At an HIV/Aids treatment centre in this war-torn African city, doctor Nino Minani is still haunted by the despairing cry of a dying patient.
”’You’ll drink the ARV [antiretrovirals] yourselves, because I’ll already be dead by the time they arrive’,” Minani recalled of the woman’s remarks. ”She kept telling us,’you’re waiting for us to die to give us treatment’.”
And, indeed, the woman was dead before benefiting from the HIV/Aids-fighting medication — difficult and expensive to come by in impoverished Africa, particularly in this volatile and desperate part of the continent.
The dearth of antiretrovirals captures a larger dilemma of accessing health care in the Democratic Republic of Congo, scarred by years of ethnic strife and civil war.
In the western part of the country, where clashes between Congolese forces and Mai Mai militia drove more than 200 000 people from their villages last year, health care is delivered by a single, small rural clinic financed by the French doctors group, Médecins du Monde.
Based in the village of Mulange, it covers a patchwork of 100 isolated villages, clinging to hills and accessible by paths in pitiable state.
Torrential rainfalls can block villagers from reaching the clinic for care that includes critical, if basic treatment for malaria and cholera. Many villagers suffer from chronic malnutrition, health workers say.
Of the DRC’s 60-million people, about 2,6-million are infected with HIV/Aids or roughly 4,3% of the population — according to official figures.
But only 5 000 people have access to antiretroviral drugs. In the eastern city of Goma, only 300 patients have access to the drugs, which is less than a fifth of the 1 600 people needing them, health officials say.
”When we announce a refusal, the sick either react violently or with great depression,” said Minani, who works at an HIV/Aids centre in the city’s main hospital built by Médecins du Monde. ”They know [the antiretrovirals] improve life and they don’t want to wait.”
Each month the centre submits the applications of 25 people considered suitable for the drugs, but only 10 are included in the programme.
The antiretrovirals are expensive, and international aid has failed to finance enough supplies for the country’s Aids population. The Joint United Nations Programme on HIV/Aids was supposed to furnish antiretroviral drugs to the DRC in July last year. But it took until March for the drugs to arrive, and shipments remain sporadic.
As with other poor countries, the antiretroviral drugs that do arrive here are ”first-line” remedies, said Pierre Sallah, Médecins’ medical coordinator in Goma.
”When a patient develops a resistance to the first line, we need to furnish him with ‘second line’ antiretrovirals” that are more efficient in blocking replication of the virus. But the stronger drugs cost $350 (â,¬278) a month for each patient, compared to $29 for the first-line ones.
Those receiving the basic treatment in Goma praise the medications.
”It’s changed my life,” said Justine, a 33-year-old single mother of four, who has been taking the drugs for a year. ”I’ve gained a bit of hope and I can eat.”
Resplendent in a purple-and-white loose-fitting gown known as a boubou, the young woman now weighs 68kg compared to only 45kg when she started the treatments.
Today, she and another HIV/Aids patient receiving the drugs are trying to help those who are not. Patients creep into the hospital through a side door, since they suffer daily from stigmatisation.
Justine is also ostracised — only her brother speaks to her and shelters her, she said.
”I no longer exist and people don’t want to eat with me.” – Sapa-AFP