Fundiswa’s Story – The Ordeal of Applying for a Disability Grant when HIV Positive
Fundiswa* lives in the community of uMqatsheni with her mother in a situation of poverty. Recently she got very sick and was transferred to the nearest hospital which is more than a two hour journey from her house. She was tested for HIV and the results were positive. She was put on ARV treatment and at this stage her CD4 count was very low. In South Africa if your CD4 count is less than 200 you are considered to have a temporary disability and therefore you can apply for a disability grant until you are deemed fit to work again. Fundiswa was advised to make an application for this grant as this money would greatly assist her in raising her nutrition levels.
However the procedure in applying for a disability grant is long and onerous in particular in Fundiswa’s case as she was too ill to leave her bed. One needs a letter from a doctor to request the disability grant application form from the Department of Social Development (DSD) in the first place. The person must present to DSD in person each time as you need to register your fingerprints. Once you get form from DSD you then need to take this form back to a doctor to get a full medical assessment. You take this form back to DSD who then request a second medical opinion. If it appears that the grant will be approved the person is then given a form for their bank to fill out stating their bank account details so that the grant can be transferred to this account. In the case of Fundiswa she did not have a bank account so we needed to get a letter from the municipality stating that she lives in uMqatsheni and then a bank opened an account.
It took three separate visits to DSD and a visit to the local doctor with the assistance of the Khuphuka Project to finally process her application where she was granted a 12 month disability grant. Without the assistance of the Khuphuka Project it is highly unlikely that she would have been able to complete the application as she was too weak to walk to get transport from her community to Underberg where DSD and the doctor are located. The Khuphuka Project drove her from doctor to DSD to bank and arranged for the DSD staff to deal with her in the Khuphuka vehicle as she would not have been able to walk and endure the long wait inside the office.
The Khuphuka Project intends to raise this case as an issue with the local SASSA officer at the DSD so that people with HIV who are too sick and weak to leave their bed, that an alternative procedure can apply in their cases in making an application for a temporary disability grant. More co-operation between the hospital / clinic and DSD in this case would have also quickened the process for Fundiswa.
Gloria’s Story – The importance of Follow On Care in Treatment of TB
Gloria* was diagnosed with TB this year. She attended the clinic in Underberg where she was advised that she had to undergo a three month intensive treatment which would involve her coming to the clinic every day for an injection. Gloria lives about 45 minutes drive from Underberg and the mini bus fare in and out costs 40 rand which she does not have. Therefore she had to default on her treatment which put her at grave risk of further deterioration and infecting other members of her family and members of her community. The Khuphuka Project offered to administer the injections at her home every day for a three month period by a registered nurse.
However Gloria became sick again and Khuphuka brought her to the clinic where she was immediately transferred by ambulance to the nearest government hospital, a two hour journey from Underberg. She was discharged two days later and told to come back three days later to get the results of blood tests and further treatment. Gloria did not go back as she did not have the money or the energy to travel to the hospital. It was only when our CCW worker visited Gloria at her home that we discovered what had happened and that she was very ill again. Khuphuka brought her to the clinic again and she was admitted for a longer stay at the hospital to fully assess her condition. She has now been admitted to a specialized TB hospital where she will get treatment for three months.
The right to access healthcare is severely limited when you are living in poverty and do not have the money to travel to your nearest healthcare service. It is important to follow up on cases such as Gloria’s where close co-operation and communication between the health service and a local NGO such as Khuphuka can mean the difference between life and death.
Vusi’s Story – The Role of Temporary Food Parcels in Alleviating Poor Nutrition
Vusi* was diagnosed as HIV positive last year. At that time his CD4 count was very low, below 200. In South Africa if your CD4 count is less than 200 you can apply for a disability grant until you are deemed fit to work again. Vusi successfully applied for a grant and it was granted for a 12 month period. When he went to renew the grant his new medical assessment showed that his CD4 count was just over 200 although he still considered himself very weak and unfit for work. His disability grant was not renewed because his CD4 count was over 200 and as he lives alone with no family support he was left in a situation of extreme poverty.
When a person is HIV positive and on ARV treatment they are strongly advised by health professionals to keep the nutrition levels to an optimum so that the treatment will take effect. Because Vusi’s grant had stopped he had no income to buy food so he applied in the Department of Social Development (DSD) for Social Relief of Distress which comes in the form of temporary food parcels for a short period of time. The DSD said that he could not receive a parcel because the Department had put a moratorium on the further distribution of such parcels as there was a concern that it was not going to the most vulnerable families. Vusi has no option but to rely on the generosity of his neighbours who give him some food from time to time but this will mean that he is effectively reneging on his ARV treatment as a result of his poor nutrition levels.
The Khuphuka Project has met with Department of Social Development to see if the Project can apply for funding for the distribution of food parcels to the most vulnerable families in the community as identified by our dedicated team of Community Care Workers so that individuals and families in the community do not have to live in situations of starvation, especially if they have a chronic illness such as HIV.
There is substantial anecdotal evidence across South Africa that people are not benefiting from antiretroviral medication because they do not have access to enough food with which to take this medication. The withdrawal of disability grants to patients whose CD4 count improves is resulting in some patients damaging their own health to maintain a low CD4 count and access the grant. The national organization Black Sash has been advocating for the introduction of a new grant for chronic illnesses such as HIV / AIDS so that people are not tempted to discontinue their ARV treatment in a desperate attempt to qualify for the renewal of their grant.
