One-stop clinics, a rare lifesaver for Zimbabwe’s sick

The Rutsanana Polyclinic is one of 10 pilot clinics in Harare offering free treatment for HIV, tuberculosis and diabetes

The Rutsanana Polyclinic is one of 10 pilot clinics in Harare offering free treatment for HIV, tuberculosis and diabetes (AFP Photo/Jekesai NJIKIZANA)

Harare (AFP) – Blessing Chingwaru could barely walk without support when he arrived at the specialist Rutsanana clinic in Harare complaining of chest pains and fatigue.

Weighing a skeletal 37 kilogrammes (82 pounds), the HIV-positive motor mechanic knew something was wrong.

He was immediately given a number of tests and told the bad news: He was also suffering from advanced-stage tuberculosis. Dual infection by HIV and TB is a notorious killer.

“My health was deteriorating and I kept wondering why,” Chingwaru, 29, recalled at the clinic.

Within hours of the diagnosis, Chingwaru was given free treatment and nursing care.

In a country where more than a dozen people die each day from TB-related sicknesses, it was a rare example of efficient public healthcare.

The Rutsanana Polyclinic in Harare’s poor suburb of Glen Norah, which Chingwaru visited, is one of 10 pilot clinics in the country offering free diagnosis and treatment for TB, diabetes and HIV.

The clinic, which opened in 2016, is staffed by 24 nurses and currently treats 120 TB patients.

Among the million-plus people living with HIV in Zimbabwe, TB is the most common cause of death, according to the World Health Organization (WHO).

HIV-positive people, and others with weakened immune systems, are particularly vulnerable to contracting the infection.

After Chingwaru’s initial visit in February, doctors had feared for his life.

But following five months of careful treatment Chingwaru has gained 15 kilos.

“Everything I need, I get here,” said Chingwaru, forming fists with both hands to show off his regained strength.

Blessing Chingwaru, an HIV positive and TB patient, has a consultation with a nurse at the Rutsanana clinic (AFP Photo/Jekesai NJIKIZANA)

– Economic and financial crisis –

In a country where public health services have practically collapsed, containing the spread of TB has been a persistent struggle.

Zimbabwe has been stuck in a catastrophic economic and financial crisis for decades and its doctors are underpaid and under-equipped.

Although TB treatment is free, the annual number of TB infections in Zimbabwe remains among the highest in the world.

The contagious infection is usually found in the lungs and is caught by breathing in the bacteria from tiny droplets sneezed or coughed out.

As HIV-positive people are so vulnerable to TB, the clinics have followed the advice of WHO officials to link TB testing and treatment with HIV prevention programs.

HIV self-testing kits are available at the one-stop clinics (AFP Photo/Jekesai NJIKIZANA)

– ‘Catastrophic costs’ –

Close to the main gate of the Rutsanana clinic, a green self-testing HIV tent has been erected to encourage people to check their status.

The clinic also offers voluntary HIV counselling and antiretroviral treatment.

Sithabiso Dube, a doctor with the medical charity International Union Against TB who heads the TB and HIV programme, said people with diabetes also have a higher risk of developing TB, so patients are tested for both diseases.

“Instead of going to seek diabetic care at one clinic and TB care at another, they are able to get these services in one place,” Dube told AFP.

Because services are free “they are able to cut down on what we call catastrophic costs to the TB patients,” she said.

Largely funded by a US Agency for International Development (USAID) programme, the pilot clinics have become lifesavers for the poor — but only if they happen to live near them.

The vast majority of the population have no access to the one-stop clinics.

As a result there are plans to scale up the programme, with another 46 similar centres to be rolled out across Zimbabwe.

Rutsanana clinic matron Angela Chikondo said the programme was crucial to minimising complications among TB and diabetes patients.

“If one is on TB treatment and also has diabetes, and the diabetes is well controlled, chances of recovering are very high,” she said.

Zimbabwe sports minister Kirsty Coventry on Friday denied that the government had been interfering in the running of the country’s cricket. Coventry, a former Olympic swimming champion, said in a tweet she was "devastated" by the effect on players of a decision by the International Cricket Council (ICC) to suspend Zimbabwe Cricket because of alleged political interference. Thursday's ICC action followed the suspension by Zimbabwe’s Sports and Recreation Commission (SRC) of the Zimbabwe Cricket board elected in June. The SRC appointed an interim committee. The ICC demanded that the elected board be reinstated within three months. Coventry said in her tweet that although the SRC was appointed by the sports minister, "SRC is not government - they are a public body." She said in another tweet: "There is need for good governance at ZC for the international success we all want to see." Coventry added that she would meet the country’s men's and women's captains on Friday. The ICC suspension means that Zimbabwean teams will be unable to play scheduled international matches in ICC events. Former Zimbabwe player Henry Olonga, the first black cricketer to represent the country in 1995, tweeted support for Coventry and the disbanding of the previous board. "Sorry Kirsty but they ain’t listening. The rest of us see it for what it is," tweeted Olonga, who left the country after he and former captain Andy Flower protested against former president Robert Mugabe's government during the 2003 World Cup. "A bunch of incompetent people were running a sport into the ground. This incompetence was known by them for five years. Why didn’t the ICC take strong action then? Curious." Corrupt and incompetent Former sports minister David Coltart said the ICC had ignored the wishes of Zimbabwean players. "Whilst I understand ICC's desire to keep political interference out of cricket the irony of this decision is that they have reinstated the politicians responsible for destroying the game in Zimbabwe," he tweeted. "They should have ordered and organised fresh elections for a new board. "There will be no introspection from the corrupt and incompetent board that the ICC wants reinstated. We need a fresh start with no political interference. Let those who love and know the game run it." Tony Irish, chief executive of the Federation of International Cricketers' Association (Fica), said in Cape Town that the plight of Zimbabwe’s cricketers was a matter of concern for players around the world. "Zimbabwe does not have a players' association but we care quite deeply about the players," said Irish in a preliminary comment ahead of a statement which he said Fica would issue later on Friday. All-rounder Sikandar Raza, who was on the recently concluded tour of Netherlands and Ireland in which Zimbabwe won just one out of 11 matches, expressed dismay at the UCC decision. "How one decision has made so many people unemployed... how one decision has ended so many careers. Certainly not how I wanted to say goodbye to international cricket." Zimbabwe were made full members of the ICC and granted Test status in 1992. They failed to qualify for the 2019 World Cup.
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