One of the biggest impediments was the clinic’s inaccessibility. In order to identify who needed the drugs, Sister Kumalo had to send off patients’ blood to a clinic many kilometers away to be tested. There was no reliable collection service and patients were getting sicker as they waited for the results which took inordinate amount to come back. She took it upon herself to hand-deliver the blood samples once a week. This entailed a 6- to 8-hour minibus journey costing approximate $8 per trip, paid for out of her own pocket. This represented about 4 percent of her salary. Everyone was delighted when, in January, the clinic was allocated its own vehicle by the Department of Health.
Sister Kumalo introduces us to Simon Qambulana, the first patient from Mdjobe Clinic to start on antiretrovirals (ARV), drugs designed to reduce a patient’s susceptibility to the illnesses associated with HIV infection. He had walked up to the clinic especially to meet us. He lives close to the road and had been looking out for our hire car, hoping we would stop and give him a lift. We knew nothing of this arrangement and had sped past him carrying our two female passengers and their luggage. We apologize profusely.
Simon started on ARVs at the end of September. Initially he felt worse, experiencing a loss of appetite and diarrhea. He said he felt a little discouraged. He was advised by the Sister to drink water with added salt and sugar to help him replace the essential minerals he was losing. After a while, he started feeling much better. Blood results indicated that his immune system was improving. He reported “feeling stronger and stronger.” Prior to going on ARVs he had “no power” to go “long distances”; now he can “do everything in the home.”
Simon is active in his community, encouraging others who are losing weight to get a HIV test. He told us he had not experienced any discrimination from family, friends or neighbors since he disclosed his status. Approximately one in five of those living in his village will be HIV positive, even if they are blissfully unaware as yet. The most vulnerable are the married women.
Simon attends support group meetings, advising patients who are about to start their treatment what they may experience by way of side effects and the importance of remembering to take their medication. The clinic now has 24 patients on ARVs with a further seven receiving counseling in preparation for this lifetime’s commitment. The prize? The medication can potentially extend someone’s life by approximately 15 years.
When asked if there is anything we can do to support Sister Kumalo, she says she would like a “prefabricated building.” She says the support group meets “under the trees.” Now it’s getting colder, they don’t want to have to do this.
We say our goodbyes and are accompanied to the car. As we walk through the waiting area, our two lady passengers, plus luggage have taken their place in the queue to see Sister Kumalo.
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