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NY Time Article on The South African AIDS crisis

SOVANE, South Africa — South Africa, trying to overcome years of denial and delay in confronting its monumental AIDS crisis, is now in the midst of a feverish buildup of testing, treatment and prevention that United Nations officials say is the largest and fastest expansion of AIDS services ever attempted by any nation.

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  Times Topic: South Africa

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  Health Guide: AIDS

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Ntswe Mokoena/Government Press Office, via Agence France-Presse — Getty Images

President Jacob Zuma's H.I.V. test on April 8 appeared in newspapers across South Africa. He disclosed that his test was negative.

The undertaking will be expensive and difficult to pull off, but in the past month alone the government has enabled 519 health facilities to dispense AIDS medicines, more than it had in all the years combined since South Africa began providing antiretroviral drugs to its people in 2004, South African health officials said.

And on Sunday, President Jacob Zuma, who recently admitted to having unprotected sex with a much younger woman, inaugurated a campaign to test 15 million of the country’s 49 million people for H.I.V. by June 2011. In a speech at a hospital east of Johannesburg, he disclosed that his own fourth test again showed he was negative and he said he made the result public “to eradicate the silence and stigma that accompanies this epidemic.”

To hoots and laughter from the audience, and with a touch of humor, Mr. Zuma said, “I’m sure South Africans know I’m open about my life generally.” A photograph of his personal doctor drawing blood from Mr. Zuma’s arm for an H.I.V. test on April 8 had appeared in newspapers across the country.

To broaden access to services, the government has trained the hundreds of nurses now prescribing AIDS drugs — formerly the province of doctors — and will train thousands more so that each of the country’s 4,333 public clinics can dispense the medicines, a step Health Minister Aaron Motsoaledi called essential to combating “this monster amongst us” in a country short of physicians.

Michel Sidibé, executive director of Unaids, the United Nations AIDS agency, said South Africa’s undertakings offered hope to the continent. “It’s the first time one country has scaled up so quickly, to so many people,” he said.

South Africa, the region’s richest nation and a symbol of democracy, has an estimated 5.7 million H.I.V.-positive citizens, more than any other country.

“In my village, when we want to kill the snake, we don’t hit the tail, but the head,” said Mr. Sidibé, who is from Mali. “The head of this epidemic is South Africa.”

The South African Finance Ministry said it expected that the broadened access to drugs would put a million more people on treatment in the next few years, roughly doubling the current case load. It has budgeted an extra $1 billion for it. Dr. Motsoaledi said that Mr. Zuma reopened the budget to get more money for AIDS when it became clear that costs would be higher.

South Africa’s understaffed public health system and the ballooning cost of treating millions of people for life will pose daunting challenges to the government’s ambitious goals.

The United States has long been South Africa’s principal donor in the fight against AIDS, giving the country $620 million this year. But advocates worry that global donors will not provide enough money to sustain a rapidly growing treatment program.

For now, though, there is optimism among the scientists and advocates who had despaired as the nation dithered on AIDS under its former president, Thabo Mbeki.

“I’ve never known such a gathering of momentum around H.I.V. as in the last month or so,” said Mark Heywood, who directs the AIDS Law Project, based in Johannesburg.

Mr. Mbeki had questioned whether H.I.V. caused AIDS and suggested that anti-retroviral drugs were harmful. Harvard researchers estimated that the government could have prevented the premature deaths of 365,000 people during the last decade if it had provided the drugs to AIDS patients and medicines that help stop pregnant women from infecting their babies.

“If we had acted more than a decade ago, we might not have been in this situation where we are,” Dr. Motsoaledi said. “Obviously, we did lose time.”

Mr. Zuma, in office for almost a year, has broken sharply with the Mbeki record, broadening access to AIDS drugs for H.I.V.-positive pregnant women and babies, as well as for people with tuberculosis. The government is moving toward routinely offering H.I.V. tests to all who come into the public health system, rather than waiting for people to ask for them.

Silindelokuhle Biyela, a widowed nurse who works at a tidy red-brick clinic in this remote village in the rugged hills of KwaZulu Natal Province, is on the front lines of the new push. She has just completed the training that qualifies her to dispense AIDS medicines. No longer will her patients have to go to a hospital 30 miles away for drugs, an $8 round trip that many are too poor to make.

