/ 22 February 2002

Mpumalanga stands firm on which hospitals can provide drugs

Sizwe samaYende and Justin Arenstein

Mpumalanga has hit the headlines repeatedly as its controversial health MEC refused to allow an NGO and doctors to provide anti-retroviral drugs for rape survivors.

This week Sibongile Manana was attacked by opposition parties and civic groups for her refusal to deviate from the national government line and make nevirapine available for HIV-positive pregnant women.

Manana instead told the provincial legislature that nevirapine use was strictly confined to just two pilot sites at Shongwe and Evander hospitals.

”Drugs are not the only answer. We need to fight poverty in order to fight HIV/Aids as has been stressed by President [Thabo] Mbeki and Premier [Ndaweni] Mahlangu,” said Manana.

”Nevirapine is not just a [headache pill]. We will not issue it over the counter without proof of its effectiveness, and not before we have proper infrastructure for counselling and follow-up treatment.”

Manana said the province would upgrade its nevirapine trials at the two hospitals by finally allocating money for counsellors and nurses.

She admitted that very few rural mothers had signed up for the treatment, because of under-funding of the Mpumalanga trials, delayed implementation and an absence of qualified personnel.

Manana also said Mpumalanga simply did not have the numbers of skilled medical staff needed. ”We refuse to distribute the drug just for the sake of handing it out. We first need to renovate hospitals, build counselling rooms, train new staff, and appoint non-profit organisations to help. Procedures have to be followed,” she insisted.

But she was unable to say when the necessary infrastructure and staff would be in place, when the trials would be complete or how many new children would become infected with HIV/Aids while the province followed procedures.

United Democratic Movement’s women’s organisation secretary Khosi Mncedane said Mpumalanga’s hardline policies relegated women and children to second-class citizenship and condemned babies to death.

Mncedane dismissed Manana’s reasoning as ”flawed”, asking whether Manana was ”advocating that the province also not treat or stop treating cancer patients because the hospitals in the province are not up to standard?”

Provincial Democratic Alliance leader Clive Hatch added that it was already national policy for hospitals to have private examination rooms for survivors of rape and abuse. ”These rooms should already exist; therefore no alterations would be necessary,” he said.

Manana rejected the comments as cheap politicking.

Meanwhile support is growing for for anti-retroviral champion Dr Thys von Mollendorff. The Rob Ferreira Hospital superintendent was found guilty of gross insubordination by a government tribunal last week after he allegedly embarrassed government by allowing volunteer workers to facilitate the provision of free anti-retroviral drugs to rape survivors.

The 40 volunteers, working for the Greater Nelspruit Rape Intervention Project (Grip), also provided rape survivors with counselling, fresh clothes, toiletries and legal advice.

Manana accused Von Mollendorff of allowing ”poison” to be distributed to illiterate black women, and twice appealed unsuccessfully to the high court to evict Grip from Rob Ferreira, Themba and KaNyamazane hospitals.

Manana refused to comment on Von Mollendorff’s case this week, but told the legislature that any non-profit, non-government or volunteer organisations that continued to defy provincial policy would be frozen out of the public health sector.

Von Mollendorff is still waiting to hear his sentence, but his attorney, Richard Spoor, insists the career hospital administrator was merely fulfilling hisHippocratic oath and will appeal the verdict.