During our teaching at the school, we made sure that questions were invited and that everyone should be free to ask anything. Problems that were commonly addressed included, “What should I do if I don’t have any food to take my ARVs with? How should I get food?” If you take the ARVs without food you become very nauseous and can vomit – which brings the pills back up, as good as not even taking them in the first place. To overcome this problem the government supplies free food supplements to some people with HIV; however you have to fit a specific criteria that is assessed by the doctor. These criteria include BMI measurement, as well as an upper arm circumference of less than 23cm.
I explained this to the group, and hopefully now next time they go to the doctor they can make sure they are assessed for the food supplements. However, while working in the HIV clinic I have seen many people who are in need of food not fit into this strict criteria. Obviously the government have a limited budget and so such criteria is necessary to ensure those most in need receive the food which enables them to take their ARV’s. However, I couldn’t help but find it heart-breaking to have such arbitrary criteria to decide on whether someone has the basic right to food. It was very obvious from talking to the group I was teaching that not having enough food to take their ARVs was the most important concern for them.
No money for Transport to hospital
Another main concern that was unfortunately repeatedly being brought up was that people could not afford to pay the hospital fee (£2), or even the bus fare to get into hospital. These financial difficulties are distressingly commonplace in the areas I have been working in.
Like the free food supplements there are systems in place to provide health care for people in the community – however, the resource again is limited and unfortunately doesn’t meet its overwhelming demand. Local hospitals send out a “home-based care” van with nurses and basic medical supplies, and when someone can’t afford the bus fare into hospital this van can serve an important purpose. For people who are very unwell and can’t cope with getting on a bus, the only option is to hire an ambulance to pick them up. This service costs a patient £85. This is obviously is a large fee for most people and even more so for those who could not initially afford the bus fare to the hospital or food to eat.
This is real a tragedy for some families, who have to make the impossible decision between sending someone to hospital (either paying for a bus and fees, as nobody can really afford the ambulance fee) or having enough money to feed the rest of the family. The help from “home-based care” is therefore essential – and with more funding this service could reach more people and this impossible decision can be prevented.