MSF brings relief to people living with HIV/Aids A Médecins Sans Frontières official attends to people living with HIV\Aids in this wire

Walter Mswazie recently in Mwenezi 

Médecins Sans Frontières (MSF), an international medical humanitarian organisation, has brought relief to people living with HIV and Aids in Mwenezi District, Masvingo Province through the rolling out of a new delivery model, Out of Facility Community ART Distribution (OFCAD).

The NGO, which launched the initiative – meant to improve access to treatment for people in hard-to-reach areas in 2016 – is sadly discontinuing the project but officials and beneficiaries are hopeful that the Government will take it up from where MSF has left.

The organisation has a reputation of assisting Zimbabwe in times of need and has provided medicines and medical expertise during cholera outbreaks and early last year, the Cyclone Idai disaster which hit Manicaland Province. MSF provided antiretroviral drugs to people living with HIV in Chimanimani and Chipinge districts.

The organisation launched OFCAD in the remotest parts of the district prioritising the hardest hit areas serviced by Mwenezi and Chirindi clinics whose catchment area also covers almost 100 km, collectively.

Assisted by Batanai HIV and Aids Service Organisation (Bhaso) , MSF has made excellent strides in improving the lives of people living with the virus in the district that there is now a remarkable change since the commencement of the project in 2016.

A number of patients have been initiated on Antiretroviral Therapy (ART) and clinics are reporting fewer defaulters on treatment citing limited access to medication. Many hard-to-reach areas were serviced by MSF, courtesy of the rapport the organisation enjoys with Bhaso and the Ministry of Health and Child Care.

MSF facilitated the establishment of OFCAD sites, 11 of them which have made life easier for community members living with the virus. 

The sites which include Chamakudo, Chovelele, Dombodema, Gadzikwa, Madamwa, Makugwe, Mvoko, Peter Peregwe, Sandawana and Zvamapere are manned by village health workers from within the community.

The new model has proved to be an effective way of reducing defaulting rates on medication and improved retention levels by clients.

The village health workers have undergone training on how to administer the model.

MSF project coordinator, Ms Rinako Uenishi said:

“We implemented the model in the hardest-to-reach areas in Mwenezi District and results show that this initiative significantly improved ART clients’ levels of retention in care. We hope people living with HIV and are on ART and those who have challenges in accessing ARVs particularly in rural areas, will benefit from this model.”

She said through OFCAD, village health workers were trained to distribute the ARVs transported from nearby clinics to identified sites.

The drugs are then given to registered people living with the virus in their communities without them having to travel long distances for medication.

People living with HIV are referred from clinics to the village health workers facilitating OFCAD where they collect supplies once every month. The village health workers keep the drugs at their secured homes, assessed and approved by MSF in agreement with the Ministry.

When the home of the village worker was not safe enough for drug storage, MSF helped in rehabilitating it to suit the requirements.

Bhaso assists in the mobilisation of patients to be recruited for OFCAD and with the involvement of nurses, clients are checked if they have been on ART for at least six months and their viral load is below 1 000 or undetectable. They should be taking the fixed dose, Tenolam E (TDF/3TC/EFV) and be living near a community village worker.

MSF wound up its three year-programme in Mwenezi last year and handed it over to the Ministry of Health and Child Care. 

MSF Medical director, Dr Reinaldo Ortuno said the organisation was sadly ending its operation in Mwenezi but was happy that OFCAD had improved access to medication by people living with HIV.

He said his hopes were high that the Ministry together with other partners still in the district will sustain the new delivery model.

“We started working in Mwenezi in 2016 by doing mentorship for six facilities. We provided training on screening of TB. We then launched OFCAD, as some patients were walking 120km to access medication. This helped communities a lot as they now get ARVs within their environs without having to travel long distances,” said Dr Ortuno.

“We also have programmes on Sexual Reporoductive Health (SRH) and water and sanitation,” he said. 

A nurse at Chirindi Clinic Ms Sithabile Mbiza bemoaned MSF’s departure saying only one quarter of the people living with HIV benefitted from OFCAD.

“We still have a long way to go and it is painful for us to lose MSF. We however thank them for assisting our patients although the figure is small. 

“Those who are getting assistance under OFCAD constitute only one quarter of people living with HIV and are unable to access treatment. We still have people who walk more than 80 km to the nearest health facility in another district, Mberengwa,” said Ms Mbiza.

“They go to Musume in Mberengwa to get their medication and sometimes find it hard to travel when the rivers are overflowing during the rainy season. There’s need to set up more outreach facilities,” she said.

A village health worker, Ms Selithiwe Paswana of Ward 1, near Chirindi Clinic echoed the same sentiments describing the loss as irreparable.

“We used to get deliveries of drugs to the OFCAD sites on time and we wonder if this will continue. MSF transport was readily available and our fear is that we may be forced to travel those long distances to the clinic once more. 

“We were also getting airtime for communication with the clinic staff but now there’s no guarantee that we’ll continue enjoying such privilege,” said Ms Paswana.

“We service 272 patients as 11 village health workers but the community has more patients on ART. We use bicycles for transport but we need new ones as they are now old and it is also painful to learn that MSF is leaving yet indications were that the organisation was willing to give us new ones.”

Mwenezi Clinic nurse Ms Miriam Dzimate said the facility’s catchment area covers Welcome Resettlement with 240 patients, Chipangayi which has 106, Turf Resettlement with 80 and Mateke, home to 30 patients.

“Most of our patients were defaulting and some of them have died due to failure to take medication. However, through outreach sites that we always do, the situation has improved. We were still waiting for MSF to assist as it has done in other areas but that has remained a pipe dream because the organisation is leaving. Some of our patients also walk distances between 10 and 60 km to get medication from Mwenezi Clinic,” said Ms Dzimate.

Bhaso director Mr Farai Mahaso however assured the OFCAD members that they would take over most of the roles from where MSF has left up to the end of the year.

“The fortunate thing is that MSF has offered one of its cars and I can assure OFCAD members that they will continue enjoying the same services till the end of December. We’re not abandoning ship but we’ll continue operating in the district if we get more funding next year. The funding for the current programme ends on December 31 but we have applied for more to continue beyond next year,” said Mr Mahaso.

Masvingo provincial epidemiology and diseases control officer, Dr Tapera Saravoye hailed MSF for assisting the Ministry in improving access to ART by people living with HIV.

He also thanked village health workers for selflessly helping the community and appealed to the powers that be to improve their welfare.

“We thank MSF for helping the Ministry improve access to treatment by people living with HIV. The village health workers are doing a splendid job and I feel there have to be more incentives for them. Their allowances need to be reviewed upwards and I hope the government will do that,” said Dr Saravoye.

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