The Sunday Mail
Forward Nyanyiwa —
As public and mission hospitals work towards attaining the 90-90-90 targets set up by the Government in the fight against HIV/Aids, Murambinda Mission Hospital, among many others, has increased its efforts in fighting the virus.
This writer recently embarked on the 245km journey from Harare to the eastern parts of Manicaland, Buhera district, so as to get first hand information on the hospital’s HIV services.
The animal called stigma is still rearing its ugly head in our polarised society, Murambinda included. I sat there in the out-patient department as the drama unfolded.
There was a hive of activity, synonymous with big hospitals as patients jostled for positions. This did not come without the traditional “norm” of exchanging harsh words among the patients.
As order finally reigned supreme, primary health counsellors started their sermon.
The main thrust of the health education was on HIV testing. Immediately, everyone was offered the service under the Provider Initiated Testing and Counselling (PITC).
The health team at Murambinda hospital is well knit and co-ordinated such that it is difficult for one to escape the web.
I decided not to get tested as that was not really why l was there. A certain primary health counsellor approached me professionally, talk of patient care.
I was soon in a one-on-one situation with the counsellor and what I got was a fully packaged counselling session. She tried her best to convince me but I stood my ground and declined the services. Eventually she had to let go.
I found my way out of the hospital. There, a group of middle-aged women were standing by the entrance and had gone through the same counselling sessions.
“At least I now know my status, had it not been for the fact that she counselled me, I would have resisted,” one of the ladies could be heard saying.
However, HIV testing services in Zimbabwe are offered voluntarily and a person has the right to opt out.
Said Dr Owen Mugurungi, the director of Aids and TB Services in the Ministry of Health and Child Care, “HIV testing is offered and it is not compulsory and anyone can turn down the offer if not interested.
“Look at the cases of pregnant women who come for ante-natal bookings, pregnancy suggests unprotected sex and it is prudent enough to offer them HIV testing because unprotected sex ranks among the highest causes of HIV infection,” explained Dr Mugurungi.
Buhera district medical officer (DMO), Dr Shelton Kwiri said they offer HIV testing at the hospital but do not coerce people into them.
He said people must not mistake their robust PITC programme, where they offer the service at every point within the hospital, with coercion.
“We don’t force patients to get the test. We offer HIV testing services and those who decline are not forced. We even have admitted patients whom we do not know their HIV statuses.
Our biggest strength is that we offer the service at every point and we have quite a dedicated team unified for results,” said Dr Kwiri.
Dr Kwiri said Buhera district is one of the country’s districts with the highest number of people on anti-retroviral therapy (ART).
“We are one of the major districts with people on ART and it is now close to eight years since we pioneered the exercise with the help of Medicines San Frontiers (MSF),” he said.
The statistics, he said, are there for everyone to see.
“From 2014 to 2016, newly tested patients stood at 11 449, 11 763 and 9 443 respectively; against a target of 4 500 patients,” he said.
They also offer night HIV testing at Murambinda Growth Point and other surrounding markets and it is proving to be convenient to some people who come for testing during those odd hours.
“We also do night clinics at the growth point and markets and the response has been overwhelming,” Dr Kwiri said.
The master-stroke, he added, is the introduction of the new programme (Test and Treat), which he said is an opportunity to meet the 90-90-90 target.
Unlike in previous years where those tested HIV positive would wait to be initiated on ART depending on their CD4 count, the new guidelines entails those who test HIV positive to be initiated on medication regardless of their CD4 count.
“With the new ART guidelines (Treat All), we are sure that by end of 2017 we will attain the target. In order to attain this, we have to continue offering PITC at all entry points.
We are also going to scale up our out-reach programmes. Index testing for those found to be HIV-positive is done down to their households and it is proving to be a success,” he said.
However, male involvement in the Prevention of mother-to-child transmission (PMTCT) programme and other HIV related issues has been their Achilles heel.
Government introduced the 90-90-90 target in line with global health’s vision to eradicate the HIV endemic by 2020.
By then, 90 percent of all people living with HIV should know their status, 90 percent of all people diagnosed with the virus must be receiving sustained antiretroviral therapy and 90 percent of all people receiving antiretroviral therapy will have viral suppression.