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XDR TB SA1 Spreads To
Lesotho, SA - Nurses Flee
Doctors Without Borders Alarmed
About TB/Aids Deaths In S Africa
By Adriana Stuijt
Exclusive to Rense.com

The international medical aid agency is urgently advertising for health care workers to address the "health care crisis in southern Africa"
LESOTHO, Southern Africa -- Doctors without Borders' medical coordinator in Lesotho, Dr Peter Saranchuk, office@joburg.msf.org reports that tuberculosis now is the leading killer of Aids- infected people in that small, landlocked African country. The World Health Organisation's Aids-expert Dr De Cock also said yesterday that XDR-TB has now reached Lesotho and has already reached a mortality rate of 85% and still climbing.
Neither men provided any exact statistics of the current XDR-TB death toll, however. The tiny mountain kingdom is surrounded by South Africa and many of its citizens work in South Africa. It only has 89 doctors -- 80% are foreign -- and at the country's top TB- hospital, more than half of the nursing posts are vacant. Nurses are either dying of Aids or TB, or finding more rewarding work - often in European hospitals. Under those circumstances, it will be increasingly difficult to combat the new XDR-TB epidemic.
The organisation warns that due to this very severe medical staff shortage in that small African country, the organisation struggles to provide free antiretroviral treatment to the population even though they have the medicines, the funds and the facilities - there's just not enough staff. http://www.africafiles.org/ article.asp?ID=15099&ThisURL=./aids.asp&URLName=AIDS%20and%20Health
Drug-resistant TB makes matters even worse...
"This problem to distribute antiretroviral treatment has been aggravated by the rapid spread of multi-drug resistant (MDR) and extensively drug-resistant (XDR) TB, further straining an already overburdened and severely understaffed health system," warned Dr Saranchuk. He appealed for medically-trained foreigners to apply for the open health slots at Doctors' Without Borders to help stave off the health crisis in southern Africa.
Lesotho - Population: 1.5-million, 89 doctors...
One 70-year-old nurse for 344 patients at Kena Health Centre:
Countrywide in Lesotho there are only 89 doctors -- and 80% of these are foreigners from other African countries who are awaiting certification in South Africa where they can get higher paying jobs.
In the Scott Hospital Health Service Area in Lesotho -- which has only four doctors -- 35,000 Aids-infected people were diagnosed -- of whom 5,000 diagnosed patients aren't getting the antiretroviral treatment they need because there just aren't enough medical personnel to run the clinics - over half of the nursing posts at its health centres are vacant.
XDR-TB has now also been identified in this region by a WHO HIV- Aids spokesman in June 2007. .
70-year-old nursing sister/midwife Emily Makha now is the only nurse at the entire Health Centre- which treats 344 children with free antiretroviral drugs."As the only nurse here, I have to do the work of at least four nurses. I take blood samples, sputum, do both ante-natal and post-natal cases, and do curative cares for general patients, baby deliveries, etc. If I have to go somewhere, the clinic remains closed. Most nurses have left for the UK or South Africa. As a matter of fact, if I was younger, I would also have gone by now!"
Lesotho is a small, poor, mountainous country with the third highest HIV rates in the world, the fourth highest TB rates -- and now also facing the XDR-TB epidemic.
As of May 2007, not a single one of the country's 14 health centres has even the minimum staffing complement, and the number of nurses has still decreased in the past year. In 2006, more than 25 nurses left the Health Service Area for other jobs and as of May 2007, 54% of professional nursing posts at health centres were vacant. This left trained nursing assistants with just two years of training carrying much of the burden of clinical work
South Africa not much better, warns Doctors without Borders:
"Those guys sitting in offices far away from the epidemic will be held responsible...
In South Africa's black townships, the problem is very much the same, Doctors without Borders warn. In the township of Khayelitsha (population 500,000) near Cape Town) they have been treating 7,262 adults and children with free antiretroviral medication since 2001 -- and 5,848 (81%) of these patients still remain in care.
These clinics are now totally saturated and many patients who apply for care remain now remain undiagnosed and untreated while waiting for the waiting lists to slot them in.
According to Western Cape health authorities, 466 clinical nurse practitioners (the most skilled category of nurse) are needed for basic health services by 2010. However the region only employs 71 nurses -- a mere 15% of the nurses needed."
Khayelitsha's health care system near Cape Town has started to collapse:
"In Khayelitsha.. the health care system has started to collapse. We are absolutely saturated, and even with all of our financial means, we have now come back to long waiting lists, and it feels again like we are losing the battle (against Aids).
"For those guys sitting in offices far away from the epidemic our message is that you will be held responsible if you are not reactive or flexible enough to find solutions to the staff shortages."
­ Dr Eric Goemaere, Head of Mission, Doctors without Borders, MSF South Africa
Aids and TB are the leading causes of death for health workers in Southern Africa:
AIDS and TB are not only creating extraordinary demands for health care in areas where health systems are already weak and overwhelmed, but is also killing off the health workforce, Doctors without Borders warn.
"Health staff is lacking across the spectrum - from doctors to laboratory technicians to pharmacists - at all levels of care.
In South Africa, Lesotho, Mozambique, and Malawi, death due to Aids is the leading cause of health worker attrition, with a significant proportion being HIV-related."
The shortage of nurses in the public sector has grown substantially worse between 2000 and 2005. For example, the number of enrolled nurses has dropped from 60 per 100,000 to 52 per 100,000 and the number of professional nurses has dropped from 120 per 100,000 to 109 per 100,000 in South Africa.
http://www.msf.org/source/countries/africa/southafrica/2007/ Help_wanted.pdf?



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