21 August 2003
MEC for Health in Gauteng,
Members of Parliament present here,
Head of Health in the province,
Distinguished guests,
Ladies and gentlemen
It is indeed a pleasure to be with you all today.
Home and community based care is a very important component of our response to HIV and AIDS, TB and other debilitating conditions. It is centred around the principles of Batho Pele and service to the people and it is geared towards community empowerment. It takes a holistic approach to the challenge of diseases related to poverty that is affecting our people and takes into account the cultural beliefs and values of individuals. Home based care programme is aimed at providing nutritional care and support at the doorsteps of any community member in need of such services.
The impact of HIV and AIDS as well as TB is felt at different levels by different sectors. It places a heavy burden on our formal health care and social security system. Hospitals are seeing increased bed occupancy rate and average length of stay putting additional pressure on our human and other resources.
Partly as a result of all these factors, Cabinet prioritized home and community based care and support as a key intervention to mitigate the impact of HIV, AIDS and TB. Cabinet saw the programme as complementing hospital care rather than substituting it.
Besides prioritising this intervention, government recognises the importance that different stakeholders play in the provision of care and support. It recognises the important role that NGOs and CBOs play when it comes to service provision and extending these services to most remote areas of our country. It is therefore important to mentor and value such stakeholders to ensure holistic services and continuum of care.
Being HIV positive does not mean that one has AIDS. A person can remain healthy for a long period before developing AIDS related disease. This can be achieved through provision of comprehensive care that includes good nutrition, healthy lifestyle and treatment of opportunistic infection.
The relationship between HIV and AIDS and poor nutrition is acknowledged internationally. Executive Director of the World Food Programme, James Morris said about a month ago that: "As a minimum first step, we must ensure that those living with HIV and AIDS receive basic nutrition that enables them to survive and care for their families as long as possible…What has now become clear to us at the World Food Programme is that food is the first line of defence against HIV and AIDS." Unquote.
WFP is not the only international organization that has emphasized the importance of nutrition. World Health Organisation and Food and Agriculture Organisation have collaborated to formulate a manual on nutrition for people living with HIV and AIDS. UNAIDS has also emphasized the role of nutrition as an important element of a comprehensive response to HIV and AIDS that includes prevention, treatment, care and support, research and surveillance as well as issues of human rights.
Good nutrition in conjunction with healthy life style such as regular exercises, stress management and stable psycho social well being, will assist the individual to live positively with the disease. Providing nutrition does not just end up with raw food but goes beyond to how the food is also prepared. Efforts have to be made to ensure that food is cooked properly to preserve nutrients.
In recognition of the importance of food security and good nutrition in mitigating the impact of the disease, and the increasing scientific evidence supporting the efficacy of nutritional supplements for the prevention and treatment of illnesses such as TB, HIV and AIDS, the Department of Health developed a Nutritional Supplementation Intervention strategy for people with TB, HIV and AIDS. The strategy includes the dispensing of macronutrients in the form of fortified porridge as well as micronutrients supplements in a pill or syrup form. The Department is investigating the availability of megadose micronutrient supplement to include in the package. The strategy targets all people with TB, HIV and AIDS and other chronic debilitating diseases.
In addition to the strategy, the use of alternative remedies such as garlic, lemon and ginger for chronically ill patients is currently implemented in Provinces. We should eat garlic because of its antibacterial and anti-fungal properties, lemon because of Vitamin C and olive oil as a source of Vitamin A and E. All these vitamins are good antioxidants and they are good for everybody.
Our home and community based care programmes complement all these efforts by supplying a comprehensive package, which includes provision of physical support like bathing of clients, medical care, emotional or counseling and spiritual care. Families are also provided with food parcels per month that are sufficient for an average family of five. The contents are basic food supplies such as maize meal, rice, sugar, soya mince, fish, washing and bathing soap to name but a few.
We need expertise from our non-governmental partners to interact with communities especially people living with HIV and AIDS in assisting them to live positively, providing emotional support and assisting them to have their own food gardens. Agricultural starter packs are available in the Department of Agriculture to assist communities in establishing these projects.
Government has embarked upon other programmes to mitigate the impact of the disease and these include the following:
In spite of the progress we are making, we need to continue to forge partnerships with all relevant stakeholders. There is no way that government alone can single handedly provide a holistic care that is require for people with TB, HIV and AIDS. Non-governmental and community based organisations are our first entry point within communities. They reach out to the furthest corners of South Africa. Therefore, we need to strengthen and sustain our relationship in the fight against these diseases.
There must be a social contract between government and communities including NGOs and CBOs that clearly outlines the responsibility towards each other. We need to start owning our programmes and move towards self-reliance.
We call on the PWA communities to come out and assist in providing care and support towards positive living. We call on this community to identify what works for them. They are a strong voice in our communities and their positive living can surely make a difference in the provision of holistic care and support.
While we pride ourselves with all these achievements as government, there are some challenges still facing us. We need to strengthen the spirit of voluntarism amongst our communities. Lets all be prepared to assist a neighbour, a friend or any community member to ensure that they take their medicine and finish the course, especially in relation to tuberculosis. TB is curable even the present of HIV. All we need to do is to take our tablets even if we feel better. If we do not, we will develop multi-drug resistant TB which is difficult and very expensive to treat.
We need to fight stigma associated with TB, HIV and AIDS. These are just diseases that can affect anyone. Instead of discriminating, we should offer our support to people who are infected and affected.
In conclusion, I call upon all of you as key partners to assist in dealing with these challenges. Our home and community based care interventions will not success without strong cooperation between us. It is our collective duty to educate communities about the importance of good nutrition, taking medicine correctly and maintenance of a healthy and positive life style.
I wish you all the best.
Thank you.