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Walter Mswazie recently in Mwenezi
Medical humanitarian organisation Medicine Sans Frontiers (MSF) has over the last three years managed to reach most people living with HIV here and provided medication through a new delivery model, Out of Facility Community Art Distribution (OFCAD).

The new model seeks to ensure people living with HIV in remote areas have easy access to treatment.

Centring on Mwenezi and Chirindi clinics that have a catchment area stretching for 100 kilometres, there are now 11 sites where people can obtain their anti-retroviral treatment without travelling for long distances and clinics report far fewer people defaulting on treatment or problems of limited access to medication.

Assisted by Batanai HIV and Aids Service Organisation (BHASO), MSF has made remarkable strides in improving the lives of people living with HIV and AIDS in the district.

This is courtesy of the rapport the organisation enjoys with both BHASO and the Ministry of Health and Child Care.

MSF has facilitated the establishment of 11 OFCAD sites which have made life easier for community members living with the virus.

The sites — Chamakudo, Chovelele, Dombodema, Gadzikwa, Madamwa, Makugwe, Mvoko, Peter Peregwe, Sandawana and Zvamapere — are manned by village health workers from within those communities.

Village health workers have undergone training on how to administer the model and basing on what was witnessed during a handover of the OFCAD tool kit to the responsible ministry at Mwenezi Development Association offices at Neshuro Growth Point on Wednesday this week, the knowledge acquired is adequate.

MSF project coordinator Ms Rinako Uenishi said the results of the pilot model are already showing significant improvement on accessibility and care.

“We implemented the model in the hardest-to-reach areas in Mwenezi District and results show that this initiative significantly improved ART clients’ levels of retention in care.

“We hope that most of people living with HIV who are on ART and those who have challenges in accessing ARVS, particularly in rural area, will benefit from this model,” said Ms Uenishi.

She said through OFCAD, village health workers are trained to distribute ARVS transported from clinics to identified sites by MSF vehicles.

The drugs are then given to registered people living with the virus in their communities without them having to travel long distances for medication.

People living with the virus are referred from clinics to the village health workers working with OFCAD and they collect their supply once every month. The village health workers keep the drugs at their homes, assessed and approved by MSF in agreement with the Ministry of Health and Child Care.

In instances where the health worker’s home does not have the conditions required for drug storage, MSF helps in rehabilitating it to suit the requirements.

BHASO assists in the mobilisation of patients to be recruited for OFCAD and, with the involvement of nurses, clients are checked if they have been on ART for at least six months and that their viral load is below 1 000 or undetectable.

MSF wound up its involvement in Mwenezi this week, handing over the programme to Government.

MSF medical director Dr Reinaldo Ortuno said the organisation was sadly ending its operation in Mwenezi, but was happy that OFCAD had improved access to medication by people living with HIV.

He said hopes were high that the Ministry of Health and Child Care, together with other partners still in the district will sustain the new delivery model.

“We started to work in Mwenezi in 2016 by doing mentorship for six facilities. We provide training on screening of TB. We then launched OFCAD, as some patients were walking for 120km to get medication.

A nurse from Chirindi Clinic Ms Sithabile Mbiza said only a quarter of the people living with HIV have benefited from OFCAD.

“We still have a long way to go and it is painful for us to lose MSF. We, however, thank them for assisting our patients, although the figure is still small,” she said.

A village health worker Ms Selithiwe Paswana of Ward 1 also echoed the same sentiments, describing the departure of MSF as a big loss.

“We service 272 patients as 11 village health workers, but the community has more patients on ART. We use bicycles for transport, but we need new ones as they are now old, and it is also painful to learn that MSF is leaving, yet indications were that the organisation was willing to give us new ones.”

BHASO  director Mr Farai Mahaso, however, assured the OFCAD members that they would take over most of the roles from where MSF has left up to the end of the year.

“The fortunate thing is that MSF has offered one of its cars, and I can assure OFCAD members that you will continue enjoying the same services till the end of December. We are not abandoning ship, but we will continue operating in the district if we get more funding next  year.

The funding for the current programme ends by end of December, but we have applied for more to continue beyond next year,” said Mr Mahaso.

Masvingo Provincial Diseases Epidemiology officer Dr Tapera Saravoye hailed MSF for assisting his ministry in improving access to ART by people living with HIV and AIDS.