Tanaka Mukuhwa (19) from Mutare is a Tuberculosis Survivor and a young person living openly with HIV. He was diagnosed with Meningitis Tuberculosis (TB) at the age of 13 when he was still in school and stayed in hospital for six months.
By Michael Gwarisa
His story illustrates the profound consequences tuberculosis can have on young people especially those at the prime of their lives. Even though Tanaka’s story has a happy ending and describes unexpected positives amidst the challenges of tuberculosis treatment, including how this disease might provide an opportunity to change a person’s health trajectory, he believes the challenges TB brings may alter one’s life completely.
Adolescence is that phase in life when a child starts developing certain attributes and interests in life. It is supposed to be exciting and worthy remembering but for Tanaka, there is nothing much to remember as he had to battle numerous ills ranging from stigma from society, self-stigma, suicidal thoughts and a TB induced disability. In his own words, TB really pushed him to the edge.
Stigma and Mental Health Challenges:
“I remember back in school after I had a positive TB diagnosis, my schoolmates would scurry for cover whenever I coughed. That was the most embarrassing moment of life,” said Tanaka.
“It was not so easy for me to accept what was on the ground and I had to struggle especially at school, in the community and in my family.”
The most common cause of TB stigma is the perceived risk of transmission from TB-infected individuals to susceptible community members. Depending on geographic region, however, TB is also stigmatized because of its associations with HIV, poverty, low social class, malnutrition, or disreputable behavior.
For Tanaka, the stigma came from all directions, be it in school, at home, community and even from within himself.
“Looking at Stigma, it has been within me. I stigmatized myself at first but now I am strong. In 2013 when I was diagnosed with TB and it really affected me.
“The stigma was also coming from external factors like school, community and family members buy I had conquer. I was focused because I knew where I was going and what I wanted and that is what made me to be here. I tried by all means to commit suicide but later realized through the help of primary counselors and doctors who told me that this was not the end of my life.”
“The other challenges I faced in my journey with TB include food and nutrition challenges. Also my personal experience with TB was not so easy because I had to eat special food yet I had no appetite.”
In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis.
In Tanaka, TB led to Meningitis which caused his right leg to be handicapped.
“Right now, I am handicapped but I can do everything and I thank God for that. When I was going t the health facility at St Joseph every day, I had challenges with transport to the health facility, because I had to go to St Josephs each and every day and I was injected 60 times every day. Right now I am surviving.”
On 26 June 2021, Tanaka was awarded an Honorary Doctorate on ending child marriages and abuses by the World Health Organisation (WHO) and the University of London.
“My successes are so many because right now I am a TB Champion and I am also a proud TB survivor who has many accomplishments. I have been recognised international and awarded a doctorate in ending child marriages. The University of London and the World Health Organisation (WHO) awarded me with an honorary degree for advocacy on ending Child Marriages. I have been recognised international and I have many posts internationally, regionally, nationally, provincially and at district level.”
At International level Tanaka has several posts which include the UNESCO Junior country director, UNCRC Junior Country Director, New Hope Foundation global ambassador, European Union (EU) Child Ambassador for children’s Affairs.
“In Zimbabwe, I am also the National Peer Advisory Chairperson and also the Junior MP for Special Constituency of the People with Disabilities and I am still the international president of Young People’s Network on Child Marriages, Abuses and Rights.”
Tanaka’s Parting Shot
“To my other young people out there, I would like to encourage you to take TB Preventive Therapy and if you are on TB treatment, keep on taking it. Don’t stigmatise yourself and don’t allow people to stigmatise you, keep on moving, the future is bright. I would like to advice all of us to keep on advocating for what is right.”
Zimbabwe has made impressive gains in reducing the number of people who have developed Tuberculosis (TB), between 2015 and 2019. Furthermore, the country’s coverage of HIV testing among TB patients and coverage with Antiretroviral therapy for HIV positive TB patients are both over 90%, a positive since HIV is the major driver of TB in Zimbabwe. The incidence rate declined from 242 per 100,000 in 2015 to a rate of 199 per 100,000 for 2019, signaling positive strides towards ending TB within the targeted period.
However, TB remains one of the biggest killer diseases in Zimbabwe especially among people living with HIV. Each day, close to 28 000 people fall ill to TB and nearly 4 000 people losing their lives to this preventable and curable disease.
While TB treatment and care is free in Zimbabwe, more than 80% of those in need of TB services face catastrophic costs in trying access these services. These costs include transport costs, food among others as TB is regarded as the disease for the poor.
There were an estimated 2.5 million TB cases in the African Region in 2019, accounting for 25% of the global burden. More than 500,000 African lives are lost to this disease every year. In Zimbabwe, it is estimated that 29 000 fell ill of TB in 2019 and about 6 300 of these succumbed to the disease. In 2019, an estimated 1 200 diagnosed TB cases had drug resistant TB.