Treating AIDS patients and rape survivors
With more than 6.5 million people living
with HIV, South Africa has the largest
number of HIV-positive people in the
world. MSF is working in low-income areas
of the Western Cape and Eastern Cape, providing
life-extending antiretroviral (ARV)
medicines and related care for HIV-positive
patients.
In cooperation with the Western Cape
Department of Health, MSF has been working
since 1999 at three HIV clinics within
primary health care centers in the impoverished
township of Khayelitsha, located on
the outskirts of Cape Town. The township,
home to almost 500,000 people, was created
during the late years of apartheid. Its
inhabitants suffer from high unemployment,
poor living conditions and a staggering
HIV infection rate of 29 percent.
The clinics' staff members provide HIV care
including ARV treatment for those with
advanced AIDS and care for opportunistic
infections. A pilot project to integrate TB
and HIV care is being conducted at the
Ubuntu clinic, (see page 16). By August
2005, the Khayelitsha HIV/AIDS clinics were
providing ARVs to 2,600 people and conducting
more than 8,000 medical consultations
per month.
A partnership between MSF and Cape
Town health authorities led to the opening
of a youth center in mid-2004. The center
aims at providing medical care, psychosocial
support and life skills to youngsters living
in the township. Its services include
family planning and care for sexually transmitted
infections and HIV including voluntary
HIV counseling, testing and education.
It also hosts activities such as debates,
dances and planning meetings.
Sexual abuse is one of the major problems
facing poor South African communities.
Nevertheless, its magnitude is hard to estimate
since it remains largely unreported.
Since 2003, MSF has supported the
Simelela Rape Survivors Center in
Khayelitsha, which is run in partnership
with provincial health and social services
authorities, the police and a local organization
specializing in rape crisis work.
Simelela offers medical, psychological and
social care — including post-exposure prophylaxis for HIV — a police service and
ongoing monitoring of patients. The
center's scope of activity expanded in
August 2005 to include forensic examinations,
and its hours have increased to 24
hours a day, seven days a week. In the
month of August alone, Simelela's staff
provided assistance to more than 130 rape
victims — about half of them children under
the age of 14.
Since early 2003, MSF has run another HIV
project in Lusikisiki, in partnership with
provincial health authorities of the Eastern
Cape province. Lusikisiki, one of the
province's poorest regions and a former
homeland, has an HIV prevalence rate of
30 to 40 percent. Since MSF established its
program in the central hospital and 12
clinics, more than 600 people have been
tested for the virus each month. Three MSF
mobile teams provide medical care to
those with HIV-related infections. MSF
began offering ARV treatment in November
2003, and by August 2005, 1,000 people
were receiving these medicines through
the program.
Central to all of MSF's activities in South
Africa is a strong, fruitful partnership with
the Treatment Action Campaign, a grassroots
movement, to advocate for better
access to HIV care and treatment. At community
level, both groups support patients'
adherence to treatment, fight stigma and
discrimination against people with HIV and
promote prevention of new infections.
Joint campaigns are also developed at the
national and international levels.
MSF first worked in South Africa in the mid-1980s and returned in 1999 to respond to
the needs of people affected by HIV/AIDS.
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