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Patients caught in bloody Aids battle

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HIV-positive patients wait in line at a clinic. The writer argues that theft and corruption have let down people in need of treatment. Picture: Cara Viereckl

Janet Smith argues that theft and corruption have let down people in need of treatment.

Johannesburg - There’s nothing inside the free condoms container. But it doesn’t look like much other upkeep has been going on at the front table where the container is perched on top of scattered pamphlets and information sheets rolled up with elastic bands.

There’s a dry fountain trying its best to make a go of the entrance, and it’s not having much luck.

Then again, why would the Malvern Clinic particularly need to try to be anything more than what it is? It’s simply a site where a poor community can access mostly free health care.

And this week, as World Aids Day was solemnly marked on Sunday, the clinic’s job is evidenced by the rows of white plastic chairs and the quiet queues of people. It counsels those living with HIV and provides them with life-enhancing drugs.

Or not.

This is, after all, one of Joburg’s many public health facilities which have sometimes battled to supply their patients with the full gamut of cocktails they need to manage a virus that is now a part of South African culture.

The people who come here are among the 2.4 million on the government’s national antiretroviral (ARV) database, deeply affected by stock-outs where 30-day supplies of life-extending medicine have at times been reduced to 10 days.

Some patients have had to skip doses, risking illnesses that could kill them, including drug-resistant strains of HIV itself which they might, in turn, take out into the world. Will they be among the 200 000 South Africans expected to die of Aids-related infections this year, or next?

Patients at Malvern Clinic, like others all over the city, have found themselves caught in a protracted, three-way tussle for responsibility – a bloody street fight between the government, its facilities and the big pharmaceutical companies. The state, which must urgently deliver on the world’s biggest HIV treatment campaign, has blamed its own clinics for not communicating properly with the suppliers, which have blamed the government for not paying them.

That argument continued, miserably for patients, for years.

Then finally, in July, as a national crisis developed, Minister of Health Aaron Motsoaledi gave up on the government’s own failed processes.

International non-governmental organisations and activists say that as many as one in five clinics such as Malvern could no longer meet the expectations of a programme which earned Motsoaledi and the government praise around the world.

So he relented, and said Joburg facilities should start procuring their own drugs.

Theft and corruption had let the people down. But the long lists of names on the ARV register at Malvern Clinic don’t necessarily know the tainted political backdrop, even though the promise on the plaque outside is of Joburg being a world-class city.

They do know they want to live and so all they hope is that they will never again have to come back here once a fortnight just to top up their meds.

People in the queues remain stoic. “It’s part of life,” said a young woman with a happy baby swaddled up to its neck in a towel on her back.

But she’d prefer to not have to worry about stockouts again because every two-way trip to Jules Street from the Denver hostels area – the “other side”, as she puts it – costs money. Three times a month? It mounts up.

She’s used to this clinic where there’s no smoking, eating, drinking or firearms allowed, but there is a flat-screen TV playing music videos, and gospel, remote as vespers, on the radio. An old scale, taped up in places, stands patiently waiting to reveal some truth about someone on the chairs.

Two women in colourful Ndebele dress whisper to each other, clutching each other’s wrists to make a point. Their conversation hums into the background as others line up at the window to collect.

Who knows their stories about HIV, except them? How much have the failures of Aids programmes cost their families in the past 20 years?

* Janet Smith is executive editor of The Star.

The Star

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