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Health staff haemorrhage limits AIDS treatment access

A severe lack of healthcare workers is compromising both quality and availability of HIV/AIDS care in southern Africa, warned international medical relief organisation Medecins Sans Frontieres (MSF) on Thursday.

In a new report exploring the situation in Lesotho, Malawi, Mozambique and South Africa, MSF said more than 1 million people were in need of antiretroviral (ARV) drugs in each of these countries but could not accessing them.

Rachel Cohen, the MSF head of mission in Lesotho, attributed part of the problem to treatment expansion efforts in the region, which was leading to staff migration to countries that offered better pay and more manageable workloads.

"In Lesotho for example, there are just 89 doctors, 80 percent of whom are foreigners from other African countries awaiting certification in South Africa for better salaries," she told IRIN/PlusNews.

According to the report, the shortage of doctors - less than 2 per 100,000 patients - made lower cadres such as nursing staff even more valuable in the provision of care, but they were also in short supply.

"As of May 2007, 54 percent of professional nursing posts at health centres were [vacant]," the study noted.

Lesotho not only has the third highest HIV prevalence in the world, with 23.2 percent of its 1.8 million population is HIV-positive, but the small mountainous kingdom is also ranked the 149th poorest country out of 170. 

MSF head of mission for South Africa, Dr Eric Goemaere, said that restrictive donor financing was not helping the situation. "Despite wide acknowledgement by donors of the crisis, they are unwilling to cover 'recurrent costs' of health staff salaries. Instead they build more clinics with no staff to manage them."

He added: "HIV-positive people do not only need drugs and clinics; they need trained, motivated health care workers to diagnose, monitor and care for them ... current donor participation is equivalent to arranging chairs on the Titanic as it sinks."

Veronica Chifaka, a nurse/matron working with MSF in the Malawi, told IRIN/PlusNews: "The vacancy rate for nurses in rural areas is 60 percent. Our treatment programme is hitting a wall because there is simply not enough nurses, doctors and medical assistants ... the few staff that we do have at our disposal are not only overwhelmed by the workload, but are also dying of AIDS-related illnesses themselves."

Even in South Africa, which has better paid healthcare workers than most other southern African countries, unequal distribution and inadequate numbers of staff was causing delays in expanding treatment.


This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions

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