VOA标准英语2009-Problems with Distribution of HIV Drugs Take

In South Africa, people with HIV are dying because they don’t have access to the medicine that would keep them alive. The government has pledged to provide antiretroviral (ARV) drugs to many of the HIV-positive people who need them. The pills bolster¹ weak immune systems, allowing people with HIV/AIDS to live long and productive lives. But in some parts of South Africa, state clinics have run out of the medicines or nurses are rationing² them in fear of shortages in the near future. VOA collected personal stories from AIDS victims and their families who are trying to cope with the shortage of drugs.

Darren Taylor | Mangaung, South Africa 21 November 2009

The soft sound of slowly rolling drums wafts³ across a wasteland of yellow grass stubble. Screaming children push rough wire cars across the stony⁴ field, between the guide ropes of the big tent that’s been erected⁵ for guests.

There’s a funeral today in Silver City.

“I am Johanna’s mother,” says Masentle Mohajane,72.  “My daughter was a huge person, with a huge heart. Johanna’s big voice could always be heard around here, singing.”  Then, fighting back tears, the old woman smiles, “I can’t say she had the best voice on earth, but it always made me happy.”  

Johanna Mohajane,40, is dead. She died alone, unconscious, lying in blood and vomit⁶, in a crowded state hospital on the outskirts⁷ of Bloemfontein, the capital of South Africa’s Free State province. 

Antiretroviral treatment (ART) could have saved her from the infections that finally killed her.  But medical staff didn’t give it to her.  “It was a pointless, needless death,” says Johanna’s sister, Elizabeth.

‘The right medicine….the right treatment’ 

She recalls how Johanna was admitted to hospital, too weak to move.  “The nurses put her in a bed.  We asked them what was wrong with her.  They all said, ‘We don’t know anything.’  A few hours later, her face was covered in blood and mucous⁸ from her nose. Her mouth was black from lack of oxygen.”

 

 

Masentle Mohajane holds a picture of her daughter, Johanna, who died, she says, after state medical staff failed to give ARVs to the HIV infected woman

“A drip that was meant to feed medicine into Johanna’s vein⁹ was blocked,” Elizabeth says. 

Her mother adds, “We begged the doctors and nurses for help, but no one came, they were all too busy, the hospital is always full of sick and dying people.”

Within 24 hours, Johanna Mohajane was dead. 

Her family blames the Free State health department. Bitter words pour from her mother’s mouth.  “If (Johanna) [had been] given the right drip, the right medication, the right treatment, she would still be alive,” she states. 

Last year, the government produced a National Strategic Plan  aiming to cut new infections in half over the next two years.  It also aims to provide treatment for opportunistic infections caused by HIV as well has psychological and nutritional¹⁰ counseling for those carrying the illness. ….

South Africa’s National Health Ministry¹¹ acknowledges that the ARV roll-out is beset¹² by problems. 

National health minister Aaron Motsoaledi recently said that the South African government will not be able to meet its target of providing ARV treatment to 80 percent of HIV-infected people by 2011.  

But the Free State government is adamant¹³ that it’s living up to its obligation to provide ARVs to all who need them and that it did not fail Johanna Mohajane. 

TB and meningitis 

According to Johanna’s government death certificate, she died of tuberculosis¹⁴ and meningitis – two diseases often associated with advanced HIV infection.  She was also taking bactrim and ilvitrim – antibiotics¹⁵ commonly prescribed for HIV infection.  

“They are telling us Johanna died of something else, not AIDS-related,” says her sister.  

 

Lerato Tsamai (right), with her younger brother in their home in Freedom Square, Mangaung. She, too, couldn't acess ARVs, but her life was saved when an NGO gave her the medicine

“Nurses at that hospital knew all along that Johanna had AIDS.  They just never treated her, for whatever reason,” Elizabeth says.

Nurses at some clinics in Bloemfontein have told VOA that because of shortages of ARVs, the medications are sometimes rationed¹⁶.

South African government guidelines say ARVs must be given immediately to those with severely¹⁷ weak immune systems,  or  a CD4 cell count of below 200.  CD-4s are specialized¹⁸ cells that protect the body from infection.  HIV attacks these cells and weakens the immune system, leading to the on-set of illnesses that a healthy immune system can withstand. 

A healthy person’s CD4 cell count is about 500.

Sello Mokhalipi, a fieldworker for the Treatment Action Campaign, which wants ARVs for all South Africans who need them, says, “All over the Free State, I am seeing people with CD4 counts of less than 10.  But they are not getting the drugs from state clinics. These people are dying of opportunistic infections.”

