![[South Africa] Despite a caseload of 3,000 patients, skilled staff management and a system of down-referral to satellite clinics has significantly reduced waiting times at Johannesburg General's ARV clinic. [Date picture taken: 01/20/2005]](https://assets.thenewhumanitarian.org/s3fs-public/styles/responsive_large_2x/public/images/20068115.jpg.webp?itok=zzn0KK4u "Officials under pressure to contain deadly TB")
Lihle Dlamini is the deputy general-secretary of South Africa’s AIDS lobby group, the Treatment Action Campaign. As the country moves to include a strong emphasis on tuberculosis (TB) for the first time in its latest national strategic plan on HIV, Dlamini recounted her experience with TB treatment almost 10 years ago:
“I’ve been cured of TB, but I see that people who have TB in 2011 still face the same challenges I faced in 2002.
“I had pleural effusion TB [in which fluid accumulates in the space between the lining of the lung and the lung tissue] and went to the Durban chest clinic. I was told to cough up sputum but I didn’t have sputum and wasn’t coughing. I had lost a lot of weight, I weighed 33kg, and was sweating a lot at night – I had all the TB symptoms except for the coughing but [doctors] insisted on getting the sputum. There was one time where I was tempted to ask for the sputum of an old man who didn’t have a problem of coughing out sputum but I realized that it wouldn’t help me.
“An X-ray was taken but it again showed no signs of TB. Lucky for me, I have an aunt who is a doctor. She took me to a hospital, and took a lot of X-rays and drew fluids from my lungs, and took them to the laboratory. I was diagnosed with TB and was put on TB medication.
“The challenge of taking TB medication at that time was that [some of the tablets] were big. I had to take five tablets every morning... [and] other tablets. I had to count all the pills that I took every morning, all together they were 17. It took me a whole hour to swallow [them].
“Another challenge was having to go to the clinic for follow-up exams - having to wait in the queue the whole day, having to wake up at 3am because the queue started at 4am. When you got there, you’d find that there were 50 people already waiting, some had to wake up at 2am to be first in line. The clinic only opened at 7am but when you come at 7.30am, you’d be turned back because you were too late.
“Those are the challenges that patients with TB still face. We need better diagnostic tools for TB, especially for extra-pulmonary TB [that occurs outside the lungs]. The diagnostic tools we have now and the ones that are still being researched - most focus on pulmonary [but] we know people living with HIV are prone to getting extra-pulmonary TB."
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“I’ve been cured of TB, but I see that people who have TB in 2011 still face the same challenges I faced in 2002.
“I had pleural effusion TB [in which fluid accumulates in the space between the lining of the lung and the lung tissue] and went to the Durban chest clinic. I was told to cough up sputum but I didn’t have sputum and wasn’t coughing. I had lost a lot of weight, I weighed 33kg, and was sweating a lot at night – I had all the TB symptoms except for the coughing but [doctors] insisted on getting the sputum. There was one time where I was tempted to ask for the sputum of an old man who didn’t have a problem of coughing out sputum but I realized that it wouldn’t help me.
“An X-ray was taken but it again showed no signs of TB. Lucky for me, I have an aunt who is a doctor. She took me to a hospital, and took a lot of X-rays and drew fluids from my lungs, and took them to the laboratory. I was diagnosed with TB and was put on TB medication.
“The challenge of taking TB medication at that time was that [some of the tablets] were big. I had to take five tablets every morning... [and] other tablets. I had to count all the pills that I took every morning, all together they were 17. It took me a whole hour to swallow [them].
“Another challenge was having to go to the clinic for follow-up exams - having to wait in the queue the whole day, having to wake up at 3am because the queue started at 4am. When you got there, you’d find that there were 50 people already waiting, some had to wake up at 2am to be first in line. The clinic only opened at 7am but when you come at 7.30am, you’d be turned back because you were too late.
“Those are the challenges that patients with TB still face. We need better diagnostic tools for TB, especially for extra-pulmonary TB [that occurs outside the lungs]. The diagnostic tools we have now and the ones that are still being researched - most focus on pulmonary [but] we know people living with HIV are prone to getting extra-pulmonary TB."
llg/kn/mw
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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