XDR
TB SA1 Spreads To Lesotho, South Africa. . .
Nurses Flee,
Doctors Without Borders Alarmed
About TB/Aids Deaths In S Africa
By Adriana Stuijt
Exclusive to Rense.com
6-8-7
The international medical aid agency is urgently advertising for health care
workers to address the "health care crisis in southern Africa"
LESOTHO, Southern Africa -- Doctors without Borders' medical coordinator in
Lesotho, Dr Peter Saranchuk, office@joburg.msf.org reports that tuberculosis
now is the leading killer of Aids-infected people in that small, landlocked
African country. The World Health Organisation's Aids-expert Dr De Cock also
said yesterday that XDR-TB has now reached Lesotho and has already reached a
mortality rate of 85% and still climbing.
Neither men provided any exact statistics of the current XDR-TB death toll,
however. The tiny mountain kingdom is surrounded by South Africa and many of
its citizens work in South Africa. It only has 89 doctors -- 80% are foreign
-- and at the country's top TB-hospital, more than half of the nursing posts
are vacant. Nurses are either dying of Aids or TB, or finding more rewarding
work - often in European hospitals. Under those circumstances, it will be
increasingly difficult to combat the new XDR-TB epidemic.
The organisation warns that due to this very severe medical staff shortage
in that small African country, the organisation struggles to provide free
antiretroviral treatment to the population even though they have the
medicines, the funds and the facilities - there's just not enough staff.
http://www.africafiles.org/article.asp?ID=15099&ThisURL=./aids.asp&URLName=AIDS%20and%20Health
Drug-resistant TB makes matters even worse...
"This problem to distribute antiretroviral treatment has been aggravated by
the rapid spread of multi-drug resistant (MDR) and extensively
drug-resistant (XDR) TB, further straining an already overburdened and
severely understaffed health system," warned Dr Saranchuk. He appealed for
medically-trained foreigners to apply for the open health slots at Doctors'
Without Borders to help stave off the health crisis in southern Africa.
Lesotho - Population: 1.5-million, 89 doctors...
One 70-year-old nurse for 344 patients at Kena Health Centre:
Countrywide in Lesotho there are only 89 doctors -- and 80% of these are
foreigners from other African countries who are awaiting certification in
South Africa where they can get higher paying jobs.
In the Scott Hospital Health Service Area in Lesotho -- which has only four
doctors -- 35,000 Aids-infected people were diagnosed -- of whom 5,000
diagnosed patients aren't getting the antiretroviral treatment they need
because there just aren't enough medical personnel to run the clinics - over
half of the nursing posts at its health centres are vacant.
XDR-TB has now also been identified in this region by a WHO HIV-Aids
spokesman in June 2007. .
70-year-old nursing sister/midwife Emily Makha now is the only nurse at the
entire Health Centre- which treats 344 children with free antiretroviral
drugs."As the only nurse here, I have to do the work of at least four
nurses. I take blood samples, sputum, do both ante-natal and post-natal
cases, and do curative cares for general patients, baby deliveries, etc. If
I have to go somewhere, the clinic remains closed. Most nurses have left for
the UK or South Africa. As a matter of fact, if I was younger, I would also
have gone by now!"
Lesotho is a small, poor, mountainous country with the third highest HIV
rates in the world, the fourth highest TB rates -- and now also facing the
XDR-TB epidemic.
As of May 2007, not a single one of the country's 14 health centres has even
the minimum staffing complement, and the number of nurses has still
decreased in the past year. In 2006, more than 25 nurses left the Health
Service Area for other jobs and as of May 2007, 54% of professional nursing
posts at health centres were vacant. This left trained nursing assistants
with just two years of training carrying much of the burden of clinical work
South Africa not much better, warns Doctors without Borders:
"Those guys sitting in offices far away from the epidemic will be held
responsible...
In South Africa's black townships, the problem is very much the same,
Doctors without Borders warn. In the township of Khayelitsha (population
500,000) near Cape Town) they have been treating 7,262 adults and children
with free antiretroviral medication since 2001 -- and 5,848 (81%) of these
patients still remain in care.
These clinics are now totally saturated and many patients who apply for care
remain now remain undiagnosed and untreated while waiting for the waiting
lists to slot them in.
According to Western Cape health authorities, 466 clinical nurse
practitioners (the most skilled category of nurse) are needed for basic
health services by 2010. However the region only employs 71 nurses -- a mere
15% of the nurses needed."
Khayelitsha's health care system near Cape Town has started to collapse:
"In Khayelitsha.. the health care system has started to collapse. We are
absolutely saturated, and even with all of our financial means, we have now
come back to long waiting lists, and it feels again like we are losing the
battle (against Aids).
"For those guys sitting in offices far away from the epidemic our message is
that you will be held responsible if you are not reactive or flexible enough
to find solutions to the staff shortages."
– Dr Eric Goemaere, Head of Mission, Doctors without Borders, MSF South
Africa
Aids and TB are the leading causes of death for health workers in Southern
Africa:
AIDS and TB are not only creating extraordinary demands for health care in
areas where health systems are already weak and overwhelmed, but is also
killing off the health workforce, Doctors without Borders warn.
"Health staff is lacking across the spectrum - from doctors to laboratory
technicians to pharmacists - at all levels of care.
In South Africa, Lesotho, Mozambique, and Malawi, death due to Aids is the
leading cause of health worker attrition, with a significant proportion
being HIV-related."
The shortage of nurses in the public sector has grown substantially worse
between 2000 and 2005. For example, the number of enrolled nurses has
dropped from 60 per 100,000 to 52 per 100,000 and the number of professional
nurses has dropped from 120 per 100,000 to 109 per 100,000 in South Africa.
http://www.msf.org/source/countries/africa/southafrica/2007/Help_wanted.pdf
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