HURUNGWE - The last time 32-year-old Shamiso Mbinga visited Chitindiva clinic Chundu area in Hurungwe district, more than 280 km north-west of Harare, she could hardly walk. Hers was an acute case of malaria infection, but one that took two days for nurses to diagnose. (Pictured:
Even then, Mbinga was sent back home to die without treatment because a new anti-malaria drug introduced by the government last year as part of a stepped-up drive against the killer disease is not readily available in outlying areas such as Hurungwe.
My sister, died after she was diagnosed of malaria, said Mbinga’s brother, Tasiyana. They (clinic) did not have drugs and we could not get tablets (anti-malaria) from the shops, he added, puzzled why the government has not made sure that the new anti-malaria coatermether drug was readily available in this malaria-infested district.
Introduced in mid 2009 by the Ministry of Health as its new frontline weapon against malaria, coatermether is a newer and more effective drug against malaria.
Unintended consequences
But in a classical case of American sociologist Robert King Mertons law of unintended consequences, its introduction has meant villagers in far-flung areas are unable to readily access treatment because coatermether, unlike its predecessors chloroquine and norolon that anyone could buy from private grocers shops, can only be administered by trained health personnel.
In addition, patients have to be tested for malaria first before they can take coatermether; another disadvantage compared to the old drugs that people once they suspected they had contracted malaria.
With the distribution of coatermether centralised at health institutions plus the cash-strapped governments inability to supply enough quantities of the drug or to ensure adequate numbers of trained staff at its clinics in the countryside and the result is often unnecessary suffering for hapless villagers or, as in the case of Mbinga death!
”It was hard for us to understand why nurses insisted she undergo malaria testing, said Tasiyana, who said his sister left behind four children aged between two months and fourteen years.
Mbingas tragic death was a truly preventable. However, more depressing is the fact that more lives could be needlessly lost here in Chundu and in other malaria-prone areas across Zimbabwe as the governments donor-backed effort to provide a better drug is negated by its inability to ensure immediate availability of the medicine to patients.
For example, villagers in Chundu and nurses at Chitindiva clinic said at least 10 people have died of malaria while admitted at the clinic because there was no coatermather to treat them.
Artificial epidemic
While malaria has always been a major problem and killer in Zimbabwe the old drugs distribution arrangement meant local communities were empowered to combat the disease, with family members often diagnosing the disease in each other and treating themselves with the then ubiquitous norolon or chloroquine .
There was rarely need for one to visit a clinic to get treatment for malaria except in cases of acute attack or in complicated situations such as when a pregnant woman contracted the disease.
However, centralisation of treatment since the introduction of coatermather has seen more people flocking to clinics and hospitals seeking treatment creating an artificial epidemic.
Cases of malaria recorded in Zimbabwe between February and May this year are more than three times the number of cases recorded during the same period last year before introduction of the new drug, health officials say.
Statistics reveal that there were 6 009 reported cases and 13 deaths of malaria between February and May in 2009 compared to 19 987 cases and 50 deaths recorded within the same period this year, said Wenceslas Nyamayaro, the medical director for Mashonaland West province under which Hurungwe falls.
Health officials from Karoi, Kadoma, Makonde, Zvimba, Chegutu, and Kariba, all areas of Mashonaland West, have declared malaria outbreaks because rising numbers of patients visiting clinics and hospitals for treatment.
Caught off-guard
A junior official at Karoi Hospital said the institution, which serves as a referral centre for smaller clinics in surrounding rural areas, was struggling to cope with the unprecedented numbers of malaria patients and often ran out of coatermather.
The malaria outbreak caught us off-guard due to centralisation, said the official, who declined to be named because he was not authorised to speak to the media.
But Nyamayaro, a trained medical doctor, insisted the government would stick to distributing coatermather through trained hands and only after tests for malaria.
He said: We used to give community care-givers malaria drugs such as chloroquine, but that was withdrawn from clinics following the introduction of coatermether. Currently it can only be administered by trained personnel for professional reasons.
Nyamayaros boss, Health Minister Henry Madzorera, said he had not received any reports of shortages of coatermather but promised to make the drug available to all who need it across the country.
I am yet to get complaints about drug shortages but as the government we hope to help every patient with drugs, said Madzorera.
Villager Donald Chabayanzara of Chundu said it was unfortunate that the new drug was in short supply when people were dying of malaria in rural and small towns.
Why did the government approve the new drug when it did not have enough stock to cater for affected areas? We are witnessing a disaster in poor medication by the government that must give service delivery to citizens,” said Chabayanzara.
In Karoi town, Martin Kabende says, ”I was tested for malaria but they did not have the tablets at the referral hospital. Those who can afford can buy at the pharmacies where they are expensive?
A course of coathermather costs US$20 at pharmacies when it costs only US$2 at the hospitals and clinics
Against this backdrop, Madzoreras words are of little help to Mbingas motherless young children!
Post published in: News