Recently, Nomathemba Gcuku,27, almost became one of these statistics.  In the Phase 6 section of the massive Mangaung district, she hangs washing under a fiery¹⁹ sun, on a patchy lawn in front of her concrete-block home, which is wrapped in barbed wire.  “To keep the criminals out,” she laughs, prodding²⁰ her mangy pet dog out of her way with her foot. 

 

Elizabeth Mohajane weeps at the funeral of her sister, Johanna

A few months ago, feeling weak and close to death, Gcuku says she was forced to “beg” for help from a private doctor after clinics and hospitals “all across Bloemfontein” would not give her the free ARV medicine she needed to stay alive. 

“November last year was the last time I got any medicine from the state,” she says.  “I have watched other people around me die when they could not get drugs.  It is inhumane.”

 

‘Fear not…. I am with thee’

Across the township, a tiny but spick-and-span house bakes in the afternoon sun.  The house is in Freedom Square, a place where thousands of people live in poverty. Inside, Lerato Tsamai is cooking lunch for her brothers, aged²¹ 11 and 16.  Music blares from two tall speakers. “Living on a thin line!” screams the song on the radio, “Tell me now, what are we supposed to do?” 

Tsamai is 23, but looks more like 12.  “The illness wasted me away,” she says, almost apologetically.

“I was sick earlier this year.  I went to the clinic in Mangaung, and they were not able to put me on ARVs because they said, ‘Sorry, we have no drugs for new people; come back later."

Nomathemba Geuku says she almost died when a state clinic refused to give her ARVs

 

She would return to the facility constantly for medicine, only to be sent home empty handed. “They kept on telling me, ‘Later, later….’” But later never came. 

“I became so sick that I was admitted into a hospice,” Tsamai tells VOA.  “I was dying. There, an NGO worker finally got me drugs, and my life was saved.”  “I am with thee,” says the poster of a golden-haired Jesus hanging above her head. She closes her eyes and smiles.

Despite testimony²² such as that provided by the Mohajane family and people like Nomathemba Gcuku and Lerato Tsamai, provincial²³ South African governments such as that in the Free State continue to deny the shortage or even the complete lack of ARVs in their jurisdictions²⁴. 

Back in Silver City, Johanna Mohajane’s body lies in a coffin²⁵ in a tiny room. Children play around it, oblivious²⁶ to death. Elizabeth Mohajane can’t help but smile at the irony²⁷. “So much life,” she says, staring at the skipping children. “So much life…..”

1 bolster   

n.枕垫；v.支持，鼓励

参考例句：

• The high interest rates helped to bolster up the economy.高利率使经济更稳健。
• He tried to bolster up their morale.他尽力鼓舞他们的士气。

2 rationing   

n.定量供应

参考例句：

• Wartime austerities included food rationing and shortage of fuel. 战时的艰苦包括食物配给和燃料短缺。
• Food rationing was abolished in that country long ago. 那个国家早就取消了粮食配给制。

3 wafts   

n.空中飘来的气味，一阵气味( waft的名词复数 )；摇转风扇v.吹送，飘送，（使）浮动( waft的第三人称单数 )

参考例句：

• A breeze wafts the sweet smell of roses. 微风吹来了玫瑰花的芬芳（香味）。 来自《现代汉英综合大词典》
• A breeze wafts the smell of roses. 微风吹送玫瑰花香气。 来自《现代汉英综合大词典》

4 stony   

adj.石头的，多石头的，冷酷的，无情的

参考例句：

• The ground is too dry and stony.这块地太干，而且布满了石头。
• He listened to her story with a stony expression.他带着冷漠的表情听她讲经历。

5 ERECTED   

adj. 直立的，竖立的，笔直的 vt. 使 ... 直立，建立

参考例句：

• A monument to him was erected in St Paul's Cathedral. 在圣保罗大教堂为他修了一座纪念碑。
• A monument was erected to the memory of that great scientist. 树立了一块纪念碑纪念那位伟大的科学家。

6 vomit   

v.呕吐，作呕；n.呕吐物，吐出物

参考例句：

• They gave her salty water to make her vomit.他们给她喝盐水好让她吐出来。
• She was stricken by pain and began to vomit.她感到一阵疼痛，开始呕吐起来。

7 outskirts   

n.郊外，郊区

参考例句：

• Our car broke down on the outskirts of the city.我们的汽车在市郊出了故障。
• They mostly live on the outskirts of a town.他们大多住在近郊。

8 mucous   

adj. 黏液的，似黏液的

参考例句：

• Healthy,skin,mucous membranes,and cilia are natural barriers to many viruses.健康的皮肤，粘膜和纤毛是许多病毒的天然屏障。
• Seromucous glands contain both mucous and serous cells.浆粘液腺既含有粘液性细胞，又含有浆液性细胞。

