Its not all bad news for the province, however, as it received the fewest reports of stock-outs by public healthcare users. Photo: Reuters

NEWS

Every three months, Vuyo* has to travel for about four hours from Matatiele in the Eastern Cape to Durban in KwaZulu-Natal to get her antiretroviral (ARV) treatment.

She has been featured in the second edition of the Eastern Cape State of Health report by Ritshidze, a community-led monitoring system developed by organisations representing people living with HIV.

The organisations include the Treatment Action Campaign, the National Association of People Living with HIV, the Positive Action Campaign, the Positive Womens Network, and the SA Network of Religious Leaders Living with and affected by HIV/Aids.

The Ritshidze data, which was launched on Thursday, reveal improvements at Eastern Cape clinics, but patients still complained about poor treatment at healthcare facilities, which saw them missing their appointments and even stopping their clinic visits.

READ: Intimate partner violence impedes ARV treatment adherence among adolescents - study

Vuyo tested positive for HIV two years ago and was getting her treatment from Matatiele Community Clinic.

On this day, I was in pain and decided to go to the clinic. I told the nurse my problem and she started shouting that I was being careless with my life for not using a condom. She called other nurses and they started talking about me as if I was not there. That day was so embarrassing, and I was hating myself so much. I even thought of dying, and thats when I decided to quit the clinic, she said.

For some time after that incident, Vuyo defaulted on her medication because, when she went to other clinics, she was referred back to Matatiele.

She said:

I then decided to go and get my medication in Durban, as my sister works there. It is working better for me like that, and they give me medication for three months. I dont have problems with the medication and I dont default.

No privacy

Ritshidze data show that 55% of the people interviewed thought that clinic staff were always friendly and professional in the Eastern Cape. This is down from 63% last year.

This poor treatment is off-putting enough for people to miss appointments or even stop going to the clinic altogether. Some report being terrified at what awaits them, read the report.

Some people complained that clinic staff members disclose the status of patients living with HIV in waiting areas.

There were also reports of two or more patients consulted with or counselled in the same room, and people living with HIV separated from other chronic patients.

According to the report for key populations, clinic visits can be traumatic, and staff can be unfriendly and even openly hostile.

Many people we spoke to had given up on healthcare altogether, including 47% of gay and bisexual people, and men who have sex with men; 41% of people who use drugs; 39% of sex workers; and 47% of transgender people.

Despite commitments by Pepfar [The US Presidents Emergency Plan for Aids Relief] and the national health department to roll out a robust key population sensitisation toolkit as part of standard in-service training for all facility staff, disrespect, ill-treatment and dehumanisation of key populations remain a widespread challenge that should be urgently fixed, with consequences for clinic staff who commit privacy violations.

READ: Study finds SA street sex workers have a high chance of being infected with HIV

The report states that, for those key populations still getting healthcare, most go to public healthcare facilities, yet specific services remain extremely limited.

Lubricants were only available in 41% of sites during this reporting period. While, notably, PrEP [pre-exposure prophylaxis] was reported as available at all 45 facilities monitored, the number of facilities that reported offering PrEP to key populations was far lower. Drug dependence and overdose treatments are not available at our clinics, neither is hormone therapy, yet 36% of people who use drugs wanted access to methadone and 35% wanted access to naloxone, and 29% of transgender people wanted access to hormone treatments at their facilities, reads the report.

Slight improvement

Its not all bad news for the province, however, as it received the fewest reports of stock-outs by public healthcare users in the current reporting period, with only 7% of patients who had left, or knew someone who had left, a facility without the medication they needed.

The report said:

Of the sites that reported a stock-out, 15% were forced to send people away empty-handed. The issues outlined in the second edition of the state of health report identify reasons people do not want to go to the clinic to access HIV and tuberculosis prevention and treatment services, and why some people interrupt treatment or disengage from care altogether.

According to the report, understaffed clinics meant that healthcare workers were overburdened, which led to longer waiting times, limited time to attend to public healthcare users and bad attitudes.

These factors directly and negatively impact people living with HIV from starting and staying on treatment. By June next year, the Eastern Cape health department should fill 70% of vacancies in the province, including the 322 vacancies reported at Ritshidze sites, and fill the remaining 30% by the end of the 2023/24 financial year.

The provincial health department should produce annual reports on the number of healthcare workers employed in each district and the number of people and size of areas covered by these healthcare workers. These reports should also include year-on-year comparisons (from at least 2020) of the number of filled posts in all districts and the cost of these posts to the government, the report recommends.

*Not her real name

Read more here:
HIV patients abused and humiliated - News24

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