[This report does not necessarily reflect the views of the United Nations]
© James Hall/IRIN

MBABANE, 23 February (PLUSNEWS) - Home-based care in Swaziland is increasingly being relied on to compensate for the inadequacies of a public health system buckling under the weight of the country's HIV/AIDS pandemic.

UNAIDS estimates the national HIV infection rate of people aged 15 to 49 at 33.4 percent, the highest in the world, a demoralising environment that has led to nurses migrating to other countries in search of better salaries and working conditions.

The strain placed on the country's resources by HIV/AIDS has resulted in the public health service failing to care for the elderly, especially in the rural areas, and it is a gap being increasingly filled by volunteers within the home-based care network.

One such initiative, started by the Baphalali Red Cross Society in 1999 and orchestrated from the Sigumbeni Clinic, in rural central Swaziland. It sees community volunteers visiting homestead after homestead to monitor their clients' conditions, ensuring medication regimes are adhered to and, if required, arranging doctors visits to the home and providing transport for the collection of antiretroviral drugs and other prescription drugs. Any medical emergencies are referred to Swaziland's second city, Manzini, a 30km drive on dirt roads.

"Our responsibility is to respond to the health needs of terminally-ill patients. These are people with AIDS, tuberculosis, cancer, people who had strokes, and the bed-ridden elderly. It's all about bringing health services to the home," said Muzi Dhlamini, a male nurse who for the past two and a half years has headed-up Sigumbeni's home-based care programme for the Red Cross.

The majority of their patients are adults in the advanced stages of AIDS-related illnesses, or the elderly, an exception being eight year-old Khanya Dube (not her real name), born HIV-positive and severely weakened by chronic anemia. She has developed multi drug resistant TB, a condition, until recently, that would have been a death sentence, because the costs of taking the child to hospital for medication and hospital checkups would have been unaffordable for the family.

The health care provided by non-governmental organisations, including the Red Cross, has brought Khanya under the wing of the home-based care system, bringing life saving assistance to her and other people in isolated rural areas.

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