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 Lack
Of Doctors Hurting AIDS War
by The Associated Press
Posted: May 24, 2007 - 7:00 pm ET
(Cape Town, South Africa) A shortage of
doctors and nurses in Africa is now one of the biggest obstacles to providing
life-saving drugs to AIDS patients, condemning untold numbers to an unnecessary
death, a new report says.
Africa has
increased the number of AIDS sufferers on treatment from
100,000 in 2003 to 1.3 million last year, but a lack of
medical workers is preventing further expansion of drug
programs, according to the report released Thursday by
Medecins Sans Frontieres.
"The
international community says it wants to achieve universal
access, and in Khayelitsha we were coming close, but at a
certain point things started to collapse," said Eric
Goemaere, who heads the agency - also known as Doctors Without
Borders - in that sprawling Cape Town township.
"We are
absolutely saturated. We have come back to waiting lists and
it feels again like we are losing the battle," he said.
Southern
Africa is hardest hit by the AIDS epidemic, accounting for the
vast majority of the 40 million infections and the daily death
toll of 8,000. Despite the advances in AIDS treatment taken
for granted in rich countries, more than 70 percent of
Africans who need it are still waiting.
On an
average day, about 200 AIDS patients flock to the clinic set
up by Doctors Without Borders in Khayelitsha. Many others
languish at home, not for lack of drugs but because there
aren't enough health workers to administer them.
At the
clinic in Khayelitsha - where about 30 percent of adults have
the AIDS virus - nearly 6,000 people are currently receiving
anti-retroviral therapy. But the number of new patients
starting treatment each month dropped from 270 in May 2006 to
100 last December - mainly because of lack of health workers.
Mpumelelo
Mantangana, a nurse at the clinic, says her workload has
soared as other nursing staff have left for better-paid jobs
in the private sector or abroad. She understands why - the
work is exhausting and the pay is peanuts.
"I work
purely because of passion for what we are doing. People come
in and they are very sick and we see them get better. That is
the only thing which gives us strength," she said in an
interview at the clinic, where long lines of people waited
patiently on wooden benches.
South Africa
has 393 nurses and 74 doctors per 100,000 people, but a high
percentage work in the private sector and shortages are
especially acute in rural areas. This compares to 901 nurses
and 247 doctors per 100,000 people in the United States.
In tiny
Lesotho, which is also ravaged by AIDS, there are just five
doctors and 63 nurses per 100,000 people. In Malawi, there are
two doctors and 56 nurses, and in Mozambique three doctors and
20 nurses.
The Doctors
Without Borders report, which focused on the four southern
African countries, made grim reading. It said that in the
Thyolo district of Malawi, a single medical assistant sees up
to 200 patients per day. In Mavalane district in Mozambique,
many patients died during the two-month wait to start
treatment, while in one of Lesotho's main hospitals, more than
half the nursing jobs were vacant.
The report
said that countries would only be able to cope with the crisis
by "task-shifting" - allowing nurses to do work
normally assigned to doctors, medical assistants to do the
work of nurses and using more community workers.
Malawi is
already doing this, and a new AIDS plan recently adopted in
South Africa also shifts treatment away from hospitals to
community-based care. Lesotho also has nurse-based treatment -
but there simply aren't enough nurses.
The report
also pointed the finger at donor countries, which pay for
antiretroviral drugs and new clinics but don't provide for
health workers' salaries to operate them.
It said the
U.S. Millennium Challenge Account has committed an $140
million to improve physical infrastructure at health
facilities. But no plans have been made to recruit the 600
additional health care workers needed to staff the facilities.
"People
living with HIV/AIDS do not only need drugs and clinics; they
need trained, motivated health care workers to diagnose,
monitor and treat them," the report said.
©365Gay.com 2007
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