„We are often the only ones who help out there“

It is half past eight and the four wheel drive vehicle stands ready in front of Blessed Gérard's Care Centre. I have the opportunity today to accompany Patrick and Wiseman (therapeutic counsellors) on their home visit tour. I know both of them from previous visits and it is a nice reunion. Home visits are a prerequisite for the successful AIDS therapy because most patients can hardly go to the HAART Clinic at the Care Centre as they live far off in informal settlements and remote rural areas, but the success of antiretroviral therapy depends on the regular and uninterrupted actual taking of the medication (adherence). Hundreds of AIDS patients  get their antiretroviral therapy through Blessed Gérard's Hospice - HAART Programme. The patients need to get a thorough  training before commencement of the treatment  and regular care thereafter. Antiretroviral therapy is much more than distributing tablets as some people far off in Europe often think. Complex counselling before, extensive medical treatment and professional ongoing care through home visits are elements of this programme. This is especially important because many patients are illiterate. The patients are poor, living under the most adverse conditions and have no South African rand to pay for the vital therapy. Without the treatment, though, they would come very quickly in the final stages of AIDS and would have to die. Under the treatment, the final stages of the disease can be delayed for many years to decades and in that time these people can raise their children, have a job and cultivate their gardens and fields and continue to live.

People who are ill with AIDS may under certain medical criteria be included in the HAART therapy programme. A complex medical decision-making mechanism, which is the medical director of the centre of the Brotherhood of Blessed Gérard, Dr. Khaya Nzimande, using internationally recognized criteria, is responsible for.

Departure: I sit next to Patrick on the front passenger seat. We chat, have much to report. The Brotherhood of Blessed Gérard is not only called a "brotherhood" following old church tradition - in this joint relief work we as helpers are really brothers (and sisters).

We drive out of the Care Centre and turn on the well-paved residential street, drive over to the crossing at the SAPPI paper mill. The ride goes further out in the direction of the township ISithebe and far beyond. A few decades ago this area here was bush land, then large factories have located here, many people moved here, but later with the result of high unemployment and poverty through changes in industrial production methods and economic dislocation. Eventually we leave the tarred roads. From here on off-road capability of a vehicle is a requirement to get ahead. On paths that do not deserve the name "road" any more it goes on "over hill and dale". The vehicles of the Brotherhood of Blessed Gérard are known out here. We are greeted with joy by many people, small children waving to us. The Brotherhood of Blessed Gérard is often the only help that people get out here.

Together with Patrick I visit people who live in part under the most adverse conditions without electricity and sanitation in very simple huts. People who also demonstrate the positive effect of antiretroviral therapy. These people can be enabled through this therapy, to live a symptom-free active life. Without this medical therapy provided through the services of the Brotherhood of Blessed Gérard these people would die quickly, like so many others. We drive up a rough path that is only passable by four-wheel-drive. Suddenly a tree trunk is lying across the road and we cannot drive on. Patrick and I first have to get out and clear the tree to the side. Soon we reach a simple hut with no comfort. The only luxury is a free-standing toilet house, of course, without sanitary installation - there is no sewer connection here. We welcomed a 30-year-old man in very shabby clothes partly torn. But he is in good spirits and appears healthy. He is very grateful for the assistance provided by the BBG therapy and for the fact that he is doing so well. Only with our help he could overcome the symptoms of advanced AIDS and regain his strength. If he continues taking his daily medication, he can certainly still lead an active life for many years. Previously, many more people have died from the effects of AIDS and still far too many (2 million people in Africa per year) die every day from this disease miserably in their huts. But this man is an example that the assistance goes further. He proudly shows us his newly planted garden, the vegetables he can sell to earn something.

I am not yet aware that this afternoon I will come with Wiseman also to people where it is too late for treatment. People who without our help would have to die bone thin on the mud floor of their huts without care, sanitation, electricity and without human care.

Around noon, after a morning in the poverty areas and settlements and a few visits to people who can live a poor but symptom-free active life through the anti-retroviral therapy, we return to the Care Centre from the townships and the informal settlement areas in Zululand. The Care Centre is a heaven of attention and care, that is what I really feel when I compare the abject poverty out there with the clean, bright and friendly care centre.

