coded ID documents and marriage certificate of the foster parents, school attendance certificate of the child/children.

? Child Support Grant ? any person who is providing for the physical needs of a child on a day-to-day basis can apply for the CSG. This primary caregiver could be a parent, a family member or a caregiver outside the family. The caregiver must not be receiving any money or remuneration for taking care of the child. If the children are not the caregiver?s, the maximum no. of children that would qualify for the grant is 6, whilst there is no limit for the number of biological children. The CSG is given for children up until 11 years of age; this would be extended to 14years in 2005.
Documents required: bar coded ID document and marriage certificate of the caregiver and an id. size photograph, birth certificate of the children, proof of responsibility of children if being cared by an outside caregiver (death certificate of parent or letter from an authentic source), proof of family income.

? Grant in Aid ? this is grant is paid to the person caring for an aged or terminally ill person. It is a supplementary grant in order to provide for the physical needs of the grantee.
Documents required: ID document of the caregiver, proof of residential address.

? Social Relief of Distress ? this grant is given on a temporary basis (usually 3 months) to those who have applied for a permanent grant and are awaiting its award. It is supposed to relieve their destitute state and is given in the form of food vouchers, the value of which is repaid when the main grant is awarded. This grant at times is given to persons who are destitute by virtue of theft, fire or other natural castrophies.
Document required: a social worker?s report verifying the family?s circumstances, a police report.

Means Test ? The most important factor when a person applies for social assistance is his/her financial position. The reason for this is that grants are only awarded if the applicant?s financial resources are below a certain level. In determining whether an applicant qualifies for a grant, and if so, to what amount he/she would be entitled, the income and assets of the applicant and spouse are assessed.

Reviews ? Grants are reviewed on an annual basis. Grantees are notified 3 months in advance of the date of the review. Reviews help to filter out those persons who are well and able to provide for themselves and no longer need to be on the welfare system.

Fraud ? When a person no longer qualifies for social assistance (due to a number of reasons, eg. death, or other social circumstances), the Department of Social Welfare needs to be informed. People who collect grants under false pretences are committing fraud. Fraudsters may be reported to the Department (anonymously if preferred) on telephone no. 031-3368704.

Unfortunately, the Department of Social Welfare is operating with limited staff and services a very large area. HIV and AIDS have exacerbated poverty and there is immense pressure on the Department to provide swift and efficient services and support. Suggestions and ideas from the public in order to improve services are welcomed.

After the overview, questions were answered. At the South Coast forum, Mr Bob
Daniels, from the Chatsworth & District Partnership Against AIDS (C.A.D.P.A.A.),
voiced his concern that the empowerment programmes offered have not been visible in the Chatsworth community. He also appealed to the Social Welfare Department to simplify the procedures involved in grant applications. He further challenged the Department to a public meeting to educate the community on the services offered. The Department of Social Welfare noted the questions and promised to follow-up on them directly with Mr Daniels.

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