EPISODE 22 - Public Health Services

The HIV epidemic has put our Public Health Services under severe strain. As more people become ill, health-care resources are increasingly strained, not least because there are too few health workers to deal with the rising numbers of patients living with HIV. In addition to the physical stress of overwork, caring for patients with incurable diseases is often emotionally draining, especially where resources are too limited to provide good treatment.

Health workers are often described as being at the "frontline" of the battle against HIV/Aids, because on a daily basis they deal directly with people who are ill or dying of the disease.

Sister Violet Ramalapa is in charge of the busy Masakhane ARV clinic at Thembisa Hospital in Gauteng. The clinic services three huge townships north-east of Johannesburg. Sr Ramalapa says that in 2004, the first year that the clinic started providing ARVs, they had 500 patients on ARVs. Now they provide ARVs to more than seven thousand patients. This number increases every day. She says they regularly see more than 500 patients a day and the clinic staff often work overtime because if they send patients away they may die before they can come back.

Public Health Nurse

The increased workload and low salaries paid to health workers in the public health service has led to many nurses and doctors leaving the country to work overseas. Last year public sector doctors embarked on an unprecedented nation-wide strike in protest against working conditions and low salaries in our public health services. In Kwazulu-Natal the health department responded to the doctors' strike by firing some 300 doctors. They soon backed down, however, and the doctors were re-instated. Dr Shailendra Sham one of the leaders of the strike says the main reason for the strike was the Health Department's tardiness in implementing salary increases for doctors. He emphasizes that the strike was not simply about low wages but also about improving the services offered to patients.

Doctors Strike

Nonqubela Nongcangca lives in the remote rural village of Quakeni near Lusikisiki in the Eastern Cape. Nonqubela and her young daughter are both living with HIV. One of the biggest issues in her life is the lack of access to clean drinkable water. Nonqubela and her daughter are both on ARVs and they are forced to use contaminated water to take their pills and to cook with. This is a huge public health issue in our country as contaminated water leads to diseases such a cholera and diarrhoea. In children under five and people with a weakened immune system, such as those living with HIV, diarrhoea can very quickly result in dehydration and death.

Clean Water