Caring for AIDS patients in South Africa in times of (financial) change
(Vatican Radio) Since AIDS was identified 30 years ago, the United States has played
a leading role in achieving scientific progress, and in translating science into programmes.
Ten years ago, the US Congress passed a legislation that established an historic
and transforming global health programme, known as PEPFAR: the Pressident’s Emergency
Plan for Aids Relief.
Since 2004 PEPFAR has committed more than $30 billion
to funding for the AIDS epidemic. It represents the largest financial commitment by
a single country to responding to HIV and AIDS worldwide and it has been described
as the “largest and most successful bilateral HIV/AIDS programme ever.
Much
of that funding has gone to Sub-Saharan Africa and in particular to South Africa,
the country with the highest number of people infected with HIV in the world.
The
news this year that PEPFAR funding to South Africa is decreasing and will no longer
go into the heands of field operators, but will be injected directly into the National
Health Care System, was received with shock by thousands of patients, NGOs and other
care-givers that operate in the sector.
The South African Government assures
that there will be no interruption of treatment and care services during the transition
of direct service provision to the South African Government and says that an advantage
of the transition is that overall costs will be reduced, allowing assistance to reach
more people in need more comprehensively under the South African National Primary
Healthcare System.
But many NGOs and missionaries who operate on the ground,
and who for years have borne the weight of caring for destitute people and their families
who are infected or affected by HIV/ Aids are suddenly faced with the urgent need
to find funds elsewhere or see entire communities sink back into despair.
One
such person is Benedictine Monk Gerhard Lagleder, who spoke to Vatican Radio's Linda
Bordoni when he stopped off in Rome during his fundraising tour of Europe.
Listen
to the interview…
Gerard Lagleder
is a Benedictine Missionary from Bavaria who was sent to South Africa 26 years ago
as a missionary. He first spent time in a tiny bush parish where he learnt the Zulu
language as well as the culture of the people. In 1990 he was sent to become parish
priest in a community called Mandeni, located halfway between Durban and Richard’s
Bay, the two largest harbors of Africa.
Today Father Gerard runs an organization
that heads a vital project for the community there. It’s called The Brotherhood of
Blessed Gerhard, Blessed Gerard being the founded of the Order of Malta. Father Gerhard
explains that his is the South African branch of the order, which he founded 21 years
ago.
He says when he was a parish priest he was sent out into the slums in
the Mandeni area and came face to face with the harsh reality that there were hundreds
of sick people who nobody cared for. So as Church, he decided to do something for
these people. On one occasion he said he was sent out to take Holy Communion to a
dying woman, and when he got to her he found that she was literally dying of neglect.
He asked her why no doctor had been called in to tend to her wounds and she explained
that she couldn’t afford one. So father Gerard took her to a good doctor who happened
to be the pastoral council chairman of the township community. He sent her to hospital
and that same night she died. The doctor himself then approached Father Gerard expressing
the need to do something for the many people dying from neglect and destitution. Father
Gerard said he knocked on “open doors – because I had been involved in working with
the Order of Malta in Germany since 1969, and I had been part of the German Relief
Organization of the Order of Malta so I knew how to organize help”.
So he
decided to set up an organization that would care for the sick and needy of the area.
But he wanted to do so involving the local population so that they would “take possession”
of it so that it wouldn’t break down once the “specialists” left.
Today, Father
Gerard says, the organization counts over 2500 members. He says “we have a very good
reputation so patients are brought in from far afield”.
AIDS is endemic in
the area and the Brotherhood of Father Gerard offers vital services such as a clinic,
a hospice, a crèche, a nursery, an AIDS education service, an ambulance, funds for
helping young people to study, emergency funding for people in need of immediate aid,
a children’s home which – father Gerard says – was a consequence from the hospice.
In the home he says there are mostly abandoned children, children who are infected
by HIV/AIDS and are being treated. From the hospice he says “we run a large treatment
programme and this has become our biggest activity”. Through this programme the Brotherhood
provides Anti-Retro-Viral drugs to hundreds of patients.
Father Gerard says
the "Brotherhood" has become a point of reference for the poor and the sick of the
area. If they can’t come themselves – he says – we fetch them in our ambulance, if
home care is possible that is what we do with a specific programme, but where home
care is not an option, we have an inpatient unit. From here we started an AIDS treatment
programme which is extremely busy and active.
He says that in January last
year “we had 440 patients in AIDS programmes, 1 and a half years later we have nearly
1000 patients in treatment, so in one and a half years the number of patients has
doubled, the other 440 have built up in 9 years, so we are exploding at the moment”.
And
this brings us to the crux of the matter.
Because, Father Gerard explains “the
finance is not exploding concurrently. In fact we have a problem because the American
funding, the Presidents Emergency Plan for Aids Relief – known as PEPFAR is coming
to an end”.
He says “the South African Bishops Conference was supported for
close to 10 years by PEPFAR and this funding is coming to an end in June next year”.
He says that they have already received an extension – the funding should have ended
in May – but because of their good reputation and track record – the "Brotherhood"
received a one year extension in funding. But, he says, but from next year on the
programme has to be mostly self-financed.
“Thank God – says Father Gerard -
the Bishops Conference spoke to the South African Government that in turn spoke to
the National Department of Health and to the Kwa Zulu Department of Health, and in
many parts of the country the Government AIDS Treatment Programmes have taken over
the patients of the Catholic Institutions”.
He points out that the Aids Treatment
Programme of the Catholic Bishops Conference had by November last year 40,000 people
initiated on Anti-Retro-Viral treatment. “Most of them have been transferred to Government
Programmes but in our area, the Government clinic is so over-swamped with patients,
they could not take over our patients, so we have no choice, but to carry on”.
Father
Gerard attributes the explosion of patients in the fact that finally people have overcome
the fear and the stigma of having an HIV text, because of the successful use of peer
counselors who have made a huge difference to the attitude of the people.
Also
the Brotherhood of the Blessed Gerard’s excellent track record is one of the reasons
they have so many patients. This is due, father Gerard explains to “our high success
rate founded on proper preparation for the treatment and on the presence of therapeutic
councilors who make sure patients take their medication and step in if there is a
problem.
Regarding the PEPFAR funding situation, Father Gerard explains that
at the moment his organization is receiving funding from the Government “not in a
financial way, but the Government pays for about 37% of our treatment costs by paying
for the Anti-Retro-Viral drugs, and also for the medication for the so-called opportunistic
infections that flourish in bodies that are immuno-compromised. And as from the beginning
of July the National Service has promised to take over all laboratory testing meaning
that blood tests will be taken care of by government services.
The Bishops
Conference has extended their help making up a total of 24% of our costs, but as from
next year “we will have to pay for about 50% of our costs ourselves”. “To say it
in plain English we will have to finance about 150,000 euros per year until June 2014,
and from then it will be about 300,000 euros which we will have to finance from our
side to supplement what is necessary to run the programme”.
That is why, Father
Gerard says, “I am in Europe today: to beg. I always say jokingly that the Benedictines
are not a mendicant order but I have become a beggar because it is about saving lives…”
To
find out more about the Brotherhood of Blessed Gerard and its activities, go to the
webpage at www.bbg.org.za