Mission Issues

Thinking and re-thinking missionary issues

Death – the inevitable result of AIDS

In an attempt to minimise stigma, I find that many people who work with others who are HIV+ or have full-blown AIDS, are reluctant to speak about death. “AIDS is not a death sentence!” we are told and in a certain sense I do agree with this. There are people who have become HIV+ twenty years ago and who are still living productive lives. There has been a great advance in the effectiveness of anti-retroviral therapy (ART) and this medication, linked to a healthy lifestyle could mean that someone who is HIV+ could live a long and healthy life.
Alas, this is not true in countries like Swaziland. ART is available, (unless if the government runs out of medication, which happens every now and then, which means that for a few weeks people have to live without taking the lifesaving medication). Many people starting ART have to stop using the medication when the expense of travelling to a clinic outweighs the advantage of using the medication. And test after test have shown that ART needs to be linked to a healthy diet for it to have a long-term effect on the person with AIDS.
In rural areas in Swaziland this is totally out of the question and with the exception of the few who are earning good salaries, even those who live in one of the larger towns in Swaziland where products such as fresh fruit and vegetables are available, do not have the resources to buy these products. This means that the majority of people who are on ART, have no choice other than to eat maize porridge (the staple food of Swaziland) – which is not unhealthy under normal circumstances, but which does not contain enough vitamins and other micro-nutrients essential to stay healthy while the person carries the HI virus.
Regular readers of this blog will know that we started with a home-based caring project in the southern region of Swaziland in 2005, where volunteers are trained and equipped to take care of the people in their communities who are too sick to look after themselves anymore. For more information on this work, you can go to http://www.swazimission.co.za/English/aids.htm
We have developed a fairly simple report form which each of the 400 volunteer caregivers fill out every month. The 12 groups which we have trained, each have a coordinator who then fill out another form, based on the report forms of the group’s volunteers and then I compile a single report from these 12 forms. I’m not all that interested in reports, but the way in which the form was developed, it is possible to see with a single glance where problems exist, how effectively we are working and also what is happening within the community.
I was wondering today how many of our clients (we prefer to speak of “clients” rather than “patients”) are dying each month. The number of clients are not stable, but on average we have about 1400 people whom we are caring for at this stage (about 3.5 clients per caregiver). To get this number in perspective: A medium to large congregation in South Africa may have around 1400 members. In a normal congregation of this size, there may be one or two funerals per month. But things are totally different in our case. In July 80 of the clients died. In August 54. September 54. October 60. November 29 and December 48. That’s 325 people who died in six months. That’s almost as many people that can travel on an Airbus A300! And this is happening only in 12 small communities in one region of Swaziland. What about all the other communities in the region where we are situated? What about the three other regions in Swaziland?
This is the ugly reality which we need to face. And we can try and be politically correct and tell our clients that AIDS is not a death sentence. Or we can face up to the reality and inform people of the horrible truth and assist them in making vital changes to their lifestyles (being tested, going on ART if they qualify, taking vitamins daily, eating healthy food if available, ensuring that they do not become re-infected with another strand of the HI virus, etc).
Every once in a while we receive reports about breakthroughs which may be coming in the treatment of people who are HIV+. I don’t get excited about these reports anymore. The harsh reality is that I believe that we are losing the battle against AIDS. And the number of people dying is proof to this fact.

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Tuesday, February 3, 2009 - Posted by | AIDS, Death, Health, HIV, HIV & AIDS, Home-based Caring, Hope, Mission, Poverty, Stigma, Swaziland, Theology

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