Chiefs for Stop Stockouts

The pill-check dissemination meeting in Traditional Authority Mwambo in Zomba, The TA and his subjects were fired up to note that the there was rampant essential medicines stock outs coupled with Volunteers deployed at their health center were rude and that one time they caught a health worker diverting 17 tins of medicines to sell to private shops at the Jali Trading center and yet when they brought the matter to the officer-in charge, the story was swept under the carpet.

Read more

Ida : a video interview

Ida lives in Libuyu, a popular compound in Livingstone. She is the head her family as her husband passed away. During her interview she told us her feedback about the medicine stockout problem, particularly in relation to the old drug distribution system, which she considered more transparent and efficient.

[vimeo clip_id="6558938" width="400" height="300"]

Vivian : a video interview

Vivian works in a public pharmacy situated in the Livingstone area. She’s responsible for receiving medicines stocks from the central drug store and dispatching drug kits to the local clinics.

[vimeo clip_id="6558991" width="400" height="300"]

Anna : a video interview

Anna is a nurse working in Livingstone, the ex capitol city located in the southern border of Zambia. She works in a public clinic and during her interview she shared her experiences regarding medicine stockouts.

[vimeo clip_id="6558972" width="400" height="300"]

Phelloner : a video interview

I met Phelloner, a woman living with her family in a compound located in the norther area of Lusaka. She was a victim of a stockout of an essential medicine to treat Malaria. -Claudio

[vimeo clip_id="6558816" width="400" height="300"]

“Dorothy” : a video interview

“Dorothy”, who prefers not to use her real name, is a nurse at a public health facility in Kisumu, Kenya. She feels that stock-outs are dangerous in that a doctor never knows for sure if a patient has been taking their prescribed medicine which makes treating their condition even more complicated. She spoke at the public forum in Kisumu and was willing to share with us some of her opinions about medicine stock-outs. Watch the video interview below.

[vimeo clip_id="6670347" width="400" height="300"]

ART stock-outs in the Free State place patients on death row

Submitted by Anso Thom and Lungi Langa

Tantaswa is 32 years old and lives in Pelindaba, in Bloemfontein’s Mangaung township. She tested HIV positive in October 2008 at National Hospital in Bloemfontein, with a CD4 count of 484. Her health swiftly deteriorated. “I had been coughing more often than usual and suffering from diarrhoea. I was not eating well and I had also lost a lot of weight,” she said.

Dissatisfied with the monitoring efforts of her local government clinic, Tantaswa consulted a private doctor. The doctor confirmed that she needed to start on ART immediately, and offered to sell her the pills at R300 per month. Having had to leave her R1000 per month job in a restaurant kitchen due to her poor health, it was an impossible task to meet these financial demands every month. After a donor-funded NGO informed her that they no longer had any capacity to help, Tantaswa was forced to return to the National Hospital. Again, she was turned away with the advice that she should buy the medication privately. This culture of passing the buck has left Tantaswa still awaiting treatment and living in fear of what could happen to her without ARVs.

“I am afraid that if my condition deteriorates I won’t be able to return to work and I won’t be able to support my child. But most of all I’m scared of dying while waiting for treatment,” she said.

Despite promises by the provincial Department of Health in the Free State that the ART moratorium would be lifted in February 2009, in March, doctors and activists continued to report that they still did not have access to the drugs within the province. The Southern African HIV Clinicians Society (SAHCS) conservatively estimates that about 30 people continue to die each day, due to their inability to access ART in the Free State. Tantaswa is fearful that she may one day be included in this figure.

“Death is painful and serious. I have seen other people die of this sickness and it scares me,” she admitted.

The Treatment Action Campaign (TAC) continues to collaborate with the AIDS Law Project (ALP), the Confederation of South African Trade Unions (COSATU) and other civil society and activist stakeholders to ensure that ART is made available to all those in need in the Free State and South Africa at large. TAC has held meetings, marches and pickets in the province to demonstrate its strong opposition to the violation of patients’ rights. TAC also picketed outside Parliament on the day of the finance minister’s budget speech to protest against the poor financial planning and budgeting mismanagement, which has resulted in ART stock-outs in the Free State.

