August 14, 2017

Call for measures to curb TB, Art defaults

Filed under: Feature,health,Uncategorized — Nhaudzenyu @ 1:42 pm
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GLORIA Mudhingo (45) looks happy as she goes about her work in the tuberculosis (TB) and HIV and Aids consultation rooms at Zvimba Rural Clinic, a few kilometres away from Murombedzi business centre.


Clad in a yellow dress and a red jersey, the heavily-built mother of two looks like any other villager as health officials at the clinic are all clad in their uniforms.

She looks like the odd one out when other village women are scattered around the nearby business centre selling vegetables, fruit and second-hand clothes.

As a group of health journalists on a provincial media tour arrive, Mudhingo is about to dash off to Masiyarwa village located 10km away.

Although the media tour is focusing on TB issues, Mudhingo believes her side of the story must be heard.

“TB cases are now surpassing those of HIV but in reality when someone is diagnosed of HIV, he or she remains a suspect in contracting TB. We must work as a community in addressing these issues, but we are facing the challenge of defaulters around here,” Mudhingo, who is the Community Linkages facilitator, says.

Her roles include making follow-ups on patients on anti-retroviral therapy (Art), who are supposed to adhere to their treatment regime to suppress their viral loads.

But for Mudhingo, too many defaulters in the communal areas of Zvimba district are breaking her heart.

“We have had 70 defaulters since January and this figure is alarming, as we have targets, as a nation on HIV matters,” she said.

Mudhingo, who has been living with HIV since 2006, says she wants to lead by example.

“Being HIV positive is a condition that we cannot wish away. Once you are positive, it is part of your life. We must train many of our members of the community to understand it better. The main challenges we face in making follow-ups are that some HIV patients did not disclose their status to close relatives and family members,” she said.

Mudhingo suggests that it is imperative that HIV+ people should be part of support groups, as this will ease the burden of thinking that they are family outcasts.

“I am a member of the Positive Women Support group here in Zvimba. As a family, we are supportive of each other’s needs and challenges on both social and health matters. No one can live as an island, so we must talk to each other,” Mudhingo said.

Zvimba Rural Clinic, established in 1957, has a catchment area for 107 981 people and has 370 TB patients, according to the senior nurse-in-charge, Elias Nyama.

HIV and Aids consultant, Mucha Cynthia Mukamuri attributes defaulting to several factors, including when patients begin to feel better and discontinue treatment.

“This is a reflection of lack of information when patients commence Art. Stigma continues to exist in our communities. Some people are not comfortable with being seen taking medication or they just become too busy,” she said.

“In some cases, the distances travelled to collect medicines can be prohibitive. The waiting period at the facility also compounds the problem. Some people are not patient to wait or their jobs are too demanding to make it easy for them to take their medication.”

Mukamuri, however, said realisation that one was HIV positive could be overwhelming, triggering fear and worry.

“This comes as a shock. It can bring feelings of anger, fear, regret and even panic that are often hard to contain. It is normal to feel this way, but there is need to seriously reflect and accept the situation and take the necessary steps with support from both family and service providers,” she said.

Mukamuri said committing to take treatment was the first big step, which included getting the requisite information about the condition.

Community Working Group on Health (CWGH) executive director, Itai Rusike said defaulters had to live with the stress of an untreated disease that put them at risk of further illness or death.

“People living with HIV are expected to remain adherent to treatment and are labelled ‘defaulters’ when they don’t,” he explained.

“The basic pillar of any public health system is the supply of medicine to clinics and hospitals, and stock-outs are indicative of a bigger problem related to management and accountability.”

Rusike said there was need for eating healthy, exercising, getting adequate rest and early treatment for any opportunistic infections if a person was to successfully manage HIV.

“Most facility level stock-outs are not a result of supply shortages, but of poor management of the distribution of medicines. The government should fully fund strong, accountable, community-based treatment literacy and adherence support along with strong social protection programmes,” he said.

Rusike concurred with Mukamuri that stigma and discrimination undermined HIV prevention efforts by making people afraid to reveal their status, seek HIV information, services and modalities to reduce their risk of infection.

