Double blow for chronic patients

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By Catherine Murombedzi

SIBONGILE MUSA is ill; she is a multi-chronic patient living with HIV, diabetes and is also asthmatic. 

The cold weather triggers off asthmatic attacks and she has had two severe knocks since temperatures took a nosedive two weeks ago. 

Musa has suffered a double blow; she has been unable to access free second line anti-retroviral therapy (ART) supplied by the Government. 

All ART medication is supposed to be given free of charge in public health centres.

Alerting the forum of women living with HIV of her predicament, many more women said they too had failed to access second line ART.

ART comes in three phases; the first line is the basic medication which caters for over a million people in Zimbabwe. 

A total of 1,3 million people live with HIV in Zimbabwe. 

There has been a shortage of second-line medication, with the Ministry of Health and Child Care issuing a circular on June 22. Second-line medication is stronger, more expensive and is given to patients who fail first-line treatment.

For Musa, it never rains but it pours; a friend managed to give her a week’s supply of ART.

As dusk sets, the weather gets chilly and usually, most people keep warm over metal fire braziers (mbaura).

For Musa, smoke is another trigger to avoid, so she shivers under blanket cover. She has been to her local clinic to be nebulized after failing to breathe on several occasions.

She has failed to get a resupply of her asthma lifeline medication too. 

The health staff at the clinic told her they had run out of medication, referring her to private pharmacies.

The pharmacies sell in US$ and it costs an arm and leg. 

This has seen Musa default. She now relies on herbal medication with unknown dosage, scientifically untested for efficacy and use.

There are more Musas in the communities and the daily trudging has been an uphill task.

Traditional medicines work well for some people. However, the challenge with the unknown dosage lies in the drug interaction for those taking other medications. 

Drug interactions render medication ineffective or even toxic.

Musa is living positively with HIV too.
She is therefore not recommended to take supplements.

Any additional medication and supplements must be done with the advise of a medical expert. 

This has not been done.

The nurses at her local clinic have informed her they are not qualified to do so, advising her to see a medical doctor instead.

Without taking her lifeline, Musa’s lease of life hangs precariously.

The HIV virus mutates and becomes drug resistant. 

Being already on second-line, the medication becomes ineffective, requiring that she is moved to the third and last line which is expensive. 

Less than 10 people in Zimbabwe are on third-line medication.

The country currently faces a shortage of the second-line ART medication.

“The Ministry hereby notifies of a shortage of Atazanavir (ATZ) stocks and advises that clients …will be receiving a month’s supply instead of the usual three months until stocks improve…shipments have been affected by the lockdown…centres are advised to share stocks with those in need… clients may be moved to Dolutegravir (DTG) if the stockout persists…” read the circular.

This does not look good for Musa, her centre did not commence her on DTG, only informing her: “Hatina (Out of stock),” and referring her to private pharmacies.

Private pharmacies are selling second-line ART for US$50 for a month’s supply. This is way beyond Musa’s pocket and the majority of Zimbabweans.

With the travel restrictions under the lockdown to minimise the spread of COVID-19, Musa, who is self-employed as a vendor, has not been able to go to work.

This has placed her family in a tight spot with one basic meal to keep body and soul together.

Her landlord understands her plight and has agreed that she will settle her rentals on resumption of work when the storm is over. 

Her two-roomed wooden lodgings are freezing as temperatures fall to unprecedented levels.

Recently, President E.D. Mnangagwa offered a safety net for the underprivileged during the lockdown.

The First Lady, Amai Auxillia Mnangagwa has been across the country, mostly in rural areas, offering relief through her trust, Angel of Hope. 

She has received massive support from the corporate world. 

“I have heard that we should be getting food packs but I do not know where to register. Well wishers have been of help, we got a bucket of maize meal from a neighbour. We now live on porridge. Our vegetable patch has wilted, Hatcliffe extension has no running water. Our well has since dried up, the rains were patchy this season,” said Musa, speaking in a group chat of Zimbabwean women living with HIV

With temperatures falling in Zimbabwe, there is a greater risk of COVID-19 cases rising.

All efforts must be made to ensure that cases do not spiral out of control; let us adhere to all the rules that seek to minimise the spread of the virus.

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