- The international medical aid agency is urgently advertising
for health care workers to address the "health care crisis in southern
- LESOTHO, Southern Africa -- Doctors without Borders'
medical coordinator in Lesotho, Dr Peter Saranchuk, firstname.lastname@example.org
reports that tuberculosis now is the leading killer of Aids- infected
people in that small, landlocked African country. The World Health Organisation's
Aids-expert Dr De Cock also said yesterday that XDR-TB has now reached
Lesotho and has already reached a mortality rate of 85% and still climbing.
- Neither men provided any exact statistics of the current
XDR-TB death toll, however. The tiny mountain kingdom is surrounded by
South Africa and many of its citizens work in South Africa. It only has
89 doctors -- 80% are foreign -- and at the country's top TB- hospital,
more than half of the nursing posts are vacant. Nurses are either dying
of Aids or TB, or finding more rewarding work - often in European hospitals.
Under those circumstances, it will be increasingly difficult to combat
the new XDR-TB epidemic.
- The organisation warns that due to this very severe medical
staff shortage in that small African country, the organisation struggles
to provide free antiretroviral treatment to the population even though
they have the medicines, the funds and the facilities - there's just not
enough staff. http://www.africafiles.org/ article.asp?ID=15099&ThisURL=./aids.asp&URLName=AIDS%20and%20Health
- Drug-resistant TB makes matters even worse...
- "This problem to distribute antiretroviral treatment
has been aggravated by the rapid spread of multi-drug resistant (MDR)
and extensively drug-resistant (XDR) TB, further straining an already
overburdened and severely understaffed health system," warned Dr
Saranchuk. He appealed for medically-trained foreigners to apply for
the open health slots at Doctors' Without Borders to help stave off the
health crisis in southern Africa.
- Lesotho - Population: 1.5-million, 89 doctors...
- One 70-year-old nurse for 344 patients at Kena Health
- Countrywide in Lesotho there are only 89 doctors -- and
80% of these are foreigners from other African countries who are awaiting
certification in South Africa where they can get higher paying jobs.
- In the Scott Hospital Health Service Area in Lesotho
-- which has only four doctors -- 35,000 Aids-infected people were diagnosed
-- of whom 5,000 diagnosed patients aren't getting the antiretroviral
treatment they need because there just aren't enough medical personnel
to run the clinics - over half of the nursing posts at its health centres
- XDR-TB has now also been identified in this region by
a WHO HIV- Aids spokesman in June 2007. .
- 70-year-old nursing sister/midwife Emily Makha now is
the only nurse at the entire Health Centre- which treats 344 children
with free antiretroviral drugs."As the only nurse here, I have to
do the work of at least four nurses. I take blood samples, sputum, do
both ante-natal and post-natal cases, and do curative cares for general
patients, baby deliveries, etc. If I have to go somewhere, the clinic
remains closed. Most nurses have left for the UK or South Africa. As a
matter of fact, if I was younger, I would also have gone by now!"
- Lesotho is a small, poor, mountainous country with the
third highest HIV rates in the world, the fourth highest TB rates -- and
now also facing the XDR-TB epidemic.
- As of May 2007, not a single one of the country's 14
health centres has even the minimum staffing complement, and the number
of nurses has still decreased in the past year. In 2006, more than 25
nurses left the Health Service Area for other jobs and as of May 2007,
54% of professional nursing posts at health centres were vacant. This
left trained nursing assistants with just two years of training carrying
much of the burden of clinical work
- South Africa not much better, warns Doctors without Borders:
- "Those guys sitting in offices far away from the
epidemic will be held responsible...
- In South Africa's black townships, the problem is very
much the same, Doctors without Borders warn. In the township of Khayelitsha
(population 500,000) near Cape Town) they have been treating 7,262 adults
and children with free antiretroviral medication since 2001 -- and 5,848
(81%) of these patients still remain in care.
- These clinics are now totally saturated and many patients
who apply for care remain now remain undiagnosed and untreated while waiting
for the waiting lists to slot them in.
- According to Western Cape health authorities, 466 clinical
nurse practitioners (the most skilled category of nurse) are needed for
basic health services by 2010. However the region only employs 71 nurses
-- a mere 15% of the nurses needed."
- Khayelitsha's health care system near Cape Town has started
- "In Khayelitsha.. the health care system has started
to collapse. We are absolutely saturated, and even with all of our financial
means, we have now come back to long waiting lists, and it feels again
like we are losing the battle (against Aids).
- "For those guys sitting in offices far away from
the epidemic our message is that you will be held responsible if you are
not reactive or flexible enough to find solutions to the staff shortages."
- Dr Eric Goemaere, Head of Mission, Doctors without
Borders, MSF South Africa
- Aids and TB are the leading causes of death for health
workers in Southern Africa:
- AIDS and TB are not only creating extraordinary demands
for health care in areas where health systems are already weak and overwhelmed,
but is also killing off the health workforce, Doctors without Borders
- "Health staff is lacking across the spectrum - from
doctors to laboratory technicians to pharmacists - at all levels of care.
- In South Africa, Lesotho, Mozambique, and Malawi, death
due to Aids is the leading cause of health worker attrition, with a significant
proportion being HIV-related."
- The shortage of nurses in the public sector has grown
substantially worse between 2000 and 2005. For example, the number of
enrolled nurses has dropped from 60 per 100,000 to 52 per 100,000 and
the number of professional nurses has dropped from 120 per 100,000 to
109 per 100,000 in South Africa.