“Fear of stigma and discrimination, which can also be linked to fear of violence, discourages people living with HIV from disclosing their status even to family members and sexual partners and undermines their ability and willingness to access and adhere to treatment,” he said.

“Thus, stigma and discrimination weaken the ability of individuals and communities to protect themselves from HIV and to stay healthy if they are living with HIV.”

Rusike said patients were relatively dependent on public services for Art and faced difficulties in affording prices in private pharmacies.

“There are logistics and supply chain management challenges, stock-outs of HIV test kits and medicines, inadequately decentralised paediatric Art services and Art initiation for children, unpredictable external funding and inadequate private sector reporting,” he said.

Rusike said Zimbabwe had made great progress from being among countries with the highest HIV prevalences in the region, but expressed concern that gender dynamics still played a big role in infection patterns.

“High gender differentials in HIV suggest that social norms and behaviours continue to put young females at risk. There have been significant improvements in service availability, although with shortfalls in continuity of medicine supplies. These shortfalls need to be addressed together with access to food and gender inequality so that Aids does not become a disease of poverty,” the CWGH boss said.

“While the policies, institutions and programmes are in place to respond to prevention, treatment and care needs, resources are still lacking for the scale-up required.
Additional measures are needed to promote uptake among vulnerable groups.”

Rusike said supply, cost and access barriers to paediatric treatment and prevention of mother-to-child transmission services in rural, low-income populations needed to be addressed.

Mukamuri also noted that nutrition played a critical role in HIV management.

“There is need for eating healthy, exercise, adequate rest, early treatment for any opportunistic infections and a stress-free life if a person is to get better from HIV-related illness,” he said.

United Nations targets by 2020 are that at least 90% of all people living with HIV will know their HIV status.

By the same year, 90% of all people with diagnosed HIV infection will receive sustained anti-retroviral therapy and 90% of all people receiving anti-retroviral therapy will have viral suppression.

Should this happen, then Mudhingo will keep on smiling, as the number of defaulters goes down.


Spirited efforts underway to lighten TB burden

Filed under: Feature,health — Nhaudzenyu @ 1:36 pm
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DEREK Banda’s wasted body shakes as he coughs. For a moment, he struggles to speak before a very faint voice echoes from him, his face registering desperation.



He used to be a robust man as confirmed by a picture framed against the wall in this dimly lit room of his house in Alaska Mine compound, which has been nicknamed the Dark City because of lack of electricity.

Banda, a widower, is looking after five grandchildren whose parents succumbed to HIV-related illnesses.

To compound his misery, Banda was diagnosed with tuberculosis (TB), following three weeks of persistent dry cough and sweating during the night.

“I started sweating during the night and had a persistent cough that made it difficult for me to sleep. In fact, my 14-year-old grandson thought I was about to die. I could not walk for a long distance because of breathing challenges. It was really tough for me,” explained Banda.

He said that besides his suspicion that he was suffering from another incurable disease, a former workmate encouraged him to be tested for TB.

“Although I am a renal patient, one of my friends asked me to get tested for TB. He assured me that TB can be treated,” Banda said.

Banda, like many former mine workers, is living in abject poverty after losing his job as an underground miner at Mhangura Mine.

Three months into the treatment regime, he is showing signs of recovery and has become a living testimony that TB can be cured.

Banda recalls how his life took a downturn when he was transferred from Mhangura copper mine 20 years ago and settled at Alaska Mine, 15km west of Chinhoyi in 2000.

Soon after he was diagnosed of TB, Banda confessed that taking medication was deterred by lack of food, since he is unemployed.

“I am in dire need of food supplies since the tablets that I am taking demand a balanced diet,” Banda said.

For him and many others, Alaska mine smelting plant was the major source of employment, along with its sister mine – Shackleton – but the two have been idle following the shutdown in 2001.

TB thrives in poor socio-economic conditions, where people live in overcrowded homes, have poor nutrition, high rates of smoking and where other health conditions such as HIV and Aids are commonplace.

The risk factors for tuberculosis read like a summary of the living conditions of Alaska.

A former worker Joseph Phiri recalled that Mhangura Copper Mine had strong links for them.

