Transport Hampers AIDS Treatment

Friday, 29th of August 2008, By Wezi Tjaronda , WINDHOEK
Lack of transport to health services for people living with HIV and AIDS (PLWHA) has resulted in some not adhering to anti-retroviral treatment.
A report of an assessment conducted in two regions, Omusati and Karas, to gauge the impact of transport on access to health services for PLWHA in Namibia, says lack of appropriate and affordable transport hinders access to health services.

This represents an economic burden to most PLWHA who already do not have a source of income and have to pay medical costs at health services.

The study was conducted by the Bicycle Empowerment Network Namibia in partnership with the International Community of Women (ICW) Living with HIV and AIDS, the Aids Law Unit of the Legal Assistance Centre (LAC) from August to September 2007.

The report said although it is common knowledge that lack of transport is a barrier to accessing health services, transport has always been treated as a peripheral issue.

Yet, it is a factor in accessing treatment, emergency care as well as the drug distribution system.

Although some people walked to collect their medication to Ruacana Health Centre and to Karasburg District Hospital, others spent between N$20 and N$40 to collect their ARVs from Outapi District Hospital and Noordoewer Health Centre.

The reasonable distance for the collection of ARVs is one to five km, yet those in Outapi, Ruacana and Aussenkher live more than 20 km away from the hospitals.

Veronica Kalambi, a member of ICW Namibia and a volunteer doing Home Based Care (HBC) in Okuryangava and Hakahana, said many HBC givers could not reach their clients because of transport problems.

Others, she said, missed their doctors’ appointments.

Lena Nakatana, one of the researchers who presented the findings yesterday, said if patients do not visit the clinics because of lack of money, they are blamed by doctors.

Aggravating the need for transport, according to Kalambi, is the fact that many people have relocated from Greenwell Matongo and Okuryangava to Otjomuise, which makes it even harder to be reached.

Clarisse Cuhna Linke, Coordinator of BEN Namibia, said the assessment focused on transport to establish the impact of transport on access to health services for PLWHA in Namibia. The focus of the assessment is on transport constraints to access health facilities, emergency care and drug distribution system.

Cuhna Linke quoted three other studies on access to health services, which also pointed to distances and lack of transport as some of the problems facing the community. The other studies highlighted distance to health facilities, which impacted negatively on ARV treatment adherence for PLWHA because distance to health care facilities was a direct barrier to women in accessing a comprehensive range of health services.

Another assessment last year also underlined distance as an important barrier faced by girls and women in Oshana and Ohangwena regions. The assessment said 41 percent travelled 20 km and more to reach health facilities.

Respondents to the assessment said PLWHA were particularly vulnerable because of their monthly trips to hospitals to collect medication. Women, they said, were particularly vulnerable because of their dependence on their husbands or partners for money.

On transport and emergency care, the assessment found that transport costs to take their relatives for emergency care by ambulance was the patient’s responsibility.

While at times, health facilities with ambulances have no drivers, others used neighbours’ vehicles to transport the sick, which could cost up to N$400. In some cases, the police helped, with most community members using donkey carts, wheelbarrows and sledges.

Some communities were also forced to sell off some of their assets or to borrow money to bear the costs of transporting the sick for emergency care.
Amon Ngavetene, Project Coordinator of the Aids Law Unit said Government should invest more in health facilities to ensure that all accessed the services that they need.

“It is not enough to give ARVs for free but what is enough is having all that need ARVs access them,” he said.

Ngavetene added that since it is Government’s responsibility to protect, promote and fulfill the fundamental rights of its people, “it is time for the Government to look at fulfilling the socio-economic rights of the people”.
Yelula/U-Khâi, the Paralegal Association and Geo Business Solutions funded the assessment.