Wednesday, May 19, 2004

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13 May 2004
Keith Alcorn

South Africa faces health care worker crisis

South Africa will need 14,000 extra health care workers by 2008 to deal with the effects of HIV/AIDS, according to findings presented this week at the Social Aspects of HIV and Aids Research Alliance (SAHARA) conference in Cape Town, South Africa.

Rob Stewart of the Health Systems Trust said that 1,786 vacancies already existed in state healthcare facilities in March 2004. The biggest shortage is among counsellors and community healthcare workers. Over and above these vacancies 6,233 additional health workers, including 271 doctors, are needed to implement the South African governmen’s antiretroviral roll-out plan.

However, the scale-up of antiretroviral treatment could also have unintended consequences for the health care system, warned Lebogang Letlape of South Africa’s Human and Social Research Council (HSRC). Unless South African health officials came up with policies to regulate how many hospital beds can be given over to AIDS patients, the health care system runs the risk of being swamped. 80% of health care facilities need more staff in order to deal with the current patient case load, she said.

HSRC reseach also shows that health care facilities in South Africa are poorly equipped to deal with basic HIV-related health care needs. In 2002 30% of primary healthcare clinics reported that they had never had sterilisation equipment. Almost 60% lacked equipment to carry out HIV tests.

Research from Durban’s McCord Hospital indicates that even where health care workers are in place, widespread lack of knowledge and training may remain a major obstacle to care. 500 staff were asked to respond to a questionnaire testing knowledge of basic medical procedures related to needlestick injuries and HIV infection. Doctors and nurses were asked to rate the following statements as true or false:

A rapid test the same day would tell if the person had been infected with HIV by a needlestick injury;
A health care worker who went on to antiretroviral (ARV) treatment after a needlestick injury would be cured of pre-existing HIV infection;
One month of ARV treatment would decrease the chance of getting HIV from the injury.
Only the final statement is true, but 50% of trained nurses who responded to the questionnaire were unable to give the correct answers.

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