Portal de Periódicos da CAPES

AIDS and odds

2008; Wiley; Volume: 63; Issue: 4 Linguagem: Inglês

10.1111/j.1365-2648.2008.04754.x

1365-2648

Alison J. Tierney,

HIV/AIDS Impact and Responses

In this issue of JAN, Akintola’s paper (pp. 357–365) highlights the stresses that face volunteer caregivers for AIDS sufferers in South Africa. The study was carried out in two semi-rural communities and his ethnographic study involved interviewing 20 volunteer caregivers, also accompanying some of them on home visits in order to observe and document their experiences. ‘Defying all odds’ emerged as the overall theme from Akintola’s analysis of the stresses and coping mechanisms of volunteer caregivers. ‘Different kinds of odds were stacked against volunteers in the course of caring’ (p. 360), he says. Families did not always welcome the volunteers because of the stigma and discrimination attached to AIDS. Sometimes this was translated into frank cruelty towards the family member with AIDS and, understandably, this was particularly distressing for the volunteers. They also had to witness the pitiable conditions in which patients were living; to deal with special care needs that sometimes were repulsive; and to accept that their own skills were ‘not good enough to significantly alleviate the pain and suffering of the patients’ (p. 361). Why on earth would anyone, without the bind of family ties, volunteer to put themselves into such a difficult and dispiriting situation? One of the volunteers said: ‘you have to be brave, must have hope and volunteer with love’ (p. 361). But, as Akintola also explains, volunteers are easy to recruit because options for alternative, gainful employment are sorely limited. The need for volunteer AIDS caregivers to be better supported is the obvious message that we take from this paper. But, for those of us who live in other parts of the world that are now less-affected by AIDS, and where services and support are in place, this study has an important sub-text. It confronts us with a stark reminder of the continuing blight of AIDS for countries such as South Africa where almost half of all deaths are caused by AIDS, rising to over 70% in the 15–49 years age group. The average life age expectancy is 54 years: a full 10 years less than it would be without AIDS (http://www.avert.org/aidssouthafrica.htm). Over 90% of all people with HIV/AIDS live in developing countries. Poverty, war and government inaction are some of the many reasons why HIV/AIDS has not been contained. Is it possible that the developing world ever will defy the odds that are stacked against their recovery from this devastating disease? The answer to that lies mainly with the rest of us. The resources needed for universal access to HIV prevention services, and to antiretroviral drugs for the treatment of AIDS, can only come from the world’s more affluent countries. Lobbyists argue, however, that G8 (the group of eight countries, including the United Kingdom and the United States of America, whose leaders work together to tackle global problems) is lagging behind in delivering on its promise to achieve universal access to AIDS services by 2010 (http://www.stopaidscampaign.org.uk). By the time you read this article, this year’s G8 summit will have taken place in Japan. Have clear targets, timetables and financial commitments now been agreed? Failure to invest now in stemming AIDS will only result in future costs continuing to escalate. Meantime, every day, thousands of people will die from AIDS. The odds are stacked against success. But failure really is unthinkable.