Lusikisiki (Eastern Cape) - On December 12, Nelson Mandela inaugurated the 'Siyaphila La' antiretroviral treatment site in the former Transkei, near Mandela's birthplace. Siyaphila La is Xhosa for 'We are alive'. The ART facility is the first site to provide ART in public primary health care clinics in a rural remote area in South Africa. Mandela has been a long supporter of ART and in particular MSF activities. One year ago, the former president of South Africa was in Khayelitsha promoting MSF's clinics there.
The treatment centre is a collaborative effort between MSF and the Nelson Mandela Foundation. His appearance in the Transkei comes just days after leading a major concert in Cape Town to help fund AIDS activities. "This partnership proves that antiretroviral treatment can be implemented successfully even in a rural area with few resources," said former president Nelson Mandela.
"Our government has recently made a very important announcement about rolling out the world's largest antiretroviral treatment program. Siyaphila La will set an example for other rural HIV treatment sites that will be established in the Eastern Cape and across the country." Lusikisiki is about a four hour drive from Durban. There is one provincial hospital serving a population of 200,000 spread across the region. When MSF offered HIV testing, 400 people volunteered for the test in the first month. Numbers have climbed to 600 people being tested per month. The facility opened in January and started to provide HIV testing.
In the first month, 400 people voluntarily asked for testing. Numbers have climbed to over 500 people being tested per month. Anti-retroviral treatment started in November and the team shall be increasing its patient base per month to a target of 400 patients.
MSF is providing assistance to people who test positive for opportunistic infections as well as providing individual and peer support and have been part of a community reaction against stigma. With an adult prevalence between 30 and 35%, Lusikisiki suffers from poor health infrastructure and scarce health staff, conditions that are very common in rural remote areas in Africa, and that can limit the effective implementation of HIV/AIDS services.
Siyaphila La is successfully overcoming these difficulties by implementing a nurse-based model and by seeking community endorsement of all elements of the program. "Rather than doctors providing ARVs at hospitals, we are implementing a community driven ARV program, managed by nurses with a stress at primary health level and using simplified regimens," said Dr Herman Reuter, MSF co-ordinator of the Lusikisiki program.
Talking about the positive spin offs of antiretroviral therapy he added, "In Lusikisiki during the first year, Siyaphila La will help 400 people to stay alive. But we will also give health care workers a new hope to tackle the daily tasks, since they will be able to do something for their patients instead of letting them die. In addition, we will also expose the community to a live-saving intervention.
If they understand it, they will break the silence and will defend the service". Siyaphila La is recognized by the provincial government of the Eastern Cape as an official service point to initiate ART in the province and part of the recently approved Operational Plan for Comprehensive HIV and AIDS Care, Management and Treatment in South Africa. It expects to enroll 400 people on ART during the year 2004.