9 vein   

n.血管，静脉；叶脉，纹理；情绪；vt.使成脉络

参考例句：

• The girl is not in the vein for singing today.那女孩今天没有心情唱歌。
• The doctor injects glucose into the patient's vein.医生把葡萄糖注射入病人的静脉。

10 nutritional   

adj.营养的，滋养的

参考例句：

• A diet lacking in nutritional value will not keep a person healthy.缺乏营养价值的饮食不能维持人的健康。
• The labels on food products give a lot of information about their nutritional content.食品上的标签提供很多关于营养成分的信息。

11 ministry   

n.(政府的)部；牧师

参考例句：

• They sent a deputation to the ministry to complain.他们派了一个代表团到部里投诉。
• We probed the Air Ministry statements.我们调查了空军部的记录。

12 beset   

v.镶嵌；困扰，包围

参考例句：

• She wanted to enjoy her retirement without being beset by financial worries.她想享受退休生活而不必为金钱担忧。
• The plan was beset with difficulties from the beginning.这项计划自开始就困难重重。

13 adamant   

adj.坚硬的，固执的

参考例句：

• We are adamant on the building of a well-off society.在建设小康社会这一点上，我们是坚定不移的。
• Veronica was quite adamant that they should stay on.维罗妮卡坚信他们必须继续留下去。

14 tuberculosis   

n.结核病，肺结核

参考例句：

• People used to go to special health spring to recover from tuberculosis.人们常去温泉疗养胜地治疗肺结核。
• Tuberculosis is a curable disease.肺结核是一种可治愈的病。

15 antibiotics   

n.（用作复数）抗生素；（用作单数）抗生物质的研究；抗生素，抗菌素( antibiotic的名词复数 )

参考例句：

• the discovery of antibiotics in the 20th century 20世纪抗生素的发现
• The doctor gave me a prescription for antibiotics. 医生给我开了抗生素。

16 rationed   

限量供应，配给供应( ration的过去式和过去分词 )

参考例句：

• We were rationed to two eggs a day. 每天配给我们两个鸡蛋。
• The army is well rationed. 部队给养良好。

17 severely   

adv.严格地；严厉地；非常恶劣地

参考例句：

• He was severely criticized and removed from his post.他受到了严厉的批评并且被撤了职。
• He is severely put down for his careless work.他因工作上的粗心大意而受到了严厉的批评。

18 specialized   

adj.专门的，专业化的

参考例句：

• There are many specialized agencies in the United Nations.联合国有许多专门机构。
• These tools are very specialized.这些是专用工具。

19 fiery   

adj.燃烧着的，火红的；暴躁的；激烈的

参考例句：

• She has fiery red hair.她有一头火红的头发。
• His fiery speech agitated the crowd.他热情洋溢的讲话激动了群众。

20 prodding   

v.刺，戳( prod的现在分词 )；刺激；促使；（用手指或尖物）戳

参考例句：

• He needed no prodding. 他不用督促。
• The boy is prodding the animal with a needle. 那男孩正用一根针刺那动物。 来自《现代英汉综合大词典》

21 aged   

adj.年老的，陈年的

参考例句：

• He had put on weight and aged a little.他胖了，也老点了。
• He is aged,but his memory is still good.他已年老，然而记忆力还好。

22 testimony   

n.证词；见证，证明

参考例句：

• The testimony given by him is dubious.他所作的证据是可疑的。
• He was called in to bear testimony to what the police officer said.他被传入为警官所说的话作证。

23 provincial   

adj.省的，地方的；n．外省人，乡下人

参考例句：

• City dwellers think country folk have provincial attitudes.城里人以为乡下人思想迂腐。
• Two leading cadres came down from the provincial capital yesterday.昨天从省里下来了两位领导干部。

24 jurisdictions   

司法权( jurisdiction的名词复数 )； 裁判权； 管辖区域； 管辖范围

参考例句：

• Butler entreated him to remember the act abolishing the heritable jurisdictions. 巴特勒提醒他注意废除世袭审判权的国会法令。
• James I personally adjudicated between the two jurisdictions. 詹姆士一世亲自裁定双方纠纷。

25 coffin   

n.棺材，灵柩

参考例句：

• When one's coffin is covered,all discussion about him can be settled.盖棺论定。
• The coffin was placed in the grave.那口棺材已安放到坟墓里去了。

26 oblivious   

adj.易忘的，遗忘的，忘却的，健忘的

参考例句：

• Mother has become quite oblivious after the illness.这次病后，妈妈变得特别健忘。
• He was quite oblivious of the danger.他完全没有察觉到危险。

27 irony   

n.反语，冷嘲；具有讽刺意味的事，嘲弄

参考例句：

• She said to him with slight irony.她略带嘲讽地对他说。
• In her voice we could sense a certain tinge of irony.从她的声音里我们可以感到某种讥讽的意味。