“The nation is dying,” Mrs. Biyela said. “The people are dying. But we are going to try to help them.”
Hundreds of private pharmacies, including the retail chains Clicks, Link and Dis-Chem, will offer free H.I.V. tests for the next year with government-provided kits. More than 2,000 retired nurses, doctors, pharmacists and other health workers have volunteered to help with the drive.

Related

• Times Topic: South Africa

• Health Guide: AIDS

The health minister said the country was racing to reduce H.I.V. infections — now 1,500 a day — before treatment costs swell even further.

South Africa pays far more for some drugs compared with the prices paid by other African countries covered under steeply discounted prices negotiated by the Clinton Foundation, which is now advising Dr. Motsoaledi.

“We must be able to purchase ARVs at the lowest prices, as we are the largest consumers” of anti-retroviral drugs in the world, despite opposition from local pharmaceutical manufacturers, Dr. Motsoaledi told Parliament this month.

The government is also pushing to prevent new infections. Three years after the World Health Organization recommended circumcision as a way to reduce a man’s risk of contracting H.I.V. by more than half, the country’s hardest-hit province, KwaZulu Natal, began a drive this month to circumcise 2.5 million men. President Zuma said Sunday that the approach would be offered across the nation by next year.

“If you really want to get a handle on the epidemic and reduce the incidence of the disease, this is the most powerful thing you can do, along with reducing the number of sexual partners,” said Daniel Halperin, an epidemiologist at Harvard University.

Dr. Motsoaledi, who became health minister in May, said he planned to personally perform many such procedures to remove the foreskin. “I want to do a thousand,” he said.

Hundreds of young men, many in jeans and track suits, heeded the call of Goodwill Zwelithini, the king of the Zulus, and lined up in a clinic and hospital in Nongoma on a recent Saturday to be circumcised. Concerned about the high rates of H.I.V. infection among his people, the king has declared that the tradition of circumcision must be revived.

It died out in the 19th century during the time of King Shaka, who suspended the custom to avoid having young warriors out of commission while they healed from circumcision cuts that sometimes got infected, said Nelson Ntshangase, a lecturer at the School of IsiZulu Studies at the University of KwaZulu Natal.

Members of the king’s own extended family were among those getting circumcised this month, including Sakhile Zulu, 18, a tall, slender 10th grader who addressed more than 100 boys at his school after he had his circumcision two weeks ago. Back for a follow-up visit, he said he had seen a dozen students from his school there that day for the procedure. “The king observed many of the men are dying,” Mr. Zulu said. “He said the custom should be brought back to save the people.”

We Have The Land...and funny thing about that land...

Yesterday we received this email from our co-worker in South Africa, Brian Niehoff:

"Just wanted to let you all know that as of about 11:30 today we (RHI) own plot 927 in Naudeaville.     The transfer is complete.  There were no problems which is very uncommon in SA.  I met with with the building inspectors yesterday and found out all the info I need to know to get approval to build.  We also found a company that is going to supply wall sections for us at a very reasonable price.  This will allow us to build a concrete wall which we could not have afforded otherwise. 

On a side note.  I went over to OUR property today with the weed wacker to try to find corner pin markers for the lot lines.  When I arrived there was a whole bunch of police cars on one side of our property between our property and an old abandoned store.  
I was turning to go down there and the police stopped me and told me I couldn't go down there because there was an operation in progress.  I said "what do you mean an operation?"  And he said "it's a hostage situation, we are waiting for the hostage negotiator".  So, I'm thinking the welkom police are making a big deal out of nothing.  I assumed there was a guy in a house that wouldn't let his girlfriend leave or something like that.  I told him I was going to park and start cutting grass on our property.  He said "no you need to leave, there are 10 men with guns in that old store and they have taken hostages".  So, I began to think the situation might be a little more serious.
I asked him if I could work on the other end of the property which is quite a ways away.  He said that was fine.  

