Catherine Murombedzi HIV Walk
MUKAI Support Group of Ndanga in Zaka has brought a new lease of life to Mr Zvapano Ziki. Mr Ziki is one of the six males that make the group. Mukai has 30 members, 24 being females. By nature, men do not want to be open about their HIV status, are not willing to be in open groups and naturally manage their health in privacy as compared to women.
Mr Ziki and his wife Miriam are both members of Mukai, a support group that was the missing link that helped him recover when he was bed-ridden.
“In 2007 the economy was bad and testing HIV-positive during that time was a death sentence.
“The harvest from our field was poor, the financial support from our eldest son who used to work in Masvingo had stopped because he had been retrenched. I had failed to report back to work in South Africa where I worked due to poor health.
“My wife literally dragged me to the hospital in a scotchcart. She saved my life. I was diagnosed with pulmonary tuberculosis and admitted to Ndanga District Hospital for six weeks. I tested positive to TB and HIV.
“It was just too much for one person, TB and HIV infection at the same time,” said Mr Ziki on the sidelines of the World AIDS Day commemorations at Garwe Stadium in Chivhu.
“I had a prolonged cough, severe chest pains and this continued for two weeks when I was in hospital.
“The doctor said that my lungs had become enlarged and there was water in the lungs. The water was drained and it filled a 2-litre container. I had heard that TB is fatal, now with it compounded with HIV, I saw myself as a dead man,” said Mr Ziki.
TB is an infectious disease caused by a bacterium called mycobacterium tuberculosis.
TB primarily affects the lungs but it can also affect the central nervous system, lymphatic nodes and the circulatory system, among many other parts.
The TB bacilli multiplies and in a person with a weakened immune system like Mr Ziki, it presented a complex manner because he sought treatment late.
Dr Owen Mugurungi, the director of HIV, AIDS and Tuberculosis Unit in the Ministry of Health and Child Care, said not everyone infected with TB bacteria becomes sick with TB disease.
People who become infected, but are not sick have what is called latent TB infection (LTBI).
People who have LTBI do not feel sick, do not have any symptoms and cannot spread TB bacteria to others. But some people with LTBI go on to get TB disease.
This is usually caused by a weakened immune system e.g. HIV infection. He also pointed out that alcohol and drug abuse make the body prone to infections.
Mr Ziki had a compromised immune system and also worked in a mine.
“My wife has been my pillar of strength. She was tested for HIV when I was in hospital in Ndanga and she too tested positive. I had worked in a mine in South Africa for 15 years, so my being away saw me live with several women Egoli.
“I think that is when I got infected and by 2007 when I came for Easter holidays, I failed to go back to work because I was so sick.
“At first I thought the chest pains were caused by working in underground conditions, so I ignored it. I took pain killers for a month and the tablets failed to work as I further deteriorated and became bed-ridden before being taken to Ndanga by my beautiful wife,” said the soft-spoken Mr Ziki.
After regaining full health, Mr Ziki decided that he would stay at home. He is now a behaviour change focal person working as a volunteer for the Ministry of Health and Child Care.
Ndanga District Hospital was accredited as an ART site in 2006.
The hospital offers opportunistic infections services from Monday to Thursday. It has 1 417 patients on first line ARVs and 30 clients on the second line.
There are nine outreach sites. The hospital also has a follow-up mechanism to track patients and uses mobile phones in cases where a client provided a number.
“If one fails to collect medication the hospital makes a follow-up through phoning or a visit by the village health worker where a phone does not exist,” according to Mr Stanley Takaona during a feedback meeting in Kadoma.
Mr Takaona is a member of the monitoring team for OI and ART Services which was set up by Zimbabwe HIV AIDS Activists Union (ZHAAU), Zimbabwe National Network of People living with HIV (ZNNP+) the Ministry of Health and Child Care with support from the National Aids Council.
He added that Ndanga Hospital does not have a waiting list and had enough stocks of medicine.
Temporary shortages were a result of the hospital sending ARVs to ART sites which had run out of stocks.
Patients always got three months’ supply for both lines.
“I am glad to say patients do not pay a cent for opportunistic infections services at Ndanga District Hospital. However, they are required to pay US$8 for chronic conditions and an ambulance fee of US 80 cents per kilometre which is rather steep considering that the population depends on subsistence farming which is a gamble, taking into consideration that the region is dry,” said Mr Takaona.
“The pharmacy is open between 8am and 16.00 hours from Monday to Saturday. There is no shortage of cotrimoxazole and the 30 patients on second line ARVs are well-catered for,” he added.
Mr Takaona lamented the lack of privacy in counselling sessions and decried that multi-drug resistant patients are treated from home.
Like all other centres, dry blood samples for children are sent to Harare and it takes between three to four weeks to get them back.
He also said the hospital has a critical staff shortage and would require more nurses to ease the patient/nurse ratio.
The issue of multi-drug resistant TB patients being treated from home seems to be widespread nationally.
It is either the hospital does not have enough room to house the patients or they are scared to have more patients infected in the hospital environment. The situation, however, is a Catch-22 as it exposes those at home again.
Dr Mugurungi said patients infected with TB for the first time should observe the treatment regime and comply with it.
It takes a minimum of six months or more for one to be cleared of TB.
“The main way to ensure that one does not get multi-drug resistant TB is to comply with doctors’ or nurses’ prescribed method. Usually patients stop taking medication when they see that they are fit yet the bacilli still exists. So the next time the TB resurfaces it is no longer treated by the main medication which is isoniazid and rifampin, thereby demanding one to be put on injections and tablets at the same time,” he said.
Since TB is air-borne, it is therefore of grave concern that multi-drug resistant patients are correctly treated as they also pass the same strain.
It would be an overwhelming challenge were more people to report with MDRTB. It would spell doom for the success that the country had recorded in being able to contain TB.
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