No authorisation to open project for HIV-positive people in Henan province

MSF team frustrated about closed doors in China

After four years of seeking permission to bring AIDS treatment to China's Henan province, Medecins Sans Frontieres (MSF) has found the door firmly shut by the provincial authorities. Henan is particularly hard hit by HIV; between the mid-eighties and mid-nineties many poor farmers got infected in a poorly run commercial programme for blood donation and transfusion.

"Since 2002 we have carried out six assessments in various districts of Henan," says outgoing Head of Mission, Luc van Leemput. "Even if the Henan government is trying hard to deal with the epidemic as part of China's national AIDS response programme, many challenges remain. There have been many repeated requests for support from patients, local administrators and local health officials."

In Hubei province, bordering Henan to the south, the MSF team is providing integrated treatment and care for HIV-positive people together with the Centre for Disease Control in the city of Xiangfan. One-fifth of the patients in this project are from Henan and the demand from people in that province to be enrolled has been increasing significantly in recent months.

"For all of us, it is very frustrating that the provincial authorities are not allowing us to start a similar clinic in a province that is one of the hardest-hit in terms of HIV-infection rates," says Van Leemput. "All the more so for our doctors, who see the patients come from Henan and have contact with their colleagues in that province, but are blocked from bringing treatment and care to the many people who cannot come to Xiangfan. We have trained doctors and other health workers in a comprehensive approach to AIDS, an approach that takes the needs of the patient into account and stimulates adherence to the treatment. But we are not allowed to put this approach into action for people in Henen who need it urgently and who are asking for our support."

MSF continues to provide treatment and care in Xiangfan as well as in Nanning, in Guangxi province. The projects go far beyond a technical approach. Patients are not merely administered anti-retroviral medication and drugs to fight opportunistic infections such as tuberculosis or pneumonia; rather, the MSF projects allow for comprehensive care to the patients and the community, that also includes testing, individual counselling, setting up patient support groups and providing information to patients' families, health workers and the wider community. Earlier, the national health authorities praised the MSF approach as an example of the kind of care that should be made available for China's HIV-positive population.


无国界医生在中国被拒诸门外感沮丧

四年以来,无国界医生一直寻求获许在中国河南省开展爱滋病治疗项目,却一直被省政府拒诸门外。河南省尤其饱受爱滋病肆虐,由八十年代中期至九十年代中期,很多穷困的农民通过经营不善的商营血站输血或卖血,染上爱滋病。

「从二零零二年起,我们在河南省不同地区进行共六次评估工作。」无国界医生前中国国家主管陆克说。「即使河南省政府有遵照全国爱滋病的应对措施,试图尽力处理这个疫症,但仍存在很多挑战。许多病人、地方行政与卫生官员不断要求无国界医生到河南,支援当地的治疗项目。」

无国界医生在河南以南的湖北省襄樊巿与疾控中心合作,为爱滋病患者提供综合治疗与关怀服务。项目中正服用抗逆转录病毒治疗的病人,有五分之一来自河南。过去数月,要求得到治疗的河南病人明显增加。

「省政府不允许无国界医生在这个受爱滋病疫症影响最为严重的省分开设爱滋病治疗诊所,对我们来说,的确十分沮丧。」陆克说。「特别是我们的医生,他们诊治由河南来的患者,亦与当地的同工有联系,却未能为无法到襄樊的河南病人提供治疗。我们训练的医生以及其他医护人员,能够提供全面的爱滋病治疗与关怀服务,会考虑病人需要,亦强调服药的依从性。惟我们未能将这套全面的方法用於河南,救助要求诊治以及有紧急需要的病人。」

无国界医生将会继续在襄樊和广西省南宁巿提供爱滋病治疗。项目不仅侧重於医疗技术,为病人提供爱滋病抗病毒治疗以及结核病与肺炎等机会性感染药物,更会为病人与整个社区提供全面服务,包括爱滋病测试、个人辅导、成立病人支援小组,也为病人家属、医护人员和整个社区提供有关爱滋病的资讯。较早前,国家卫生部表扬无国界医生采用的方法为典范,中国爱滋病人应得到同样的治疗。
Location
2006
Issue
2006