Mberengwa Cries For Help…Battles High ARVs Coverage Gap

AT a time when other districts are doing well in terms of advancing treatment and care to Antiretroviral Treatment (ART) clients, Mberengwa remains in the negative despite efforts by partners and the ministry of health and child care to advance treatment to the area.

Mberengwa has a low ART coverage of 44, 5 percent as of last year, making it one the districts with the highest ART  gap (3,000 – 10,000) along with 19 other districts which include Zvimba, Gokwe, Chipinge, Bulawayo, Goromonzi, Insiza, Umguza, Kwekwe, Mt Darwin, Lupane, Mazowe, Tsholotso, Matobo, Marondera, Bubi, Umzingwane, Mutasa and Bulilima.

Mberengwa is also a United States Government President’s Emergency Plan for AIDS Relief (PEPFAR) district where it funds partners such as the Zimbabwe National Network for People living with HIV (ZNNP+) and its consortium member namely the Midlands AIDS Caring Organisation (MACO) among other organisations.

MACO covers Mberengwa South Constituency with five wards namely Mataga, Musume, Makuwerere, Dunda and Muketi in the coordination of Sexual reproductive health and rights (SRHR), HIV and Gender-based violence mitigation programs.

However, poor road network and long distances to health facilities have had a negative impact on treatment literacy and coverage in the district.

Mr Munyaradzi Chakuinga said MACO has developed initiatives such as having SRHR cadres, Join In Circuit on Love and Sexuality (JIC) for young people as well as treatment literacy but the poor uptake of voluntary treatment literacy work by cadres has slowed down progress in the area owing the a plethora of factors, chief among them being the poor road network.

We have treatment literacy being supported by PEPFAR funding through ZNNP+ as their main partner. In Mberengwa, we bemoan the low number of treatment literacy cadres who are 15 at the moment covering a vastly sparsely populated area. The distance to the health centre might be long.

“We find that these 15 cadres are overwhelmed covering only two wards. We are saying there might be some people missed due to this problem. Funds permitting, we would have loved to have 15 cadres per ward or 15 covering two wards. There are three wards left behind having similar challenges as those covered,” he explains.

Mberengwa South’s promixity to Beitbridge bordering South Africa and Gwanda has infrastructural challenges such as poor roads. The distance between Mataga Rural Clinic and Zvishavane, is 113 Kilometres and time taken to cover this distance is about 3 hours instead of an hour due to a poor road network.

“Most of our roads are not tarred and by that, there are not so many partners wanting to offer services here. The services are erratic. Medicines are delayed here due to the poor road infrastructure. I remember assisting Mberengwa District Hospital with our vehicle for the cervical cancer team to beat their set targets which they usually failed.

“We had to carry them everywhere because they didn’t have transport. Issues of transport and communication are still a challenge here. Over and above all, we are grateful for the little we get but we think Mberengwa residents deserve the same quality of services being given to those in other places. Our doctors are found at Mission Hospitals in Musume, Masase, Munene and they are far.”

He adds communities in Mberengwa need more education on ART and HIV management.

“This area being closer to Beitbridge and South Africa makes it a transit zone. As we approach December, the Injivhas (Returning Zimbabwean migrants from South Africa) return and erode the gains we would have achieved. They come with money and end up reinfecting our people here. The other danger we have is that people coming from across the Limpopo come here with resistant diseases like MDR-TB.

“If the community is not made aware of these things, they will not know, leaving us with any people having the disease at a time we don’t have strong medication for treatment. Our plea is for partners like STOP TB to give us programs in Mberengwa, Mwenezi, and Gwanda because they share the same river Mwenezi. They interlink well. What happens in Gwanda, happens here because we are neighbours,” said Chakuinga.

He said the gap in Mberengwa district can be addressed by capacitation health facilities in the fight against drug resistant TB. Chakuinga also decries the delayed deliveries and few centres of viral load testing which he feels should be in Gweru, the Midlands provincial hospital.

“Mpilo might be close but the institution is overburdened covering all Matebeleland Provinces,” he said. There is a high treatment gap in this district caused mainly by distance challenge. The nearest clinic from Mataga is 30 KM away with another 47 KM.

“This means our health centres are sparsely separated. Secondly infrastructure for provisions is heavily damaged. We cannot take the economic crisis for granted. Our council is overburdened. Mataga is a government health facility but most of the health centres here are council run. So availability of health services differs. So many people end up coming here at Mataga because the other centres will be for administrative work.”

The male population in Mberengwa is mobile as most engage in artisanal mining. They go where the money is but in the end leave a trail of destruction.

MACO also applauded the introduction of the DTG drug. The areas under MACO has 15 treatment literacy cadres, 32,SRHR cadres and 50 young boys and girls, out of school under the Joining Circuit on Love and Sexuality another HIV mitigation tool for young people.

They have support groups in Mberengwa an old yet effective HIV mitigation tool. The concept was started by the ZNNP+. Covering the Mataga ward is a JIC champion aged 26 named Besta Nyamayevhu involved in educating adolescents, children and young adults about HIV alongside Gender based violence issues.

“I understand the viral load concept because I had my sample collected and got the results. The first time, they told me it was stable. The second time I was again told it was fine. So we were also told if the viral load was OK, we would get the new drug,” she says.

When she learnt of her HIV status, Lindiwe immediately went public about it, openly taking her ART medication. Lindiwe says it is important to disclose one’s HIV status.

Another ART client Jennifer Shoko aged 38 is an adherence counselling roving around Mataga tracking defaulters, mobilising people for testing and viral load monitoring. She follows up on defaulters, counsels people on the importance of HIV testing, VIAC and viral load testing. She was initiated on ART in 2006. She learnt that even if people are not infected they are affected as one would have relatives who succumbed to HIV due to lack of information.

“I not only give credit to the ART medication but to God Almighty who kept me till now,” she says.

“On the day I was diagnosed HIV positive, the doctor counselled me saying there was nothing wrong to be living with HIV. He said I was special and could live long,” Shoko said. She was also told she was able to things done by those HIV negative.

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