So, I tooled on down to the end of the property and started cutting the grass along the property line.  All of a sudden about 10 trucks packed with what appeared to be storm troopers came roaring up the road.  They stopped about 100 ft from the abandoned store and they all got out, organized and started to storm the building.  Then there was a whole bunch of shooting and yelling.  I had walked about half way across our property to watch, and when they started shooting I said to myself "I think it would be best if we (me, myself and I) go".  I started running like a school girl towards my little Volkswagon and took off.  I went straight home to get the camera and I went back.  By the time I got back the ambulances were there and they were leading handcuffed people out of the building. So I knew it was over.  

I walked to one of the storm troopers vehicles and asked what had happened.  He said it was a training exercise for the South Africa Special Forces.  The US Special forces were there training them on counter terrorism.  I think I saw Jack Bauer in the background (from the show 24 for those of you who don't know).  There were about 12 US special forces guys there.  The whole thing was part of the preparations for the World Cup.  

It started out as a very bad feeling thinking that we had just bought land next to a building that was being used to hold hostages.  But it turned out to be ok after all.  If it happens for real I'll get my pellet gun and shoot out the terrorist's eyes.

Brian

Garage Sale

This Saturday there will be a sale to benefit the construction of Restoring Hope Village.  Most of the items from this sale were to be packed in the container that was shipped, but we were overwhelmed with generosity, and many great things just couldn't be crammed in.  Please see below for the announcement and details.




Please pass the word around to your churches, families, friends and
coworkers (and even a few strangers if you'd like!):

What: HUGE Donation (Garage) Sale
Where: 601 Story Street (Hwy. 210), Slater
When: SATURDAY, APRIL 24th, 9:00am to 2:00pm...follow the Neon signs
that say "SALE"

Every offer regardless of price will be cheerfully accepted!
At this donation sale, YOU say what you want to pay and that's final!
All monies will be donated to a current children's home being built in
South Africa by the name of Restoring Hope Village.

Here is a PARTIAL list of what we have to offer:

FURNITURE: Dressers, tables, sofas, chairs, etc
BICYCLES: Many bikes, many sizes
Baby/Children items: Toys, toddler beds, cribs, exersaucers, etc
Housewares: Glass dishes, pots, pans, cutlery, sm. kitchen tools, etc
Books: Fiction, non-fiction, educational, Bible story books, etc
Shoes: Children, Men, Women, athletic (including cleats)
Shelving Units
Garage and Yard tools

All items are a result of an overwhelming response to pack a Container
to ship to South Africa. Now it's our turn to bless the community with
what could not fit to ship!

****Local delivery available****

The Life & Times of Louis & Amber - Time Flies

I apologize for the delay in between posts.  Life has been a bit crazy for us recently, as you'll likely hear in an additional post or email update.  In the last couple weeks were were finally able to take advantage of our "furlough" time to actually relax a bit - although I use the term "relax" very loosely.  We spent about 10 days in CO with Amber's family at the end of March-beginning of April.  Then we had 3 days back in IA catching up on lots of RHI work before leaving for another week of vacation with my family.  Check back for another post on those details.

DJ, one of the young men from Bible Study, emailed us pictures of his younger twin siblings.  "Pablo" & Miranda were born a couple months before Drake, and we have kept up with them while in South Africa.  After seeing this picture it really hit us again how long we've been gone.  They were just babies when we left and now they look like they're about all grown up.  Man, we can't wait to get back!!!

Help Needed Quickly

One of the problems with packing and shipping a container, is that once it is full and shipped you always think of something you forgot.  The container left Slater last Tuesday, and Brian just emailed me with an urgent request.

When we have work teams come over to assist with construction projects we need to make sure we have enough tools to keep everyone busy.  Since we will have so much new construction we will need some additional tools.  Most of them we were able to ship with the container.  Unfortunately, we forgot one important item.

I've been told that you can find them in the left-handed aisle at Home Depot or Lowe's.  Unfortunately, we are in SE Colorado right now, which doesn't seem to have the population to support the big-box stores.  If anyone has a left-handed hammer, or knows where to find a good deal on one, please let me know.  You can email me at louisotool@gmail.com, or call me at 712-830-1245.  We need to have a couple of these before we leave for South Africa ourselves, so the sooner we can locate one or two, the better we will feel.

