Get more Mail & Guardian
Subscribe or Login

The ART of treatment

The hospital on the outskirts of Nairobi wasn’t built because of its proximity to the Kenyan capital’s massive townships, although the chaotic slums do provide it with an overflow of patients.

It wasn’t constructed using millions of dollars of donor funds, which is why it consists completely of cold, grey cement, overcrowded wards and medical equipment dating back to the 1960s.

The wind created Mbagathi Hospital.

”It blows a lot on the hill here. We treat many people with airborne diseases, like TB [tuberculosis]. And we believe the wind provides good ventilation so that bacteria don’t flourish. It sounds simple, but it’s the truth. That’s why this location was a good choice for a clinic,” says Roselyne Okumu, the institution’s sole social worker.

But as much as Okumu lauds the wind, it can’t blow Aids away. Kenya is a country where at least 1,2-million people are HIV-positive and about 300 people die every day as a result of the epidemic.

Yet these days at Mbagathi, a new breeze is stirring up old beliefs and the much-maligned hospital is a shining example of how anti-retroviral therapy (ART) can be rolled out, even in an under-resourced, impoverished setting.

Kenya is wracked with infighting in the ruling National Rainbow Coalition — a government consisting of largely conservative politicians who are anti-abortion, pro-death penalty and support abstinence — yet it is also fully in favour of ART.

Last year Kenya got a bigger share ($75-million) of US government funds to fight HIV/Aids than any other African country because of the cooperative way programmes are being rolled out.

With far fewer resources than South Africa, Kenya has given ART to 25 000 of its HIV-positive citizens who require the drugs. In contrast to South Africa, the Kenyan government has clearly defined and publicised roll-out targets: by April next year, it plans to provide 45 000 people with ART; and 75 000 by the end of 2005. If this objective is indeed attained, Kenya would be providing access to ART to more than 40% of its HIV-positive people who need it.

But beyond the cold statistics and bold intentions, Okumu puts a human face on the revolution at Mbagathi: before the hospital started giving ART, few people visited the social worker’s clinic to be tested for HIV.

”They didn’t want to know their status, but now that they know that ART gives them a chance to live, they come for testing and they have the courage to face up to Aids,” Okumu enthuses.

”Far fewer patients seem to feel stigmatised by being HIV-positive. They are now quite open, which was not so a year ago.”

And until recently, Mbagathi’s wards were filled to capacity with disease- ridden HIV-positive patients. But now that ART is being administered, these people no longer fall ill with chronic opportunistic infections, freeing up much-needed beds. But the hospital has also become a victim of its own success: its achievements with ART have doubled staff workload, yet the government has so far failed to appoint additional personnel.

”It’s difficult,” Dr Shobha Vakil, a provincial ART officer, admits. ”Patients need to be closely monitored; ART won’t work if patients don’t take the drugs at the same time every single day. It takes a lot of time and effort, and a lot of counsellors, nurses and doctors to make sure this happens. There is great pressure.”

It’s easy to elevate the Kenyan example, yet imperfections remain: patients are expected to pay up to 1 300 Kenyan shillings, about R100, for ”pre-ART” tests that determine whether or not they need the drugs, and the government also charges individuals KSH500 (about R38) a month for the therapy.

Patricia Atieno isn’t bothered with analysis of perceived failures and successes. For her, the country’s ART roll-out is ”only about life!

”My kids are no longer scared of their mummy dying.”

  • Estimated worldwide HIV infections: 60 094 374

  • Subscribe for R500/year

    Thanks for enjoying the Mail & Guardian, we’re proud of our 36 year history, throughout which we have delivered to readers the most important, unbiased stories in South Africa. Good journalism costs, though, and right from our very first edition we’ve relied on reader subscriptions to protect our independence.

    Digital subscribers get access to all of our award-winning journalism, including premium features, as well as exclusive events, newsletters, webinars and the cryptic crossword. Click here to find out how to join them and get a 57% discount in your first year.

    Darren Taylor
    Darren Taylor is a freelance journalist based in Johannesburg. He is a regular contributor to several African and international news organisations.
    Mia Malan
    Mia Malan
    Mia Malan is Bhekisisa's editor-in-chief and executive director. Malan has won more than 20 African journalism awards for her work and is a former fellow of the Reuters Institute for the Study of Journalism at Oxford University.

    Related stories

    WELCOME TO YOUR M&G

    If you’re reading this, you clearly have great taste

    If you haven’t already, you can subscribe to the Mail & Guardian for less than the cost of a cup of coffee a week, and get more great reads.

    Already a subscriber? Sign in here

    Advertising

    Subscribers only

    R350 social relief grant not enough to live on

    Nearly half of the population in South Africa — one of the most unequal countries in the world — is considered chronically poor.

    More top stories

    Popularity will not guarantee mayoral selection — Ramaphosa

    ANC president Cyril Ramaphosa has promised a more rigorous mayoral selection process, which will involve the party’s top six

    Nowhere to turn for abused bakery workers

    After being chased away for asking for minimum wage, Gqeberha bakers who endured racism turned first to the CCMA, then to a political party, then to a union. None helped

    Health director general suspended for alleged involvement in Digital Vibes...

    After initially defending Sandile Buthelezi’s personal leave, the health department has announced that he has been placed on precautionary suspension

    For many SA women, home is hell

    Gender-based violence often takes place at home or in intimate relationships, taking a traumatic toll on victims, their families and friends
    Advertising

    press releases

    Loading latest Press Releases…
    ×