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Book Review: AIDS: The Health Care Challenge: A Practical Guide for Nurses, Doctors and Health Care Professionals

As the AIDS epidemic continues to unfold in South Africa, the challenge of care for people infected with HIV/AIDS becomes more and more crucial. In her book, AIDS: the health care challenge. Alta van Dyk looks very specifically at the role nurses, doctors, and health care professionals can play in providing care for people with AIDS. A recurring concern in AIDS work is the level of risk of infection faced by health professionals in the care and treatment of people infected with HIV and with AIDS. Picking up on the social unease about this disease and the panic surrounding the epidemic, many professionals have felt anxious about their professional risk of infection and about whether they have the right to refuse treatment to infected people. There are some notorious cases of surgeons who refuse to operate on HIV+ patients and dentists who have refused to accept HIV+ people as patients. While these actions are relatively isolated, and clearly in contravention of the SAMDC guidelines, they do highlight the difficulties which many health professionals face in coming to terms with this disease. This book goes some way to addresssing these fears. It offers a very detailed, comprehensive, and careful overview of the care and management of AIDS by health care workers, mainly in health care institutions. Following one of her dictums in the book, Be safe: not ridiculous, van Dyk details the precautions to be taken in general situations (gloves, masks, washing, etc.) and for more specific instances (birth, blood, needles tick, etc.). The general message and guide she offers to health professionals is not to sec HIV as significantly different from other infections, Hepatitus B for instance, but to follow the regular infection control proceedures, taking extra precautions where these are really required. The attention to detail is at times daunting, and makes the reading heavy going. The organization of the information while carefully numbered and under headings, could have been more rationally done to avoid some of the repetition and cross referencing. Nevertheless, for many health professionals this will be a useful and handy reference work in their practices, wards or clinics. It is encouraging that regarding perhaps two of the most controversial aspects of care she makes recommendations in line with the beliefs of most AIDS workers: (i) that testing each patient is as irrational as it is unnecessary, and (ii) that generally there is no good reason to nurse patients with HIV and AIDS separately from other patients. In the first sections of the book, she sets out the clinical S.-Afr.Tydskr.Sielk.1993.23(2)