1US$ = R10

Margaret Fondo

When we spoke to Margaret Fondo, a primary school teacher in Takaungu sub-location in Coast Province, she was deeply concerned about the availability of medicines in the area.

As a teacher, the 44 year-old mother had a medical allowance which paid for most of the treatment that Margaret and her family of four needed. However, despite having the assurance of a medical allowance, unavailability of medicines within the village and the inconvenience of having to travel far to get medicines was a major worry.

“I am thankful that we don’t fall sick often. I say ‘thankful’ because I know that when someone falls sick they have to spend a lot of money on medical expenses. As a teacher I have a monthly medical allowance, so I hardly spend money from my pocket on treatment. But even so, there is still a problem in getting medicines. In September 2007, for example, I had a skin rash that needed attention. The local dispensary was out of stock of the medicine I needed, so I had to travel to the next town to buy it. Medicines are not regularly available at the local dispensary. There may be medicines at the dispensary today and none tomorrow. That is unfortunate because many people rely on the dispensary which, as a government health facility, is supposed to offer medicines free of charge. The dispensary is also the only health facility in Takaungu. Some medicines, such as malaria drugs and painkillers, are usually available. However, medicines for chronic illnesses, such as HIV and AIDS, are hardly ever available.

Worse still, there is no chemist shop in Takaungu where people can buy prescribed medicines. If the local dispensary was well stocked, Takaungu residents would not have to travel all the way to Kilifi town to buy medicines. To get to Kilifi using public transport involves one taking a boda boda (scooter) ride from the village to the main road, that costs KSh50. After that, one has to spend an additional KSh50 on a matatu (minibus) to Kilifi town, which means spending KSh200 for the round trip. Many people have resorted to consulting traditional medicine-men when they are sick.”

Onyango Wambia

Onyango Wambia is a small-scale farmer from Lela village in Kisumu district, in the western part of Kenya. Although Onyango is diabetic, he rarely uses medicine because he cannot afford to buy the prescribed regimen. How does he then manage his condition? “This is what I use for diabetes,” he says peeling off a clove of garlic and throwing it into his mouth. “I eat an average of eight of these a day. I have done this since 1998, when I was diagnosed with diabetes. Someone tipped me about the garlic, and I have found it to be useful.” The cloves of garlic and a sizeable piece of ginger that he also adds to his self-treatment cost him about KSh10 per day. He is convinced that this routine controls his blood sugar.

Winnie Akinyi

A mother of three and living on a monthly allowance earned from voluntary work in Nairobi, 28-year-old Winnie Akinyi’s monthly income was not enough to enable her to make an outright payment for treatment. This was not an uncommon problem for Akinyi or those living within her neighbourhood.

That is why, in early 2007, she had to leave her TV set at the local health clinic as security for treatment received on credit. This unique system was set up by a non-profit organization to enable residents in low income communities such as Kibera, to access treatment when they did not have ready cash.

Winnie’s story:

Before, some clinics used to give out medicines without demanding instant payment as long as one surrendered his or her ID3 and returned later to pay their bills in full and reclaim their ID. However, after a while the clinic administrators realised that some patients did not honour their pledges; they would abandon their IDs at the clinic and apply for new ones, just to avoid paying the bills.

These clinics still offer treatment, but now, if we don’t have money, we hand over a household item, such as a chair or any other personal property, as security until we pay off the outstanding amount. This is a good arrangement because it allows us to pay for medicines in manageable instalments.

I have personally benefited from this credit system. Not so long ago, I had to part with my television set for two months until I raised enough money to pay for the medicines that I was given at a clinic. My bill was KSh 600, which I could not raise immediately. So I took my TV set to the clinic in order to get the medicines. I repaid the money two monthly instalments and got my TV set back.

Submitted by HAI Africa from the publication: “The costly access to essential medicines in Kenya: Voices of consumers on affordability and availability” published March 2009.

Next Page »