“The mine closures brought a lot of unhappiness here, and at Shackleton mines. Nearly 100 men out of the 254 former mine workers retrenched in 2001 have already died at Alaska alone. The majority are terminally,” said Phiri, adding that the situation continues to deteriorate.

Former motor electrician and Alaska workers’ representative, Roger Mlotshwa, said many former miners are now destitute after being exposed to highly toxic chemicals in mines.
“Some workers suffer from lung diseases such as pneumoconiosis,” he said.

Pneumococcus is an occupational lung and a restrictive lung disease caused by inhaling organic and inorganic dusts retained in the lungs.

Jobs associated with the disease include asbestos mining, fabric manufacturing, quarry mining, sandblasting and stone cutting.

According to SafAids media manual on TB and HIV TB transmission occurs indoors.

“An individual risk of exposure is determined by the concentration in contaminated air and length of time a person breathes that air. The risk is high when one has had close and prolonged indoor exposure with the affected person suffering from TB as it will affect approximately 10 and 15 people per year,” the manual in part read.

The Parliamentary Portfolio Committee on Health and Child Care has called on urgent need to put TB on the political agenda.

Presenting its findings to Parliament recently, the committee noted that TB among artisanal miners should be a top priority issue that needs to be addressed with the urgency it deserves. State must move in to fund treatment, the committee recommended.

The MPs described the 7% budget allocation towards TB as a mockery saying the disease was a public health threat.

In light of the increased TB risk in mining communities among other at risk population, the ministry supported by USaid’s Challenge TB and Global Fund, embarked on a TB targeted screening initiative by getting into communities at risk of infections as they sought to find all missing TB cases.

Funded to the tune of over $1 million, the programme has seen the ministry setting up mobile clinics in high risk communities.

According to the ministry, high risk communities include people living in mining areas, prisons, people living with HIV, diabetic, health care workers and the elderly; hence the approach has seen them getting into such communities.

International Union Against Tuberculosis and Lung Disease (The Union) country director, Christopher Zishiri, said his organisation is carrying out targeted screening for active TB in communities that are at high risk including former mine workers and those in the mining sector through the targeted screening for active TB among high risk groups project.
“These people are receiving free chest X-rays and consultations by a medical doctor. In addition, they are also being tested for HIV and diabetes mellitus which also increase their risk of developing TB,” he said.

He added that this year 18 prioritised districts from all the 10 provinces will be screened.

“To date former mine workers and those in the mining sector (both formal and informal) and other high risk communities from 13 districts namely Mazowe, Bindura, Gwanda, Umzingwane, Makonde, Chegutu, Mutasa, Shurugwi, Kwekwe, Bulawayo, Bubi, Nkayi and Matopos have been screened for TB and those diagnosed initiated on appropriate treatment at their nearest health facilities,” Zishiri said.

According to the World Health Organisation (WHO), Zimbabwe is among the few countries battling 80 to 85% of the global TB, TB-HIV and drug-resistant TB (DR-TB). The global body says TB is one of the world’s most deadly diseases, killing three people every minute.

In 2015, the prevalence of TB in the country was 292 cases per 100 000 populations. Every year, 9 million people develop TB, and 1,5 million die from the disease as it is one of the top 10 causes of death worldwide. WHO report in March 2017 say 10,4 million people fell ill with TB and 1,8 million died from the disease in 2015. Over 95% of TB deaths occur in low- and middle-income countries, according to WHO.

With the Health ministry and other stakeholders’ commitment to end TB by 2030, better strides have been made to eradicate TB with former mine workers like Banda being beneficiaries of the success story.

Chikangwe maternity wing in limbo

Filed under: Feature,health — Nhaudzenyu @ 1:31 pm
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DONATED goods, such as refrigerators, scanning machines and delivery bedding for expecting mothers, are gathering dust at the Chikangwe proposed 24-hour maternity wing since 2015 due to financial and water crises.


Chikangwe 24-Hour Clinic

Zim-Health, a non-governmental organisation from Netherlands, donated the goods to ease maternal health challenges in Karoi town, covering Chikangwe and Claudia suburbs, as well as the Nyama resettlement area and was expected to benefit 15 000 women.

