Lockdown threatens adherence to antiretroviral treatment

By Fiona Ruzha

Harare, 23 April: His life is punctuated with set backs beyond his imagination and control.

Born HIV positive and only discovering that at the age of 13 when he seriously fell ill, Tinopona Mukundi(25)  (not his real name)could not think of anything else but escaping Mother Earth to a world that has never been seen by the living.

Fortunately, a series of counselling services were refreshing enough to reboot his thinking.

A positive mindset was installed and since then, Mukundi has been “building his own paradise”, he says, as he grapples with life challenges.

Unfortunately life has not been kind enough. He lost his father in 2014 and later on his mother succumbed to HIV.

As he battles with the HIV virus and fending for his family as he is the eldest of the two siblings, Mukundi is today faced with yet another challenge-the Corona Virus widely referred to as Covid -19.

The virus which originated in China’s Wuhan province has not been kind to the global community, leading to several countries Zimbabwe included, declaring a total lockdown for five weeks.

Mukundi, a very reserved man who has been taught through life challenges to always find a way in the midst of any set back, is worried.

“Life has not been kind to me since the day I knew about my HIV status and it got worse when I lost both parents and left to fend for my brother and myself.

“I knew about my status when I seriously fell ill during Form 1 first term after suffering from fever, soar throat, cough and difficulty in breathing.

“Tests were done and I was found HIV positive and diagnosed with TB as well.

“ That moment all hell broke loose as my parents status was also revealed which they hid for 14 years,” he says.

Growing up having told that HIV was a sexually transmitted virus and to him knowing he had not encountered any sexual activity with anyone, Mukundi thought of taking his life.

“At first, it was hard for me to accept my status to an extent that at one point I thought of committing suicide but through  counseling my mindset changed.

“However, the Heavens took my father in 2014 after a short illness and my mother followed after she defaulted in taking her medication,” says Mukundi.

After the twist in events, Mukundi and his brother had to move from Glenorah (one of the high density surburbs in Harare Zimbabwe) to Epworth which is regarded as the poorest suburb in the capital city.

The economic hardships has left the two boys in agony as they had little means of survival since Mukundi is barber while his younger brother is a vendor in town.

Mukundi has not been spared during this period of Covid-19 which has infected more than 2 million and more than 200 000 are dead.

Mukundi, who is used to collect his antiretroviral drug Delutograv at a local clinic in Glenorah, risk defaulting on his medication as it has become very difficult for him to go collect during the lockdown.

Mukundi narrates his efforts to get clearance to go past roadblocks which were hitting dead-ends.

“My usual health facility for the drug is a clinic in Glenorah.

“However, during this lockdown I had to pass through a police roadblock to access my medication and efforts to get clearance to go past roadblocks are hitting dead-ends as the police are not considering hospital books.

“Two weeks ago, I was supposed to go and collect a refill since my four-weeks package was almost empty left with one tablet I had to take the following morning.

“When I tried to pass through a roadblock, the police denied me access to proceed with the journey so had to board another ZUPCO bus to return home.

“The following day, I thought of trying my luck by going back there so that I access my medication but it was to no avail.

“This left me stressed because of the risk I am putting myself by defaulting on ARVs,” he says.

Mukundi’s case is not in isolation as there are many people living with HIV who have faced the same predicament.

Director TB and HIV/AIDS in the Ministry of Health and Child Care Dr Owen Mugurungi said they have heard cases similar to Mukundi’s that is why the ministry has suggested many months supply of ARVs.

“During this period we would want our clients who are people living with HIV to get many months supply of drugs because usually it was per month.

“So we have decided to give them 3-4 months supply to decongest health facilities during this period of Covid-19.

“We are also aware of clients who used to collect their medication far from their area of residence yet at their nearest clinics ARVs were available.

“Therefore, we encourage them to get from their nearest clinics because as ministry, we have decentralized treatment and care at every clinic countrywide,” he says.

Dr Mugurungi urges security forces to allow HIV clients to access their medication.

“In case of police denying access to HIV patients, we encourage them not to do that because people have genuine reasons which needs urgent attention by the health care workers.

“And when they end up defaulting on treatment, they face a lot of consequences whereby they develop resistance on medication and they will end up in need of second and third line drugs which are very expensive.

“Also if they default on medication, they might lose their lives,” he says.

National AIDS Council chief executive officer Dr Bernard Madzima says they were happy that the Ministry of Health and Child Care allowed all health facilities to remain open during this lockdown.

“During this period of lockdown, the Ministry of Health and Child Care has assured that all health facilities will remain open for collection of medicines because it is important that people living with HIV do not know default on medication.

“In recent years we have lost many people due to defaulting hence we do not need the same to happen during this period,” he says.

Community Working Group on Health executive director Itai Rusike expresses concern by the total disregard by those enforcing the lockdown of people’s right to essential health services.

“People on ARVs must be allowed to access the services they need as their lives depends on accessing such medications.

“ I fear that the strict measures adopted during lockdown by security forces could lead to a lot of people defaulting on medications as they are prevented from accessing health institutions or get clearance past police checkpoints,” he says.

Zimbabwe Republic Police Assistant Commissioner Paul Nyathi says they were doing their best in ensuring that people living with HIV are not denied access when they want to collect their medication.

“We are advising members who are in need of health services especially people on ARVs who want to collect their medicines to visit the nearest local police station and see the officer in charger who would document a pass which allows them to proceed when they get at roadblocks.

“We also encouraging patients to walk with their hospital books which indicates that they are going for treatment so that they won’t be any inconveniences caused,” he said.