- KHAYELITSHA, Cape Town --
Half the staff at the cutting-edge Khayelitsha hospital near Cape Town,
which dispenses daily life- saving medicines to TB/Aids-patients under
the strict regimen required to prevent Extremely-Drug-Resistant Tuberculosis
(XDR-TB) from developing, have now been fired by the ANC-regime. These
dedicated, top-educated health workers denied in an urgent law suit filed
in Cape Town High Court yesterday that they had willingly participated
in the civil servants' strike, now in its third week.
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- Many of the fired health workers had been intimidated
by striking mobs when they tried to treat patients and had been threatened
and attacked, even at home, the court heard. The ongoing violence- driven
strike has disrupted SA health- and educational institutions countrywide
since June 1. The High Court will make its judgment known on Tuesday,
June 26.
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- http://www.mg.co.za/articlepage.aspx?area=/breaking_news/
breaking_news__national/&articleid=312011
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- "Irreparable harm has been caused" by dismissing
the health workers in Khayelitsha clinics said Dr Eric Goemaere, head
of Médecins sans Frontières in South Africa. He told the
Cape High Court that patients whose treatment had been interrupted could
become ill and die.
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- Khayelitsha's research-driven clinic is unique on the
African continent: run by the Nobel Peace Prize-winning aid organisation
Doctors without Borders, the role of their trained health workers is
vital: the clinic also treats many patients who are co-infected with
Tuberculosis and the Aids-virus. The research at this clinic is focused
on finding much faster, more accurate diagnostic tests and drug-resistance
testing to detect XDR-TB is also carried out there. The clinic's task
has become much more urgent now that XDR- TB has become an epidemic in
South Africa within just the past six months, with hundreds of patients
dying countrywide and more than 1,250 people per 100,000 of the SA population
(total 47-million) now infected with it according to the last statement
made on the subject by the National Department of Health -- in March 2007.
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- At the moment, people often die long before their diagnosis
can even be confirmed in the laboratory: a 120-year-old sputum test still
remains the only diagnostic tool and with South Africa's eight understaffed
laboratories, it can take up to 2 months before the results are known.
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- The law suit contends that these dismissals infringe
the constitutional rights of patients to health services and to life
and dignity.
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- LINKS to Treatment Action Campaign:
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- http://www.tac.org.za/nl20070618.html
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- These summary dismissals of half their health-care staff
by the country's health minister is a particularly bitter blow to Dr
Goemaere who heads the Doctors without Borders international health- care
organisation's South African office. Six months ago he had already issued
an urgent call for more health workers worldwide to sign up for jobs at
these unique clinics, which treat and diagnose co-infected TB+Aids patients.
SouthAfrica has 3,6-million people who are co-infected with TB and the
Aids virus. Dr Goemaere issued an urgent call for foreign medically-trained
workers to sign up for these southern African clinics, including at Khayelitsha,
in a broadcast on the Voice of America radio station. He warned that
there was such a severe shortage of doctors and nurses that many of their
patients had to forego their medicines.
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- Patients with the TB+HIV coinfection often develop XDR-TB
once their drug-taking regimen is interrupted. Dr Goemaere also warned
in his VOA broadcast that 'diagnosing new TB+HIV patients also is becoming
problematic (in South Africa) because there aren't enough nurses to take
in new patients."
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- Hear Dr Goemaere's his VOA broadcast on:
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- http://www.doctorswithoutborders.org/home.cfm
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- "We can try to control the damage that we see today
from drug- resistant TB," said Dr. Goemaere this week. "But we
are only seeing the tip of the iceberg". He spoke in reaction to
the World Health Organisation's new $2-billion plan, unveiled on June
22, to contain drug-resistant Tuberculosis worldwide:
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- read The WHO Plan, June 22 2007:
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- http://www.wtopnews.com:80/index.php?nid=106&sid=1172581
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- In South Africa, patients with the unique local strain
of XDR-TB called SA-1, which is a mutation of the tuberculosis bacillus
and the human-immune-deficiency virus, are dying within 20 days according
to local doctors:
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- Listen to NPR interviews about the struggle to contain
this XDR-TB strain with South African doctors and patients at two TB-hospitals:
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- http://www.npr.org/templates/story/story.php?storyId=6479589
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- Treatment is very difficult for patients co-infected
with HIV/AIDS. "These patients have to take between 13 and 16 pills
a day. Also, there are interactions between AIDS and TB treatment which
cause side effects like liver problems or allergies," highlights
Dr. Gilles Van Cutsem, the young Belgian-born doctor who coordinates
one of MSF's programs at Khayelitsha. He heads the clinic at Khayelitsha's
"Site B" since September 2003.
