PartnersGF - 2004-07-15

IAC 2004: Keeping health and education sectors alive – do we need special ARV programmes for health workers and teachers?
HDN Key Correspondents Team
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Today's Quote
"As part of my efforts to help in the fight against AIDSD, I have dedicated my energy to working on developing HIV/AIDS messages through the media in order to reach out to as many people as possible."
Richard Gere
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The HIV/AIDS epidemic in the developing world has adversely affected the education and health sectors. This paints a gloomy picture unless affected groups can be targeted with increasing access to treatment.

The prevalence of HIV among teachers and health workers infected by HIV/AIDS in developing countries is worrying. In Zimbabwe it is estimated that by the end of 2003, 30% of all teachers were HIV positive. If half of these develop AIDS and there is no way for them to access treatment, this will massively affect the supply of teachers in the education sector lowering the teacher-to-student ratio and lowering the quality of education.

A study in two Zambian hospitals in 1991 and ‘92 found the HIV prevalence was 44% among midwives and 39% in nurses. The study also revealed that AIDS-related mortality among health workers rose fivefold between 1980 and 1991. In Harare hospital in Zimbabwe, the number of staff deaths increased from 75 in 1993 to 250 in 2000.

On the other hand, health workers – mainly field officers – health assistants and general hands accounted for the largest number of deaths and discharges on grounds of poor health.

Also in Zimbabwe, a health research institute with 120 staff lost 15 members between 1992 and 2002. Ten of the employees had typical symptoms of HIV/AIDS at the time of their death. Almost half of the deaths were among scientists and senior laboratory technicians. Such deaths clearly affect the nurse-to-patient ratio and impact on the quality of care.

The situation in other countries with severe epidemics is probably much the same. These figures cannot be ignored, because they apply to the groups on which developing nations depend for their development. Health workers and teachers play a pivotal role in delivery of basic services.

For instance, in Botswana nurses educate and train caregivers on access to antiretroviral drugs. Teachers in Uganda, we are told, offer HIV/AIDS education on a fortnightly basis. Loosing such professionals through death, sickness or invalidity is therefore a double tragedy for any poor nation.

Developing countries have of late experienced a brain drain, loosing health workers and teachers to HIV/AIDS, especially in rural areas. However, those who remain are also threatened by HIV/AIDS and are unable to deliver their services. Therefore, those who are sick have to be supported in all ways, including by having access to treatment that will prolong their lives and ability to continue to perform their jobs.

Provision of AIDS medicines to teachers and health workers is more than an ethical consideration. For example, health workers are involved in the day today management of patients, including care and support of people with HIV/AIDS, while teachers support children and orphans in their institutions. Unless existing programmes also address these professionals needs there is a danger they will lose interest and motivation for what they are doing.

The need is clear but there are problems in practice. According to Dr Ndwapi-Ndwapi of the government of Botswana antiretroviral programme, previous experience to target health workers has not yielded great success.

For example, when the government began providing antiretroviral drugs, health workers were sensitised and the affected ones were encouraged to enrol. However, problems such as reluctance to test for HIV, stigma and uncertainty about confidentiality kept them away from accessing the drugs.

These are critical issues that should be addressed as we target HIV positive professionals with medicines. Developing countries can ill afford to ignore providing treatment for their skilled workers while they try to fight the epidemic.


HDN Key Correspondents Team
Email: correspondents@hdnet.org