analysis
Dianne Black
Richard*, a part-time employee of very long standing, had been steadily losing weight and suffering from recurrent bouts of illness. When he told me that he had had swollen glands for weeks and they would not go down despite the medication he had been receiving, I didn’t have to be a physician to suspect what might be wrong.
My general practitioner (GP) was discretion itself. Richard would need to have some blood tests. No, he did not know what was wrong. No, he could not suggest what it might be. Only once the initial tests were done and Richard had given his permission were my husband and I brought into the discussion.
And that is when theory gave way to experience and we began really to understand that for the millions who are not Richard, who do not have access to caring private doctors, easy transport, convenient clinics, information and, above all, relatively large bank accounts their own or those of somebody willing to help HIV-positive may indeed be a death sentence.
It is only once we found ourselves in a sense “living with Aids” that we realised how very little the average privileged South African knows about how to deal with it. What were we in for? What could we do? Where could we find the information we needed to help a man who has been in our lives for more than 25 years handle something he clearly did not understand? We were on a learning curve.
So was Richard. The first thing he had to do, counselled the GP, was to go home and tell his wife and family. How? The GP gave me the number of a hospice which, in turn, put me on to the dedicated counsellors in a clinic in Esselen Street, Johannesburg. Had Richard not already had the blood tests done, they would have organised those for him.
But where to go for the triple cocktail that would control the rampant virus that had invaded his bloodstream? Perhaps we were particularly ignorant. Perhaps, influenced by the reams that have been written about abandoned Aids clinics in hospitals, we didn’t even try what might have turned out to be an easily accessible option. Our GP knew little more than we did. He knows he will ultimately have to learn a whole lot more but the problem is only now beginning to filter into his northern suburbs practice.
Here too, though, we are fortunate in our ability to access a range of contacts. Through a close friend who works actively in the fields of Aids activism and is, himself, HIV-positive, we were referred to a private medical practice specialising in the problem. Here Richard was examined; counselled; told simply, quietly and insistently what drugs were being prescribed and exactly how he should take them; and assured that if he encountered problems, advice was at the end of a telephone line.
He doesn’t discuss it. We don’t ask. He has his drugs. We hope he will take them and live to enjoy a relatively healthy and economically active life for many years. We don’t know what we will do if he becomes really ill. We are concerned and not a little frightened by the prospect of lingering, terminal illness. But if the time comes we will find a way to handle that too. We have the resources and the access to information.
If Richard did not have anyone to fall back on how would he cope? The answer has to be that he, like millions of South Africans, would not cope at all; he would simply get sicker and sicker, be unable to work to support himself or his family, and eventually die, probably in abject poverty.
The costs we have run up thus far look like this:
l Private doctors, several consultations around R500.
l Blood tests, private laboratory around R1 000 (a second set will be done in six weeks at much the same cost to determine whether the medication is working).
l Drugs R978 a month, if the pharmacy does not offer them at cost R685 if it does.
Had this problem arisen four years ago, those drugs would probably have totalled in excess of R4 000 a month. We are assured that at some time in the future the cost will decrease even further. Perhaps it will. Perhaps it won’t. We can’t wait.
Perhaps the government will stop ducking and diving and take steps to make the drugs available to those who need them most and can afford them least. Perhaps they won’t. Those people can’t wait either.
For the price of a multibillion-rand defence contract, a presidential jet, a clutch of official Mercs, millions of South Africans could remain economically active, could have a future, could be given a chance. But they won’t. A country has to have its priorities. Doesn’t it?
Poverty, it has been said, contributes to the spread of Aids. There may be some truth in that. What is certain, though, is that Aids contributes to the spread of poverty.
* The names of both the writer and the subject have been changed to protect their privacy