Why we must provide treatment information

Vuyiseka Dubula

South Africa

Many nurses not trained in HIV. They are seeing patients with opportunistic infections but they are not allowed to prescribe certain medications – fluconazole, for example – because only doctors can prescribe it. But the doctor only comes once a month. The nurses see people who are sick but can’t help them. They tell them, “Go home, there are no fluconazole tablets.”

If a nurse tells you there is no medication and turns you away, then the next time you won’t spend your money for transportation. So, you take a five minute walk, and see a friendly face at the traditional healer. They will take time with the patient and that patient may not go back to the HIV clinic. That’s why some people will opt for spiritual healing and look for purification with bleach or something like that.

Our treatment literacy practitioners are in the clinic to educate people about what to expect before they start treatment. There is limited time to explain everything when a patient sees the nurse, but if the treatment literacy practitioner has explained things the nurse can spend only five minutes instead of an hour. Treatment literacy practitioners can also do voluntary counselling and testing (VCT) and relieve the burden on nurses. There is only one pharmacist for 500 people, so our practitioners can also be trained as assistant pharmacists. Treatment literacy practitioners are now participating on some clinic committees.

90% of people using public healthcare system are poor people. Only 10% of our population uses the private sector – but more money is allocated for the private sector than the public.

In the private sector you will not come into contact with a treatment literacy practitioner and you may never hear about side effects and learn the things you need to know. So going to the private sector also has disadvantages.

A big problem for us in South Africa is our president and our Minister of Health. Our president says there is no health care crisis in our country. But isn’t having only one nurse for 500 people a crisis?

This web presentation is based on a book with photographs by Wolfgang Tillmans. It follows a global meeting held in Cape Town in 2006 organised by the Treatment Action Campaign, South Africa and i-Base, England.