AIDS epidemic overwhelms health facilities

Ana Ndongue, 19, travelled from Buzi, about 30km from the port city of Beira, in Mozambique, in search of a better life.

She sold snacks on the beach and her best clients were fishermen. She fell in love with one of them, Manuel, but in 2006 he died from an AIDS-related illness.

Today she is a patient at the Central Hospital in Beira, where she lies on a mattress in a corridor. "I've been here for two months and the care isn't very quick, I think because there are so many of us," said Ndongue, who has no relatives in the city.

Beira is in Sofala Province, where the 26.5 percent HIV prevalence rate is the highest in the country, and much higher than the 16.1 percent national average.

Hospital staff said the growth of the epidemic was overwhelming the facility. In the last five years, the number of new patients has tripled and is still climbing. According to the hospital registry, in March the general ward had 120 in-patients, almost double its capacity, while the tuberculosis ward had 90 patients - 50 more than its capacity. 

According to Célia Silva, director of the hospital's HIV/AIDS clinic, 60 percent of the patients in the general ward and 90 percent of those in the tuberculosis ward were infected with HIV. "Today it is known with certainty that the avalanche of new cases is a manifestation of the reality of the disease," she said. 

The "first wave" of an HIV epidemic is characterised by the rapid spread of infections. Mozambique is experiencing the so-called "second wave", when opportunistic diseases begin to manifest in large numbers.

Health workers at Central Hospital are just as susceptible to the virus as their patients and their HIV-related health problems have also affected the hospital's performance.

"There is absenteeism," Silva told IRIN/PlusNews. "Doctors, nurses and medical assistants are becoming infected and are unable to contribute because of their own lamentable state."

Despite having easier access to health services, many staff members are still afraid to be tested for HIV or seek treatment, Silva added.

Four hundred patients pass through the Central Hospital's HIV/AIDS clinic every day and many have to wait for hours in the corridors.

Christina Rui, 27, from Muchatazina, a neighbourhood on Beira's outskirts, is in her fourth week of TB treatment. She has to walk more than an hour each day to reach the old colonial building that houses the hospital.

"I need to get here early in order to get attended to early. When I get here late, at 7am, I sometimes only leave the hospital after noon," she said.

The HIV/AIDS clinic assisted 28,675 infected people between April 2003, when antiretroviral treatment became available at the Central Hospital, and April 2007. Of those, 2,697 are now on treatment.

On average, 90 to 120 people begin treatment per month - an improvement compared to four years ago, but an added challenge to the hospital's capacity.

Four more clinics in Beira are now administering antiretroviral treatment to cope with the demand, and another two will open soon.

ac/ks/he