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- He recently co-authored several published scientific
reports on the field-testing methods being tried out at Khayelitsha to
try and detect TB+HIV co-infection quicker and more efficiently. At the
moment it takes up to 2 months for the sputum-test to diagnose the condition,
and even longer for the drug-resistant tests. Many patients die before
the test results come back to the clinic. In a June 2007 report entitled
: "Clinical, Immunological and Epidemiological Importance of Antituberculosis
T-Cell Responses in HIV-infected Africans" . Dr Van Cutsem noted
that:"the human immunodeficiency virus (HIV)-associated tuberculosis
was a major cause of mortality in Africa."
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- LINKS TO VAN CUTSEM'S STUDIES:
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- http://www.lib.bioinfo.pl/pmid:17516410
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- http://www.lib.bioinfo.pl/pmid:17522328
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- SEVERE HEALTH WORKER SHORTAGE IN SN. AFRICA REPORT :
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- http://www.doctorswithoutborders.org/publications/reports/2007/
healthcare_worker_report_05-2007.pdf
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- South Africa's University of Stellenbosch tuberculosis
expert Dr Nulda Beyers said the key to controlling drug-resistant strains
of the disease was to treat ordinary cases properly, preventing the creation
of more difficult ones. She said most of the new spending (announced by
the World Health Organisation on June 22) should be devoted to more medical
staff."If one just put all the money into labs and fancy drugs, that's
not going to do the thing," she said. "We need to build human
capacity. We need people to do the work."
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- South Africa has the largest number of people with Hiv-Aids
in the world, with about six million people infected -- and 60% (3.6-
million) of those people also are co-infected with TB+HIV - a condition
which becomes progressively untreatable with any available drugs and ultimately
leads to their death from Extremely- Drug-Resistant Tuberculosis (XDR-TB).
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- On June 22, 2007 during the introduction of their R2-billion
TB- campaign, Dr Paul Nunn of the World Health Organisation also stressed
the need for a massive increase in laboratory capacity in poorer countries
to diagnose and treat patients. "There is no way that we can even
begin to diagnose and treat the number of patients that need to be diagnosed
and treated unless we have a huge scale- up in lab capacity," he said.
He also noted that there are more such laboratories in South Africa alone
than in all of sub-Saharan Africa. South Africa has eight laboratories
countrywide capable of handling such tests and all are grossly undermanned
and underfunded.
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- The WHO first became concerned about XDR-TB in March
2006, and a particularly deadly outbreak among Aids-patients in South
Africa only confirmed their worst fears, Nunn said. "In a worst case
scenario, the 8.8 million annual cases of treatable TB worldwide could
be replaced by an equivalent number of XDR-TB cases," he warned,
noting that each one case of TB infects between 10 to 15 other people
each year."The possibility is that you could replace that epidemic
with a drug-resistant epidemic, in other words you could have 8.8 million
cases of drug-resistant TB wandering around -- and then you will be back
to the pre-antibiotic era," Nunn said.
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- LINKS TO ABOVE:
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- http://news.brisbanetimes.com.au:80/who-seeks-over-2-billion-us-
dollars-to-tackle-drugresistant-tb/20071922-jx4.html
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- http://www.msf.org.au/stories/twfeature/2006/113-twf.shtml
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- http://www.washingtonpost.com/wp-srv/content/article/tb_6-22.html?
hpid=topnews
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- Doctors without Borders/Medicins Sans Frontieres media
contact:
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- Email: michael_goldfarb@msf.org
- Telephone Direct: USA (1) (212) 763-5783
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