In the afternoon, I drive a different route, along with Wiseman. Again we leave the care and hospice center and make our way in the townships. Again we leave the paved roads. The housing situation of people is getting bleaker. Simple huts, the only "luxury" again an outhouse in the open without water flushing. The four-wheel drive SUV, which was solely financed by donations, labours up the hill on paths, which are hardly recognizable as such.. We are the only ones again who come to the aid of these people. People are basically left alone. We come to the hut of a young man who could be about 20 years old  The single room is equipped with very few old furniture that would stand out negatively in Europe even when disposing of bulky trash. The man, blind in one eye, sits lost in thought on a chair. He gazes into the distance. He complains of pain and numbness in the legs. Wiseman recognizes immediately that this man would have to seek medical treatment in the Care centre so that the causes of his complaints could be found out and he could get help. But this man can not come on his own steam to the Care Centre. He can not organize transport, not even having money for his food, as he has no job. He lives by the medical assistance of the BBG, and also through donations of food. But he needs help and so Wiseman organized an appointment with our doctor through his mobile phone and he will then collect them in his emergency vehicle and take him to the therapy center.

We drive on to a family. Wiseman told me very concerned that this whole family is HIV positive and some already suffering from AIDS. These people can be enabled to live a symptom free active life only by the anti-retroviral therapy. AIDS is not curable in the true sense - but the final stages will be delayed by up to two decades by the therapy. Otherwise, this whole family would have to die soon. And that is not a rarity but it has been the norm in recent years. There are still too many people who have to die and need the care and attention in the hospice. Neither the government hospitals and nursing facilities or state treatment facilities have the capacity to provide sufficient support. Many people rely on the help of a donation-based humanitarian organization like the Brotherhood of Blessed Gérard.

We drive to another family that lives under very poor conditions. The patient is the 16 year old daughter. A few years ago she was raped and she has an infant now, who also lives with her and her parents. Even that is unfortunately a totally normal story in this part of the world. The mistaken belief that through sexual intercourse with an HIV-negative Virgin one could get rid of the virus again is still prevalent in many HIV-positive men here. Therefore HIV / AIDS is spread widely and therefore educational programmes are also important and such an education programme is one of the projects of the Brotherhood of Blessed Gérard. Now the girl is HIV positive herself and only by the anti-retroviral therapy, she will be able to live and provide for her little baby.

But here we are alerted. The girl's mother asks us to have a look at her neighbor, he was really bad. We take our car to get there and drive a short distance over a hill. Wiseman told me "state ambulances do not drive out there. They have no four-wheel driven vehicles and not enough ambulances and it's too far for them. The somewhat "richer" people live in simple huts on the tarred roads, the very poor in even more primitive huts here far out and alone." Here we enter a dark, dirty, damp shack. A completely emaciated and helpless man lies on an old rusty bed without mattress covered only with a blanket coughing terribly. He has tuberculosis and of course AIDS. He has not taken his tuberculosis tablets for a long time. Getting progressively weaker he is lying there absolutely helpless, emaciated to the bone. This man would not likely survive the coming days without help. We know immediately that this man must be admitted to the hospice. Public hospitals would not admit this man. He has nothing, can not pay and of course has no health insurance (because a national health insurance system, such as in Western Europe does not exist) and often there is a lack of staff and of medicines in public hospitals. We can not take him along in our 4x4 vehicle, and Wiseman phones the crew of our ambulance. The ambulance of the BBG arrives soon manned by two trained nurses and paramedics, and transfers the poor man with his consent from the hell of filth and poverty into the heaven of care and attention of the Care Centre. It is probably for the first time in his life that this man ever got help from someone. As I look at him images of the victims of concentration camps appear in my mind. He is equally as emaciated and just as sick. I've seen probably a lot in my over 20 years working as a doctor, but here I have to fight my feelings massively. I feel that I am soon to cry but I'm here as a helper and have to show professionalism.

I remember well having experienced this situation a few years ago here in Zululand with my wife Martine for the first time. Even then, we have remained strong on duty, but have often cried at night after such a day - from sadness for these people but also from happiness that the Brotherhood of Blessed Gérard can bring these poor people the needed help. Each of these people is worth all this effort and all the help - unconditionally.

On our continued trip, we are confronted with other similar situations. The picture is similar, and basically hard to describe with words. After this long day when I saw these people in their poverty and disease in the slums and townships, but also the positive developments with the help of the therapy provided by the Brotherhood of Blessed Gérard, many images go through my mind. The prosperity in Europe and the need for assistance. My fervent appeal to all readers of this newsletter, to support the further work of the Brotherhood of Blessed Gérard with all means available, and donations. It is really important. It is about life and death, and about human dignity - and nothing less.

Dr.med. Andreas Heinze

This page is part of the Newsletter No. 30 of the Brotherhood of Blessed Gérard

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This page was last updated on Tuesday, 15 January 2013 12:49:59