[Ip-health] AP -- Lack of doctors and nurses killing AIDS patients, says MSF

[Buddhima Lokuge]

Lack of doctors and nurses killing AIDS patients, says MSF=0D
=0D
The Associated Press=0D
Thursday, May 24, 2007=0D
=0D
CAPE TOWN, South Africa. Lack of medical staff is emerging as one of the=0D
biggest obstacles to providing patients with anti-AIDS drugs, condemning=0D
untold numbers of Africans to an unnecessary death, says a new report.=0D
=0D
As Africa slowly gets to grips with providing anti-AIDS drugs =E2=80=94 inc=
reasing=0D
the number of people on treatment from 100,000 in 2003 to 1.3 million in=0D
2006 =E2=80=94 the dire shortage of doctors and nurses is now jeopardizing =
more=0D
widespread provision of the lifesaving therapy, according to a report=0D
Thursday by Medecins Sans Frontiers. 'The international community says it=
=0D
wants to achieve universal access, and in Khayelitsha we were coming=0D
close, but at a certain point things started to collapse,' said Eric=0D
Goemaere, who heads MSF =E2=80=94 also known as Doctors Without Borders =E2=
=80=94 in a=0D
sprawling Cape Town suburb. 'We are absolutely saturated, we have come=0D
back to waiting lists, and it feels again like we are losing the battle,'=
=0D
he said.=0D
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Southern Africa is hardest hit by the AIDS epidemic, accounting for the=0D
vast majority of the 40 million infections and the daily death toll of=0D
8,000. Despite the advances of providing treatment taken for granted in=0D
rich countries, more than 70 percent of the Africans in need of treatment=
=0D
are still waiting. On an average day, around 200 AIDS patients flock to=0D
see Mpumelelo Mantangana and her closely knit medical team at a clinic in=
=0D
an impoverished part of town. Many others languish at home, not for lack=0D
of drugs but rather lack of health workers to administer them. At the=0D
clinic started by MSF in Khayelitsha =E2=80=94 where about 30 percent of ad=
ults=0D
have the AIDS virus =E2=80=94 nearly 6,000 people are currently receiving=
=0D
anti-retroviral therapy. But the number of new people starting treatment=0D
each month dropped from 270 last May to 100 in December =E2=80=94 mainly be=
cause=0D
of lack of health workers. Mantangana, a nurse at the clinic, says her=0D
workload has soared as other nursing staff have left for greener pastures=
=0D
in the private sector or abroad. She understands them =E2=80=94 the work is=
=0D
exhausting and the pay is peanuts.=0D
=0D
'I work purely because of passion for what we are doing. People come in=0D
and they are very sick and we see them get better. That is the only thing=
=0D
which gives us strength,' she said in an interview at the clinic, gazing=0D
at the long lines of people waiting patiently on wooden benches on the=0D
concrete floor. South Africa has 393 nurses and 74 doctors per 100,000=0D
people, but a high percentage work in the private sector and shortages are=
=0D
especially acute in rural areas. This compares to 247 doctors and 901=0D
nurses per 100,000 people in the United States. In tiny Lesotho, which is=
=0D
also ravaged by AIDS, there are just 5 doctors and 63 nurses per 100,000.=
=0D
In Malawi, it is 2 doctors and 56 nurses and in Mozambique 3 doctors and=0D
20 nurses.=0D
=0D
The MSF report, which focussed on the four southern African countries,=0D
made grim reading. It said that in the Thyolo district of Malawi, a single=
=0D
medical assistant can see up to 200 patients per day. In Mavalane district=
=0D
in Mozambique, many patients died during the two month wait to start=0D
treatment because of the lack of doctors and nurses. In one of Lesotho's=0D
main hospitals, more than half the professional nursing posts were vacant.=
=0D
The report said that countries would only be able to cope with the crisis=
=0D
by 'task-shifting' =E2=80=94 allowing nurses to do work assigned to doctors=
,=0D
medical assistants to do the work of nurses and using more community=0D
workers. Malawi is already doing this and a new AIDS plan recently adopted=
=0D
in South Africa also decentralizes treatment and care away from hospitals=
=0D
and gives community a much bigger role. Lesotho also has nurse-based=0D
treatment =E2=80=94 but there simply aren't enough nurses.=0D
=0D
The report also pointed the finger of blame at donor governments, who were=
=0D
willing to pay for antiretroviral drugs and new clinics but not contribute=
=0D
toward staff salaries to operate them. For instance, it said the US=0D
Millennium Challenge Account had committed an unprecedented $US 140=0D
million to improve physical infrastructure at health facilities. But no=0D
plans had been made to recruit the estimated 600 additional health care=0D
workers needed to staff the facilities. 'People living with HIV/AIDS do=0D
not only need drugs and clinics, they need trained, motivated health care=
=0D
workers to diagnose, monitor, and treat them,' the report said.=0D
=0D