JOHANNESBURG, 24 August 2010 (PlusNews) - A strike for better wages by South African health workers is putting the lives of HIV-positive people on the line as industrial action disrupts treatment programmes.

Services providing antiretroviral (ARV) and tub erculosis (TB) treatment, and prevention of mother-to-child transmission (PMTCT) of HIV are among the programmes disrupted by the public sector strike, which is about to enter its second week.

Local health lobby groups like the Treatment Action Campaign (TAC) are trying to ascertain the extent of disruptions nationally, but in townships outside Johannesburg and the capital, Pretoria, the strike has already closed smaller clinics that dispense HIV treatment, and disrupted some of Johannesburg's largest ARV and PMTCT programmes. Disruption of HIV/AIDS programmes have also been reported in Mpumalanga and KwaZulu-Natal provinces in eastern South Africa.

An estimated 1.2 million public sector workers, including nurses and teachers, downed tools on 18 August as wage negotiations stalled. Unions have rejected the government's latest offer and protests are scheduled for Thursday 26 August, with additional unions threatening to join the mass industrial action in solidarity.

Service disrupted, doctors pushed

Johannesburg's Rahima Moosa Mother and Child Hospital treats about 30,000 patients annually. Dr Ashraf Coovadia, head of the hospital's paediatric HIV section, said outpatient services, including antenatal care, were simply not available.

"Women in labour are still being received by the hospital's casualty section but antenatal services - where PMTCT starts - have been shut down," Coovadia told IRIN/PlusNews. "Patients are not getting the medication or services they deserve; they're being turned away."

Staff have been telephoning patients taking HIV and TB medicine to ensure they have sufficient drug supplies to prevent treatment disruptions that could increase the likelihood of drug resistance and treatment failure. Staff have also been arranging to give them their medication at the facility's gates because many patients were too intimidated by striking workers to enter the hospital.

At the Charlotte Maxeke Johannesburg Hospital, another of the city's large ARV clinics, fear of violence and intimidation by striking workers has also reduced patient attendance, but director Dr Jeff Wing said HIV services had been minimally affected.

South Africa's largest hospital, Chris Hani Baragwanath, has seen the army and police deployed to guarantee service delivery and guard against possible strike-related violence, said hospital spokesperson Nkosiyethu Mazibuko, who maintained that HIV services had not been affected by the strike.

However, workers who wished to remain anonymous reported that the hospital's pharmacy was understaffed and had been closed most of the time since late last week, with doctors forced to fill their own prescriptions to ensure HIV-positive patients could get top-up supplies of ARVs or TB medication.

The Gauteng provincial government has won a court interdict against striking workers to prohibit acts of intimidation against health workers still reporting for work in and around Johannesburg, but TAC and the Rural Doctors Association of Southern Africa have called on the national government to take further measures to guarantee the provision of essential services while the strike continues.