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JANUARY 08, 12:28 EST

AIDS Overwhelms S. Africa Hospitals

By ANDREW SELSKY
Associated Press Writer


AIDS patients in South Africa
AP/Themba Hadebe [21K]
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PORT ELIZABETH, South Africa (AP) � Doctors scribble notes into patients'
folders while a young man lies nearby on a gurney, dying from AIDS-related
tuberculosis.

His abdomen convulses with gurgling gasps as he struggles to fill his
saturated lungs. The doctors will not transfer him to a bed in the intensive
care unit because of lack of space.

``He's busy dying,'' says Dr. Iwan Bekker, sweeping past the youth in Dora
Nginza Hospital. ``Sometimes we have to play God.''

The AIDS epidemic is overwhelming South Africa so badly that some public
hospitals are turning people away, limiting treatment and forcing doctors to
make hard decisions about whom to save.


Lucky to be in hospital
AP/Themba Hadebe [17K]
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Looking for desperately needed help from the developed world, the governments
of South Africa and other African states are eagerly awaiting a speech Monday
by Vice President Al Gore to the U.N. Security Council on the impact of AIDS
in Africa.

With an estimated 4 million South Africans � one of every 10 people � already
infected with the AIDS virus, the epidemic poses a huge challenge to the
country's public health system.

At Hlabisa Hospital in KwaZulu-Natal Province, some patients must sleep on
foam mats underneath beds holding other patients.

Hospitals in the Johannesburg area are trying to stretch their budgets by
limiting lab tests and releasing patients sooner. They are also training
families of AIDS sufferers to care for them � and prepare for their deaths �
at home.

In the developed world, debates sometimes arise over whether heroic measures
should keep a critically ill person alive. In state hospitals in South
Africa, as in the rest of sub-Saharan Africa, such expensive measures are
rarely an option.

``We can't afford to spend money on people who are going to die,'' said Karen
Michael, a researcher on AIDS at the University of Natal in Durban.

Health Minister Manto Tshabalala-Msimang is trying to recruit all sectors of
society into the fight against AIDS. ``The government will never be able to
cope with it alone,'' she said in a phone interview.

Tshabalala-Msimang said the government is considering inviting the private
sector to create a fund to help fight the epidemic. It also plans to step up
its AIDS awareness campaign and the promotion of abstinence or safe sex
practices.

With limited resources, the government can only take limited measures. In
fiscal year 1997, the government spent $3.4 billion on health care for the
nation's 40.5 million people, or less than $85 a person, the statistics
office said.

Unless health funds are increased � and that would mean taking money away
from housing, education and other strapped programs � the government can't
afford costly AIDS drugs like AZT.

But some people say the government must throw its resources into halting the
epidemic.

``We need a 'war cabinet' for AIDS,'' said the Rev. Barry Hughes-Gibbs, an
Anglican priest who runs AIDS home-care training in a black township near the
capital, Pretoria.

Public hospitals, which serve 86 percent of black South Africans, are on the
front line in the fight against AIDS, which in sub-Saharan Africa is
transmitted primarily by heterosexual sex.

``Hospitals are now stretched to capacity,'' said Michael, the AIDS
researcher. ``Staffers are working chronic overtime without overtime pay, and
they're having a flood of patients who are not able to look after themselves.
It's pretty bleak.''

At Dora Nginza Hospital near the Indian Ocean city of Port Elizabeth,
HIV-positive babies will be admitted for treatment only once, then are
restricted to outpatient care, said Bekker, the head of pediatrics.

He pointed out rooms crowded with HIV-positive babies.

``We have a limited budget,'' Bekker said. ``When a baby gets bad, like with
pneumonia, we won't admit it for the second time, but will tell the mother to
take it home and let it die.''

It's a grim policy for Fanizwe, a young mother whose HIV-infected baby has
already been admitted once for pneumonia and released. Infected with the AIDS
virus herself, Fanizwe now faces the prospect of sitting in their shack,
helplessly watching her baby succumb to the disease.

``If the baby gets sick again, he will be beyond my care,'' she says,
cuddling the youngster.


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