Cape Town – It is one of the most scenic regions in the Western Cape and home to some of the province’s wealthy, but this means nothing to many residents of Eden district as they battle with social ills and poor access to health care.
About 85 percent of the region’s population have no medical insurance and depend solely on public health care for services.
The district – which includes the southern Cape towns of George, Mossel Bay, Knysna, Plettenberg Bay, Oudtshoorn and parts of the little Karoo – is home to more than 500 000 people.
While these towns are popular tourist attractions, many residents say problems such as substance abuse, poverty, unemployment and poor access to healthcare are rife.
According to the Community Survey of 2007, just over 12 percent ofEden’s population are unemployed and 5 percent of households live below the breadline, with an income of less than R400 a month.
HIV/Aids and tuberculosis are a major burden for the region’s poor.
Edenhas been chosen as one of the 10 districts nationally to pilot the National Health Insurance – a programme that is expected to revolutionise the country’s health-care system.
The R1-billion pilot phase is expected to cover about 20 percent of the country’s most vulnerable people.
During aCapeArgusvisit to the region last week, residents spoke of their anticipation of the programme, which they hoped would end their health struggles and frustrations.
Some told of having to walk long distances to access health care, while others were dependent on mobile clinics for their needs.
For Thulani Rali – an HIV-positive patient from Qolweni location, an informal settlement along the N2 inPlettenbergBay– getting his antiretroviral treatment means walking about 10km to and fromKwaNokuthulaDayHospital.
“Apart from being HIV-positive I’m also asthmatic and walking to the hospital can be such a mission,” Rali said.
“I sometimes get cramps in my legs and feet, which restrict my movement, but I have no choice as the clinics nearest to me have no ARVs. I used to get treatment from Plettenberg Day Hospital, which is just across the N2 highway from my home, but as from last year this was stopped and we all have to go to KwaNokuthula to get any form of chronic treatment.”
For some, the long distance to health services has resulted in them defaulting on their medication.
Kenneth Magaga, an HIV-positive Treatment Action Campaign (TAC) member from Qolweni, has stopped taking his ARV treatment.
He is unemployed and cannot afford a taxi fare to the clinic.
“Sometimes I have no food to eat before taking my treatment, and I struggle to walk for such a long distance. Walking to the hospital can also be a risky business as people get robbed on the way. There is neither proper public transport nor patient transport in Plettenberg Bay to help those who live far from facilities.”
Magaga blamed the problems on the centralisation of services by health authorities.
Though there were two clinics within a kilometre of his home, he cannot use them as they stopped providing chronic treatment after the opening ofKwaNokuthulaHospitallast year.
Marshall Laminie, director of the Knysna Alcohol and Drug Centre, said while substance abuse was a major problem, there was a lack of detoxification and drug rehabilitation centres.
“People have to travel toCape TownorWorcesterto access these centres. A lot of drug users go through a revolving door phenomenon as they struggle to get rehabilitation services,” Laminie said.
Dr Petrus du Doit, who has ageneralpractice in Oudtshoorn, said although the burden of diseases such as HIV/Aids, TB and trauma was huge, there was a critical shortage of specialist doctors, with most based in George and only visiting some district hospitals once a week.
The provincial Health Department has budgeted at least R11 million for the rollout of the National Health Insurance pilot, with R8.5m to be used to hire teams of specialists.