A maternity wing was established to assist expecting mothers before referring them to Karoi District Hospital, catering for 32 outlying clinics in a district with a 329 197-strong population, according to the 2012 national census.

The official opening of the wing has been staggered due to lack of coordination from senior officials and financial resources coupled by the worsening water crisis affecting the farming town situated about 204 km north-west of Harare.

The problems have been blamed on lack of coordination within the municipality’s management, with one councillor claiming that the council approved the employment of midwives, who have “a dark past”.

The ministry of Health and Child Care reportedly demanded that the community hall be fenced before it could authorise the use of the maternity wing, but nothing was done.

Two full council meetings were postponed in May, as policy makers wanted a briefing on the progress from the housing department.

According to the June full council minutes, Ward 1 councillor, Travolta Matekenya raised concern that the facility was yet to become functional long after the set deadline and this was prejudicing residents.

Sha Mujuruki responded that there had been no progress made.

“She (Mujuruki) said nothing had changed and everything was at a standstill and work was still pending since management had not discussed anything pertaining to financing for the maternity wing,” read the minutes in part.

Matekenya further asked about the challenges being faced since most goods were donated and council input was minimal, but the director argued that financial challenges were the hindrance.

Matekenya, however, argued that the real problem was “lack of commitment and incompetence on management’s part”.

Health officials at Karoi district and Chinhoyi provincial hospitals were evasive on the matter.

“We are only witnessing pregnant women registering here for antenatal and postnatal care. We do not know how they would have delivered, as the clinic is still to offer the service here,” a source close to the development said.

The maternity wing is currently being used by breastfeeding mothers, who are on antiretroviral therapy and a recent visit revealed that it has not been working as a maternity wing, with three beds in the other room gathering dust, while scores of other donated materials are locked in another room.

“We had a challenge of a sink. It was installed, but nothing has been done to show commitment on when the maternity wing will be opened,” another source said.

A seven-member commission appointed by Environment Water and Climate ministry to see if council had the capacity to take over water from the Zimbabwe National Water Authority recently was informed that the maternity wing could not be officially opened because of water challenges.

Karoi Residents and Ratepayers Association chairman Freck Kuchekwa expressed concern over lack of progress on the facility.

“We are concerned that expecting mothers have to use a district referral hospital, when donated goods are gathering dust because there is no water to make it function,” he said.

Karoi Town Council town clerk, Wellington Mutikani said the council would soon use the public health and amenities cross-cutting team to investigate the matter.

“Public health is council’s priority and issues of maternal health cannot be overlooked,” he said.

The Zimbabwe Demographic Health Survey says at least 20% of Zimbabwean births for the last five years were home deliveries, which have a negative impact on maternal mortality.

Maternal mortality occurs when a woman dies while pregnant or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy.

The causes maybe related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes and the Karoi scenario aptly points to one such potential case.-

June 26, 2017

Hurungwe Aids gala- when the dead smile and dreams fulfilled

Filed under: Feature,health,Uncategorized — Nhaudzenyu @ 10:19 am
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By Nhau Mangirazi

MAGUNJE– Sir Philip Sidney once said: ‘They are never alone that are accompanied with noble thoughts’

When Karoi based National Aids Council, Nac official Rumbidzai Manatsa mooted the idea of Ministry of Health spearheading Magunje Aids gala, some took it as a daydream.

It was a tall order and few understood it well.


The late Biggie Tembo

Unknown to her and other partners was that the late Mhosva Marasha aka Biggie Tembo and Prince Tendai Mupfurutsa kept their fingers closed and smiling in their graves.

For the late Hurungwe music icon it was time for their kith and kin to enjoy music near their rural homes. It is here where they were raised before venturing to the modern world but came back to be buried here.

Prince Tendai the ‘Character’ hit maker body lies under Mupfurutsa  village a few kilometers from the venue- Magunje stadium.

Likewise, Tembo who led the Bhundu Boys is buried in Hurungwe.

Both made music lovers happy during their lifetime as Tembo’s band was the first to tour United Kingdom while Prince Tendai’ Barbed wire music, the first genre before Zimdancehall came up nearly two decades later made international impact musically.

Tendai Mupfutsa

The late Tendai Mupfurutsa

These two musicians are smiling in their graves following the successful musical gala recently.