The Niehoff Return

Another huge hurdle has come and gone for Restoring Hope International.  On Tuesday, March 23, Brian & Lois, along with their two children - Liam & Lindie - flew from Des Moines to Atlanta.  The next day they left Atlanta and arrived in Johannesburg sometime on the evening of March 25th.
(farewell dinner at Hy-Vee)

By their reports all travel went well.  The kids slept for most of the 16 hour flight.  Of course, the drawback to that is that the kids aren't tired after they arrive, while parents are usually ready to crash.  (Saying goodbye to the grandkids)  They were able to spend Thursday night with Mark & Chris Harding, good South African friends who care for 16 children in their own home (read about their ministry here).

Apparently the night was a bit of an adventure, since Mark & Chris were being overrun with ants.  Such is life in South Africa sometimes.  They are now living with Lawrence & Trish Dargie, (Lois with her sister Rebekah) another couple who have become dear friends.  Lawrence & Trish live in Welkom, so Brian & Lois are able to make that their home base for a couple weeks.  They have located a house to lease for a short time until we can complete construction on their own house.

For those of you who know Brian & Lois personally, you'll not be surprised to learn that they have jumped right into the work.  Brian has already had some success with government officials, getting paperwork through on the purchase of the Restoring Hope Village property.  Here is what Lois wrote to us:  "Another great achievement today, Brian was able to get the clearance certificate for the land today. He will be paying for the land tomorrow and then the transfer will go to Bloomfontein. The assistant at the attorney's office said the transfers have been getting completed in 2 weeks recently, no more then a month. So that is fabulous news! "  

They currently have limited access to internet, so they may be a bit delayed in corresponding with people.  (group prayer before departure) It is always exciting to get an email from them and hear about the latest developments...and they've only been there less than a week.  It is such a blessing to Amber & me to work with people who are such go-getters.  We can't begin to express our appreciation to God for His amazing provision to this point.  Imagine, just 6 months ago we were returning to the US to begin fundraising, and now they are ready to complete the purchase and start building.  We serve an awesome God.

Of course, Amber & I can't wait to get there and start helping.  We anticipate leaving around the end of April.  Currently we have about $111,000 in our Capital Campaign.  (Liam gets his own backpack this time...with candy included)  As long as we have $120,000 by the end of April we are cleared to return.  We are trusting that God will provide this last amount and we'll be able to get back.

Once we arrive at the $120,000 we have our goal within sight.  Our initial construction goal was $150k, so while there is still some work to do, we are excited to get the ministry going and begin reaching more children for Christ.

Please continue to pray for us, for Brian & Lois, and for the ministries of RHI in the US and South Africa.

(taking advantage of every last minute with the grandkids)

The Life & Times of Louis & Amber - In case you were wondering...

If you've ever wished for that delightful hot-dog taste in the convenience of a bite-sized sphere, I am happy to let you know that in South Africa your dream can be a reality.

The Life & Times of Louis & Amber - Meredith Quote of the Day

Today at Grandma Maggie's house, Meredith was hanging out with Uncle Peter (11 years old).  On the farm we burn any burnable trash.  Peter had just taken a broken toy apart and said "I'm going to go out and burn this in the yard."

Meredith's response:  "Peter, you are teaching this little girl here to do bad things."

The Life & Times of Louis & Amber - Meredith "Quote of the Day"

Meredith was listening to Patch the Pirate this evening.  Specifically she was listening to Camp Kookawaka Woods which talks about the return of Christ at the Rapture, when all those who have trusted Him alone for forgiveness of sins will be taken to Heaven.  For anyone who is not familiar with Patch the Pirate stories, I highly recommend them for teaching Biblical truths to young children.

So the last song is called "Listen for the Trumpet", a reference to I Thessalonians 4, which describes Christ's return as being accompanied by the Trumpet of God.  Amber & I believe that Meredith truly understands what salvation means.  I ask Meredith if she understands that Jesus is coming back to get those of us who believe in Him, hoping to prompt a good conversation about God.

When I say "Meredith, did you know that Jesus really is coming back to take us to Heaven?" she responds "Yeah, it's a good thing I'm packing my things."  And when I looked, there she was loading all her most important toys into a backpack.  So while she obviously understands many Biblical truths, it is also clear that some are still a bit over her head.