*All of the above names are fictional to protect identity of person
Fundiswa* lives in the community of uMqatsheni with her mother in a situation of poverty. Recently she got very sick and was transferred to the nearest hospital which is more than a two hour journey from her house. She was tested for HIV and the results were positive. She was put on ARV treatment and at this stage her CD4 count was very low. In South Africa if your CD4 count is less than 200 you are considered to have a temporary disability and therefore you can apply for a disability grant until you are deemed fit to work again. Fundiswa was advised to make an application for this grant as this money would greatly assist her in raising her nutrition levels.
However the procedure in applying for a disability grant is long and onerous in particular in Fundiswa’s case as she was too ill to leave her bed. One needs a letter from a doctor to request the disability grant application form from the Department of Social Development (DSD) in the first place. The person must present to DSD in person each time as you need to register your fingerprints. Once you get form from DSD you then need to take this form back to a doctor to get a full medical assessment. You take this form back to DSD who then request a second medical opinion. If it appears that the grant will be approved the person is then given a form for their bank to fill out stating their bank account details so that the grant can be transferred to this account. In the case of Fundiswa she did not have a bank account so we needed to get a letter from the municipality stating that she lives in uMqatsheni and then a bank opened an account.
It took three separate visits to DSD and a visit to the local doctor with the assistance of the Khuphuka Project to finally process her application where she was granted a 12 month disability grant. Without the assistance of the Khuphuka Project it is highly unlikely that she would have been able to complete the application as she was too weak to walk to get transport from her community to Underberg where DSD and the doctor are located. The Khuphuka Project drove her from doctor to DSD to bank and arranged for the DSD staff to deal with her in the Khuphuka vehicle as she would not have been able to walk and endure the long wait inside the office.
The Khuphuka Project intends to raise this case as an issue with the local SASSA officer at the DSD so that people with HIV who are too sick and weak to leave their bed, that an alternative procedure can apply in their cases in making an application for a temporary disability grant. More co-operation between the hospital / clinic and DSD in this case would have also quickened the process for Fundiswa.
Gloria’s Story – The importance of Follow On Care in Treatment of TB
Gloria* was diagnosed with TB this year. She attended the clinic in Underberg where she was advised that she had to undergo a three month intensive treatment which would involve her coming to the clinic every day for an injection. Gloria lives about 45 minutes drive from Underberg and the mini bus fare in and out costs 40 rand which she does not have. Therefore she had to default on her treatment which put her at grave risk of further deterioration and infecting other members of her family and members of her community. The Khuphuka Project offered to administer the injections at her home every day for a three month period by a registered nurse.
However Gloria became sick again and Khuphuka brought her to the clinic where she was immediately transferred by ambulance to the nearest government hospital, a two hour journey from Underberg. She was discharged two days later and told to come back three days later to get the results of blood tests and further treatment. Gloria did not go back as she did not have the money or the energy to travel to the hospital. It was only when our CCW worker visited Gloria at her home that we discovered what had happened and that she was very ill again. Khuphuka brought her to the clinic again and she was admitted for a longer stay at the hospital to fully assess her condition. She has now been admitted to a specialized TB hospital where she will get treatment for three months.
The right to access healthcare is severely limited when you are living in poverty and do not have the money to travel to your nearest healthcare service. It is important to follow up on cases such as Gloria’s where close co-operation and communication between the health service and a local NGO such as Khuphuka can mean the difference between life and death.
Vusi’s Story – The Role of Temporary Food Parcels in Alleviating Poor Nutrition
Vusi* was diagnosed as HIV positive last year. At that time his CD4 count was very low, below 200. In South Africa if your CD4 count is less than 200 you can apply for a disability grant until you are deemed fit to work again. Vusi successfully applied for a grant and it was granted for a 12 month period. When he went to renew the grant his new medical assessment showed that his CD4 count was just over 200 although he still considered himself very weak and unfit for work. His disability grant was not renewed because his CD4 count was over 200 and as he lives alone with no family support he was left in a situation of extreme poverty.
When a person is HIV positive and on ARV treatment they are strongly advised by health professionals to keep the nutrition levels to an optimum so that the treatment will take effect. Because Vusi’s grant had stopped he had no income to buy food so he applied in the Department of Social Development (DSD) for Social Relief of Distress which comes in the form of temporary food parcels for a short period of time. The DSD said that he could not receive a parcel because the Department had put a moratorium on the further distribution of such parcels as there was a concern that it was not going to the most vulnerable families. Vusi has no option but to rely on the generosity of his neighbours who give him some food from time to time but this will mean that he is effectively reneging on his ARV treatment as a result of his poor nutrition levels.
The Khuphuka Project has met with Department of Social Development to see if the Project can apply for funding for the distribution of food parcels to the most vulnerable families in the community as identified by our dedicated team of Community Care Workers so that individuals and families in the community do not have to live in situations of starvation, especially if they have a chronic illness such as HIV.
There is substantial anecdotal evidence across South Africa that people are not benefiting from antiretroviral medication because they do not have access to enough food with which to take this medication. The withdrawal of disability grants to patients whose CD4 count improves is resulting in some patients damaging their own health to maintain a low CD4 count and access the grant. The national organization Black Sash has been advocating for the introduction of a new grant for chronic illnesses such as HIV / AIDS so that people are not tempted to discontinue their ARV treatment in a desperate attempt to qualify for the renewal of their grant.
*All of the above names are fictional to protect identity of person