Access to treatment a concern for displaced living with AIDS

The Zimbabwe government's recent controversial clean-up drive, 'Operation Restore Order', which left some 700,000 without homes or livelihoods, also denied people living with HIV/AIDS (PLWHA) access to antiretroviral treatment. Chip Maphosa, a single mother of three, was among the thousands affected by the campaign. Her family spent two weeks sleeping in the open after the shack she was renting in Makokoba township in the southern city of Bulawayo was destroyed by police. The HIV-positive Maphosa has now found temporary shelter for her family at the Salvation Army Church in Makokoba. Rattled by a coughing fit, and sneezing regularly, she told IRIN "my condition is getting worse... this cough is not good". The clean-up campaign had disrupted her antiretroviral (ARV) treatment. Zimbabwe has one of the world's highest HIV/AIDS prevalence rates at 25 percent of a population of 11.5 million. According to the joint United Nations Programme on HIV/AIDS (UNAIDS), a minimum of 180,000 Zimbabweans died of AIDS-related illnesses in 2004, while in 2005 an estimated 3,500 were succumbing to the disease every week. It is thought that over 1.5 million children have lost one or both their parents to the epidemic. A survey by the Bulawayo-based Matabeleland AIDS Council (MAC) said about 200 terminally ill people had been displaced by the clean-up campaign and most were in dire need of food, clothes and drugs. It was also difficult for AIDS workers to locate evicted PLWHA, who were often unable to continue their treatment as a result. Hlengiwe Ngwenya has also found shelter at the Salvation Army facility. She tearfully recalled the day in June when police swooped on Killarney, a squatter camp south of Bulawayo, and destroyed her shack and everything in it, including her medical records. "I have to start afresh. I was receiving ARVs but my schedule has been disrupted," she said. Methuseli Ndlovu lost his HIV-positive wife soon after they were removed from an urban area to their rural home, 90 km north of Bulawayo. "She required urgent medical care, but the clinic in my village has had to close due to drug shortages," he told IRIN. In his report following a visit to Zimbabwe in July, Rod Macleod, director of the London-based Catholic Institute for International Relations, related how a widow who had lost her husband to AIDS and was struggling to look after four children was given 24 hours to knock down her own house and had to spend winter exposed to the elements. Nurses at clinics in Bulawayo said patients who had been receiving treatment for tuberculosis (TB), one of the main opportunistic diseases associated with HIV/AIDS, had disappeared. "We have tried to make follow-ups at their homes but we have been told that they no longer stay there after their homes were destroyed," said a matron at Bulawayo's Central Hospital, a major referral centre. "Most of them are infected with pulmonary TB and they are spreading it." Home-based care providers were no longer available to help look after the sick, and health workers said community-based AIDS initiatives crumbled when their members were dispersed. Maintaining a healthy lifestyle had become difficult for the displaced, because they no longer had access to counselling sessions or much choice in what they ate. Church leaders estimated that over 20,000 displaced people were housed in ecclesiastical facilities across Bulawayo, waiting to be moved to a transit camp at Helensvale Farm, 20 km northwest of the city. Pastor Albert Tatenda, a member of a group of 200 clerics involved in discussions with the government over the plight of those displaced by the clean-up campaign, said facilities in transit camps had to be upgraded to avoid outbreaks of communicable diseases. "There is much to be done, like setting up the tents and clearing the grass. We have made it clear to the government that this has to be done before people move in," Tatenda noted. According to the government, evictees are to be allocated houses under a US $300 million programme dubbed Operation Garikai/Hlalani Kuhle (Operation Live Well), currently underway. However, critics have argued that the state does not have the resources to house all the displaced people, some of whom had been on housing waiting lists for over 10 years, and pointed out that the programme was moving at a slow pace. Others have alleged it would only benefit those supporting the ruling ZANU-PF party. Nevertheless, people like Maphosa look forward to being relocated, as long as they are resettled closer to Bulawayo, because "I need to have access to a referral health centre for tablets and check-up".