HIV and TB: Swaziland Battles To Survive the Health Plagues

Zodwa Mahlabane meticulously takes out her tablets from small yellow bags and puts them on a white tray.

She counts 15 pills in different colours, sizes and shapes and uses a large plastic jug full of water to drink her multi-drug resistant tuberculosis medication.

This is how the 29-year-old starts her day and it is how she finishes it. And that's not even counting the pills she takes for her HIV infection.

"This has been my life for the past two years," she said.

Her story is similar to hundreds of patients who go to Nhlangano health centre in Swaziland's southern Shiselweni region to treat the killer twin epidemic of AIDS and TB.

According to the international medical aid organisation Doctors Without Borders (MSF), 80 percent of TB patients in Swaziland also have HIV, placing severe pressure on the small kingdom's public health system.

Those challenges are the subject of a three-day workshop ending Friday, sponsored by MSF and the Swazi government to find ways of tackling a problem that the medical group says threatens to destabilise the nation.

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"Each year there are roughly 14,000 new TB cases diagnosed among this very small population of just over 1.1 million people," said MSF head of mission Aymeric Peguillan.

"This double epidemic of HIV and TB means that life expectancy has fallen to under 32 years in Swaziland."

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Mahlabane, the mother of a six-year-old boy and openly living with HIV, said she was first diagnosed with tuberculosis in 1996, but she only finished her second phase of treatment last week -- a process that involves being injected every day for nine months.

"At first I took the tablets but they made me sick so I stopped. When the TB came back again I refused to take medication, but my son begged me to and I went back on treatment.

"I continued taking my pills but I was not getting better. I knew about my status but I was not doing anything about it until 2003."

That's when her doctor placed her anti-retrovirals because important cells in her body's immune system had disappeared to dangerously low levels.

With 80 percent of Swaziland's population living in impoverished rural areas, getting healthcare services to families is extremely difficult.

Mahlabane stays with her sister in a rented one-room mud-brick house furnished with a bed, fridge, radio and few food items on the floor.

"I had to move from another village to Nhlangano because I became very sick and couldn't afford to take a taxi everyday. I was not working so all my money I had to save for food," she told AFP.

Joyce Sibanda, an MSF nurse at Nhlangano health centre, said more than 100 patients come every day for help from only four nurses on staff.

The country has very few doctors and no medical school.

"The workload is a lot, there are many registers and forms to fill in," Sibanda said.

"We have also started the integration process where if someone has TB and also HIV positive they can take medication in one place, unlike before where people had to go to different places to get medication."

She said most patients complained about their weak finances, mistreatment at home because of their illness, and side effects of the medications.

Another patient, Nomcebo Mhlanga, a 31-year-old high school teacher who has been on multi resistance TB drugs for over a year, said she almost gave up on the treatment because instead of getting better she got worse.

"I experienced severe itching every hour after taking tablets, and this could go on for seven hours.

"All my limbs and joints became stiff and painful. My eyesight started failing. I almost became blind and worst of all the medication deafened me -- I am still deaf," Mhlanga said.

Source-AFP
TAN