Thousands of South Africans are avoiding health facilities, shunning life-saving treatment out of fear of being infected by COVID-19 and being harassed by police. Daily Maverick reports that even mobile clinics that provide HIV, TB and contraceptive services have reported a huge drop in clients – possibly because all health services are being associated with COVID-19.
“Head counts at some Johannesburg clinics are down by between 30% and 70%,” says Professor Francois Venter, an infectious diseases doctor at Wits University’s faculty of health sciences. “These clinics are delivering absolutely essential services. We are going to spend the next six months cleaning up this catastrophe – the lack of contraception leading to unintended pregnancies and increased demand for terminations, diseases from lack of immunisations, untreated diabetes. We are likely to see a wave of mortality linked to HIV and TB. The HIV and TB programmes have been doing well and we could lose all that progress,” adds Venter, who is also a member of the Ministerial Advisory Committee on COVID-19.
The report says periodic clinic closures when health workers test positive for COVID-19 has fuelled community fear of being infected if they venture into clinics.
The Health Department “has observed this legitimate fear” people have of health facilities, says Popo Maja, the department’s director of communications. “We are developing messaging to encourage people to observe the COVID-19 preventative measures when accessing health services – wearing masks, sanitising hands and physical distancing. The managers at our facilities have also been requested to ensure that stringent infection control measures are adhered to throughout the facilities.”
“I have been grappling with how we can integrate COVID-19 into our services, as it is an infectious disease and another health priority alongside HIV and TB,” says Professor Linda-Gail Bekker, COO of the Desmond Tutu HIV Foundation. “Infection control is key to protect staff. We are looking into installing perspex screens between staff and patients and having consultations outdoors.”
The foundation operates five mobile clinics, providing HIV, TB and contraceptive services to almost 100,000 people in under-served Cape Town communities. But demand for their services was “almost zero” during Level 5 of the lockdown, adds Bekker.
The department’s Maja says the government is trying to ensure integration: “We have had discussions with the SA National AIDS Council and COVID-19 testing has now been integrated into the Cheka Impilo wellness campaign, which tests people for HIV, TB and non-communicable diseases. “We are very worried that if we don’t integrate TB and HIV services with COVID-19, the gains we have made against our country’s high burden of diseases will be erased.”
[link url="https://www.dailymaverick.co.za/article/2020-05-25-as-people-shun-clinics-doctors-fear-a-non-covid-19-death-spike/"]Full Daily Maverickk report[/link]