It was a revival when the crowd sang along Fred Manjalina aka Kapfupi,  Freeman’s real name Energy Sylvester Chizanga and Blessing Shumba who

drove all the way from Mutate to entertain the crowd.

But hold on, another late legendary artist is smiling broader as his dream was fulfilled.

This is none other than the late actor, poet and Aids activist Eliot Magunje known as Madzibaba Jazzman in Paraffin drama series who passed on April 2003.

His body lies near Kemureza dam near Magunje growth point.

He is among few of Zimbabweans to openly come out about his HIV-positive status and was influential in promoting better health for people living with HIV/Aids in the country.

Magunje had a dream when access to testing was limited besides stigma associated by disclosure then.

He was angry that drugs to prolong life on HIV patients were too expensive.

By then, late Magunje’s dream was never understood but it was literally accomplished at the weekend when at least 800 people were tested and counselled about HIV and Aids for free.

This is besides over 150 women who underwent Visual Inspection with Acetic Acid and Camera, or VIAC- an effective way to prevent cervical cancer in women age 30-50 years old.

About 60 people were tested on Sexually Transmitted Infections, STI while over 100 women got family planning services that came close to their villages.

Even pensioners had a chance to inquire on services provided by National Social Security Authority among other services.

Sixty seven Rogers Matanha of Mupingashato village said the gala could have been good to honor local talented musicians on such events.

‘We hope the organizers will get to understand historical background of the area and associate it with current events.  It was going to be good to mention Magunje as pioneer on advocacy for free testing here in Hurungwe.  While Tembo and Prince Tendai Mupfurutsa are gone, they remain our musical heroes’

Nac communication manager Madeline Dube said music galas are making an impact on the society as they offer HIV and AIDS services to the community in a more relaxed manner.

‘We are now offering better services to males who are often left out by other health programmes. As Nac, we are providing HIV and AIDS services in a comprehensive manner under one roof ‘one stop shop” approach’, said Dube.

Hurungwe district medical officer Doctor Annamore Mutisi said there no one on Antiretroviral Therapy, ART with 28 558 people accessing it for free.

‘Zimbabwe has identified sex workers, youths, long distance truck drivers, artisanal miners and prisoners as key populations that need more and targeting prevention interventions. It is worth mentioning  that these groups are predominant in Hurungwe. More efforts need to be done so that we close the gap in new infections. Its no longer going to be business as usual,’ said Mutisi.

The gala held under the theme Closing the tap on new HIV infection, indeed made dreams of the late Magunje become a reality.

July 28, 2015

TB jails Zimbabwe prison guards

Filed under: News — Nhaudzenyu @ 2:59 pm
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By Nhau Mangirazi

KAROI-Prison officer Mathias Kadiki (not his real name) has been on guard to Roderick Chambwe (not his real name) for the past three weeks at Karoi hospital side ward.

Chambwe, a convicted criminal is serving part of his sentence at the local prison.

He is on tuberculosis medication but the two are now sharing tiny side ward at the hospital where a prisoner lies on the bed as he coughs.

Not protected

‘’ I am exposed to contact TB though I am assigned to night-duty with some patients suffering from TB. As workers no one is concerned about our welfare and plight’’ says Kadiki in our interview punctured with deep hard coughs from Chambwe.

Kadiki is not protected against TB that can be spread through the air. The writer had sneaked into the hospital room during lunch hour.

A SafAids media manual on TB and HIV says, ‘’TB transmission occurs indoors. An individual risk of exposure is determined by the concentration in contaminated air and length of time a person breathes that air’’

The risk is high when one has had close and prolonged indoor exposure with the affected person suffering from TB as it will affect approximately 10 and 15 people per year’’

Transfer on medical grounds

Prison sources at Hurungwe prison situated about 50 kilometers south of Karoi town say one officer had to apply for transfer on medical grounds early this year.

‘’ Our prison cells are in deplorable state as we are using former farm tobacco barns as cells while we are using former farm workers’ houses as accommodation. It is pathetic here for both prisoners and the officers.’’, an officer who can not be named for professional reasons says.

