AFRO-NETS> Kaiser Daily HIV/AIDS Report: Thu, 16 Aug 2001

[Cecilia Snyder <csnyder@ccmc.org>]

Kaiser Daily HIV/AIDS Report: Thu, 16 Aug 2001 
-----------------------------------------------

*South African Hospital Faces Overcrowding, Staffing Shortage with 
'Flood'   of AIDS Patients 
*'Pressure' to Fight HIV/AIDS Might Hamper South African Government's 
  Efforts to Combat Heart Disease 
*Twenty-Two Percent of Americans Followed Coverage of U.N. Special
  Session on HIV/AIDS, KFF/Harvard Survey Says

Global Challenges

  South African Hospital Faces Overcrowding, Staffing Shortage with 
'Flood' of AIDS Patients

Officials at Chris Hani Baragwanath Hospital in Soweto, South Africa 
(the largest hospital in Africa with 3,300 beds) say the facility is 
"Overwhelmed" with a "flood" of AIDS patients and lacks the beds and 
staff to accommodate the numbers admitted each day, the Wall Street 
Journal reports. The institution is the main teaching hospital for 
the University of the Witwatersrand, the "Harvard of South Africa," 
is staffed with "highly trained and fiercely committed" physicians 
and "pride[s] itself on never turning away a patient."  But admis-
sions have increased nearly 40% in the past five years without subse-
quent increases in beds or staff, leading to a higher rate of inpa-
tient mortality.  Hospital statistics show that when 43 patients are 
admitted per day, an average of 8% die during their stays, but when 
120 patients are admitted more than 10% die. In 2001, the hospital 
has averaged 108 admissions per weekday. Nurses, working at more 
than 35% below allocated staff levels, can no longer provide daily 
basic services for each patient and their "morale has sagged."  In 
addition, exhaustion and overwork has led to a "shocking" rate of 
needle stick injuries -- 69% among interns.  

Seeking Change

Prof. Ken Huddle, head of the department of medicine at the hospi-
tal, said that with such a high admission rate and overworked staff, 
"We can no longer go on like this." He said the current crisis 
"cries out for a national plan," adding that he would like a plan 
that would allow the hospital to reroute patients to other hospitals 
when the facility reaches its capacity. Hospital staff say that the 
problem is as much the result of "poor government policy toward AIDS 
as it is by the disease itself," criticizing the government for 
stalling on providing antiretroviral drugs to patients as other Afri-
can nations construct plans to distribute the medicines. Following a 
"desperate" letter sent by Huddle to the hospital's CEO last month, 
the heads of Johannesburg's three major hospitals met to plan a 
strategy in response to the "swelling avalanche" of AIDS patients at 
their sites and this week met with Laetitia Rispel, head of the 
health department of Gauteng Province. Rispel said that Baragwanath 
"bears some responsibility for its crisis," noting that senior physi-
cians have conceded that not all patients require hospitalization and 
recommending "better use of the existing referral network" (Schoofs, 
Wall Street Journal, 8/16).

'Pressure' to Fight HIV/AIDS Might Hamper South African Government's 
Efforts to Combat Heart Disease

Although heart disease is poised to become South Africa's "next 
health tragedy," some doctors are questioning whether the government 
will turn its attention away from HIV/AIDS to address it, the Balti-
more Sun reports. Dr. Anthony Mbewu, executive director of research 
at the Medical Research Council of South Africa, said that high blood 
pressure and other risk factors for heart disease are increasing 
among the country's population due to lifestyle changes such as more 
access to sedentary jobs and an increase in the consumption of fast 
food.  Health officials warn that heart disease will grow among 
blacks in South Africa and place "new burdens on a taxed health sys-
tem," but they question whether the government "will be ready to meet 
the challenge." The Sun reports that the government might be hesitant 
to fund heart disease prevention efforts because of the "pressure" to 
control HIV/AIDS. Mbewu agrees that securing funding for heart dis-
ease prevention might be difficult, stating, "Policy makers are so 
fully preoccupied with AIDS that heart disease is like a distraction.  
They should deal with the No. 1 health crisis, but they should not 
forget the No. 2 health crisis." Mbewu added, "There is more to dying 
in South Africa than HIV/AIDS," he said (Murphy, Baltimore Sun, 
8/16).

Twenty-Two Percent of Americans Followed Coverage of U.N. Special 
Session on HIV/AIDS, KFF/Harvard Survey Says

Twenty-two percent of Americans followed the U.N. General Assembly's 
special session on HIV/AIDS recently held in New York City in June, 
according to a poll in the July/August edition of the Kaiser Family 
Foundation/Harvard School of Public Health's Health News Index. The 
survey of 1,005 adults found that between June 25, 2001, and July 25, 
2001, 7% of respondents followed coverage of the summit "very 
closely," while 15% followed the event "fairly closely" (Health News 
Index, July/August 2001). A poll of 1,001 adults in the May/June edi-
tion of the Health News Index showed that 43% of survey participants 
said that they followed the issue of the U.N. Global AIDS and Health 
Fund "very" (15%) or "fairly" (28%) closely between April 25, 2001, 
and May 25, 2001.  However, only 9% of respondents correctly answered 
that the United States has agreed to contribute to the fund, while 
63% said that they did not know whether the nation had pledged money 
(Health News Index, May/June 2001).
--
The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, 
a free service of The Henry J. Kaiser Family Foundation, by National 
Journal Group Inc. c 2001 by National Journal Group Inc. and Kaiser 
Family Foundation. All rights reserved.

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