Lack of resources hinder HIV/AIDS response
in [Physics]
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From: as on 13 Aug 2010 04:58 Lack of resources hinder HIV/AIDS response http://www.thestandard.co.zw Wednesday, 11 August 2010 15:36 IT is 3:30am on a humid early Thursday morning at St Theresa's Mission Hospital in Chirumhanzu District in the country's Midlands province. Everyone in the wards and staff residences is still asleep, except for a few night-shift nurses and a lone man puffing a cigarette at his desk in the hospital's laboratory. In front of him are sealed boxes inscribed PMTCT Mvuma, St Theresa's, Muonde and Holy Cross outreach. A desk fan that keeps him awake blows off some sheets of paper on his desk. The man picks up the sheets and then wipes off sweat rolling down his forehead. He opens one of the boxes, pulls out a test tube and inserts it into a CD4 count machine. As he monitors the machine, he pulls out yet another cigarette from a pack on his desk while the wall clock ticks away towards yet another hectic day ahead, which will see him going out on an outreach programme with other members of the Anti-retroviral Therapy (ART) team. Such is the nature of work and sacrifice that Simbarashe Chirasha, the only laboratory scientist at the hospital, has to put up with to cope with the increasing demand for HIV and Aids services in the district due to increased awareness programmes. He has had to endure sleepless nights to ensure that he determines the HIV status of thousands of people going for tests at some health centres in the district. This trend is the same nationwide for personnel involved in the ART programme who comprise of doctors, primary care counsellors, nurses, pharmacy technicians and laboratory scientists. It is through such sacrifice by the few health workers that 247 000 people have been put on the ART programme nationwide, but the figure could have been much more were it not for the acute staff shortages, inadequate equipment, lack of incentives and fuel, among other factors. In an interview during a recent media tour of ART sites in Chirumhanzu, Chirasha said due to human resource constraints, he was forced to work overtime to deliver the much expected CD4 count results. "The district has only one CD4 count machine and I am the only scientist expected to analyse over 250 blood samples per week. "Our sister hospitals conduct tests and send blood samples of patients who are waiting to be initiated on ART. "The blood samples should be analysed within 48 hours. That's why I am forced to work overtime for the expectant villagers to get their results on time," said Chirasha. Chirumhanzu district has less than 20 ART staff who cater for over 10 000 patients. The shortage of health professionals has left the burden on a few staff supported by the Global Fund (GF) and the Expanded Support Programme (ESP). The GF and the ESP are supporting the programme at 22 and 16 district hospitals respectively. Each health centre receives support in terms of ARV drugs, vehicles and support salary for two doctors, laboratory scientists and two pharmacy technicians while the rest of the supporting staff are not covered. An ART nurse at Mvuma District Hospital, Kudzai Hoko said he was demoralised because he was not getting any incentives. "I am the only ART nurse at Mvuma hospital and when we conduct our community outreach programmes for HIV patients I have to attend to nearly 200 patients a day. "What is demoralising is that other cadres under GF are getting paid whilst I am not. I work without any incentive and this has also resulted in some staff leaving these stations," said Hoko. Senior clinical medical officers in Chirumhanzu district echoed the same sentiments. The acting medical superintendent at Muonde hospital Dr Ponesai Nyika said staff running the ART programme were now suffering from burn-out. "The shortage of nurses in this district shows what is also happening at all ART sites countrywide and this situation has a negative impact on those living with HIV and Aids," said Nyika. This is confirmed in a recent report of the Mid-Term Review of the Zimbabwe National HIV and Aids Strategic Plan (ZNASP) 2006-2010 conducted by consultants which states that: "Critical shortages of human resources and severe inadequate funding for the national response pose grave and present danger to the successful implementation of the ZNASP and all efforts must be made to immediately improve the critical shortage of human resources whilst long term plans are developed for a sustainable human resources base for the national response." The report says the ZNASP target to have 75% of adults between the ages of 15-49 years counselled and tested for HIV (HCT) by 2010 is unlikely to be met as only 15% of adult population had accessed HCT services by the end of 2007, according to the NAC estimates. However, current (2008/09) estimates put adult coverage at 29,6 % and children coverage at 10%. "Both targets are very much unlikely to be met by 2010. "This inability to meet the targets stems from an acute shortage of doctors to initiate ART treatment," reads the report. The reluctance by some doctors to initiate treatment based on the WHO clinical staging alone in the absence of CD4 counts, ARVs stock-outs at some sites, payment for non-ARVs aspects of the ART programme by patients at some facilities, and inadequate decentralisation of the programme nearer to communities were also cited in the report. In Mashonaland Central Province, the shortage of staff is also affecting the implementation of the ART programme. The Government medical officer at Concession District Hospital, Dr Solomon Mukungunugwa, said fuel shortages, inadequate ART trained nurses were affecting the scale-up of the ART programme. Dr Kwenzakwenkosi Ncube, the GMO at Karanda Mission Hospital in Mount Darwin said that ART nurses at the health centre were working as late as midnight to cater for over 300 ART patients per day. "We are working as late as midnight to assess the health of our ART patients because we are limited. "We go out in rural areas on outreach programmes and we do not get incentives and food allowances, leaving us stressed at the end of the day because we have to go to work on the following day," said Dr Ncube. A survey in Midlands and Mashonaland Central has shown that over the 50 health centres in both provinces were operating with less than five CD4 count machines, 30 ART nurses and pharmacists to cater for thousands of people seeking treatment. However, the few ART staff in the provinces have continued to work extra hours to put 247 000 people on treatment. The figure is set to double following the start of the five-year Global Fund Round Eight grant and the extension of the ESP programme to 2011. The recent decision by the Ministry of Health and Child Welfare to harmonise salaries for health personnel under the Health System Strengthening (HSS) programme should help retain and motivate junior staff involved in the ART programme. By Orirando Manwere
From: Goldy on 13 Aug 2010 16:06 I think diseases are the main causes of poverty worldwide. People who are too sick are too weak to perform labor and so remain poor. Their lack of money to pay for medicine exacerbates their situation until they reach a helpless situation where thery are simply left to die.
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