Government took over the farm in 2003 during the height of land reform but it has not been rehabilitated for prison officers.

2 Billion Infected

Approximately 2 billion (one-third of the world population) are infected with Mycobacterium tuberculosis the cause of TB. It is cause of one person in every three people AIDS worldwide.

Doctor Mkholeli Ngwenya within the ministry of Health‘s TB and Aids unit admits that even health workers are at risk to be infected during the discharge of their duties in assisting TB patients.

Silent death for care givers

‘’There is need for advocacy and assistance to health workers as well who are fighting to combat the spread of TB and Aids. Care givers are dying in silence. They are vulnerable’’ he says.

Dr Ngwenya explains that the health ministry is working with other ministries among them defence, police among others in educating them on the link between TB and Aids as a health issue. ‘’We are working together on TB at workplaces to lobby for policy shift by the authorities. Generally prisons are overcrowded with poor ventilation and lack of sunlight’’ says Doctor Ngwenya.

Hope renewed

His words of assurances are what prison officer and many others in his predicament have been waiting for too long. Hope is renewed as Kadiki says, ‘’every worker has a right to shelter food among other basics ‘’

For Zimbabwe workers which is ranked the 17th among 22 high burden countries on TB worldwide, there is great need of policy shift as it is a major public health with estimated incidence rate of 539 cases per 100 000 people according to World Health Organisation Global Tuberculosis’s report of 2009.

As the battle to combat TB continues, officer Kadiki says, ‘’ I hope it will be soon that workers Government and other stakeholders address our health plight”

For Kadiki and some prison officers, only time will tell.

January 7, 2015

UK doctors empower women on cervical cancer

Filed under: News — Nhaudzenyu @ 9:52 am

By Nhau Mangirazi

KAROI-Two United Kingdom based medical doctors were in the country to assist some women on cervical cancer screening last week here.

The two are Doctors Tsitsi Chituku and her friend Fadzai Kanyangarara spent two days in Karoi where they assisted women on health matters and later screened them for cervical cancer, one of the non-communicable diseases affecting mostly developing countries including Zimbabwe.

Doctors Fadzai Kanyangarara and Tsitsi Chituku in Karoi assisting women on free cervical screening

Doctors Fadzai Kanyangarara and Tsitsi Chituku in Karoi assisting women on free cervical screening

They live in Kettering, Northampton shire, United Kingdom.

Kanyangarara said they were overwhelmed by the response by the women who were eager to learn more on health matters.

‘’The response was inspirational and we are grateful to the community. We wanted to empower women on health matters as this will help the society in the long run. Generally, women were eager to learn more on health issues. It is encouraging that we are already focusing to have this as an annual event and we have to mobilize more human resources for the next edition’’, said Kanyangarara.

Chituku hails from Karoi town and said it was the little they could do to give back to the community.

Some women waiting for their turn during cervical cancer screening in Karoi

Some women waiting for their turn during cervical cancer screening in Karoi

There is room to raise awareness on health matters and Karoi was our port of call for this project that we think will improve with time’’ added Chituku.

The two doctors assisted in high blood pressure, breast and cancer screening where at least 124 women were screened during the two day exercise.

38 year old Muchaneta Yawera said the move was welcome for women in the farming town.

‘’It is good for us during the New Year as we are assured of good health status. Knowing your status on disease is not a death penalty but you know what you must avoid or better knowledge of survival.   Health is a right for everyone, said Yawera, a mother of two children.

A male nurse asssting women at Chikangwe clinic during cerivical cancer awareness and screening while Doctor Tsitsi Chituku looks on

A male nurse assisting women at Chikangwe clinic during cervical cancer awareness and screening while Doctor Tsitsi Chituku looks on

Leading cause of death

Cervical cancer accounts for one-third of all cancer cases in Zimbabwe and is the leading cause of cancer deaths among Zimbabwean women according to Better Healthcare for Africa.

According to World Cancer Research Fund International

, Malawi leads the top twenty with the highest rate of cervical cancer, in 2012 pegged at 75.9 percent while Zimbabwe is placed fifth with 56.4 percent.

World Health Organization says cervical cancer is the commonest cancer among sub-Saharan African women.

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