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AIDS:
A multifaceted South African crisis (continued)
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The supply of AZT at Baragwanath hospital's HIV perinatal unit is almost tapped out because at the end of last year the South African government decided to stop funding the Petra study. The government sites budget constraints, equitable distribution of resources and limited findings as the reason for its decision. "Our budget is 57 million and the cost estimate given [for supplying AZT nationwide] is 80 million. It's much more than you even have for all of the medical programs that the government department of health is to provide," Similela says. Similela, a trained OB/GYN, defends her boss health minister Dr. Nkosazana Zuma and the decisions of the ANC government. "Because you can't discriminate, it means you are going to have to provide AZT to everybody," Similela says. Beyond the issue of equity, Similela is skeptical that AZT will have the desired effect given that use of the drug in a breast feeding population only reduces transmission by 37 percent. "So you still have a certain percentage of women who will transmit the virus to their babies despite your efforts," Similela says, "You've got to make sure that whatever resources you have you don't throw them into a bottomless pit." So this Wednesday as they have done every week since the funding dried up, Gray and her staff huddle around a brown cardboard box, counting what is left of their stock of AZT. The pills are so precious, that they count the 100 milligram tablets down to the half bottle. "Forty-three and a half," Dr. Violai Avy announces. That means that Gray has enough AZT to start seventeen more HIV positive women on the four-week regimen of three blue tablets two times a day for the last month of their pregnancies. "We can't take too many women at the same time. If we put 100 women on it might only last a week," Gray says, "We are holding out hope to some women and none to others." Gray is outraged by her predicament and the health ministry's stance. In December she filed suit against the government. "No longer are we researchers. We are activists taking the government to court," Gray says. Gray is making her presence known in the courts and on the political landscape. Gray designed the black and white photocopied "No AZT, No Vote" sign that stands out among the pamphlets and colorful AIDS awareness posters in her office -- proving once again that in the fight against AIDS, Gray is as she repeatedly says "an activist first and a physician second." She hopes the slogan will become a rallying cry for the ill-fated women she sees at her clinic. She wants the women to let the country's health minister, Dr. Zuma know that they will fight to get AZT. But not one of the 28 HIV positive expectant mothers at Ngobeni's Wednesday morning support group has attended any of Gray's anti-Zuma protest marches and rallies in Guateng province. "We have done this type of march three times and no pregnant women showed up," Ngobeni admonishes the women. "You don't come because you are scared you will be identified, scared your neighbor will recognize you," Ngobeni says, "but you will have a dying baby on your hands because of AIDS. Like many of the women, Ngobeni knows the ravages of HIV/AIDS firsthand. She lost her husband and her daughter to the virus four years ago and is herself suffering from the disease. But, even Ngobeni's example cannot convince women like Mpho Moloi, a 25-year-old support group member, to share her story with family and friends. |
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