STARING DEATH IN THE FACE...

I have done a number of stories on AIDS. And I know people who are HIV-positive. But I have never come face to face with someone who is dying from it.

So when I entered the home of a woman, in her mid-late forties, who was in stage three of the disease, my eyes were instantly drawn to her gaunt face and arms, which were almost as thin as a curtain rod. Her home was no bigger than a walk-in closet that one may find in a master bedroom of a typical suburban Washington McMansion. Plastic shopping bags hang from the roof “to catch the rain water”, she later explained.

When I enter her bedroom, she was crying out in excruciating pain…but somehow, she still manages to show me a slight smile when I grasp her hand. She is one of Gloria Shabalala’s patients from Inanda Community Hospital. Gloria makes the rounds regularly to about 40 patients in this community toting a bag full of medicines and supplies . On this visit, she provides the woman with vitamins and electrolytes. But one thing that she can’t deliver is ARV’s (antiretroviral drugs).

“The ARV’s are free… but getting there is not,” Shabalala explained, stating that there is limited transportation to get to the nearest hospital that is located several kilometers away. Furthermore, she tells me that there is a wait list of at least nine months or more for many patients to obtain ARV’s. And even if the woman were able to take the drugs, she would need to have proper nutrition. Since she lost her job and disability grant, she can’t afford to buy food and often goes hungry. Much of the burden has fallen onto her 13-year-old son who helps to take care of her.

It is a disturbing predicament. But the situation is also challenging at King George Hospital in Durban. It is a tuberculosis hospital where doctors are starting to see an increase in the number of patients who have contracted drug-resistant strains of tuberculosis, known as MDR (multiple drug resistant) or XDR (extensively drug resistant). Because it is untreatable with first-or second-line drugs, many patients, specifically those who contract XDR-TB, often die within a short period of time. HIV positive patients have become especially vulnerable to this co-infection. Dr. Iqbal Masters, who runs the ward, said that 70 percent of his TB patients are HIV positive.

“ I am a bit pessimistic about how MDR/XDR is going to do…especially with HIV fueling it, probably the situation is going to get worse,” Masters explained.

I hate to think about it…but it is likely that many of the patients that I saw will probably die prematurely. So what happens next? According to Thembinkosi Ngcobo, head of Parks and Recreation for the Ethikweni District (which includes Durban and the surrounding municipalities), they may not have a place to be buried. About 98 percent of the cemeteries in the municipality are filled to capacity. There is only one open cemetery, he explained. Because of the shortage, many graves are being recycled. Remains are exhumed after ten years and reburied deeper into the ground in order to make more room for other bodies to be interred above on the same plot. Cremation is also becoming an essential alternative, though most local residents are against it for religious reasons. Ngcobo said that AIDS-related deaths are likely to blame for the high mortality rate within the district, with 80 percent of the burial victims between 25-35 years old.

“Every weekend we have to go to funerals,” said Ngobo, who lost his older brother to the disease 10 years ago. “We may not be able to say and know for sure… but it is common knowledge that the majority of young people are dying because of HIV/AIDS. I only hope that once as a country we admit that , we will be able to stand up and deal with the problem decisively.”