The ManicaPost
Ray Bande recently in Makoni
“EACH time that we came here at the clinic to get our medication, we had become used to seeing other patients or visitors pointing fingers at us.
| Waiting for anti retroviral drugs on a given date and time at this clinic had become more tormenting than the knowledge of being positive itself. Some of the people that I started taking Anti Retroviral Treatment (ART) with occasionally defaulted and some of them succumbed to HIV and Aids after defaulting. This was all because of the conditions that we were subjected to each time we came in droves on a day that medication was supposed to be collected at the clinic for individuals.” |
These were the words of Charles Mushanya of Ward Six, Namie Resettlement area deep in the thickets of Makoni district to a group of journalists that toured Namie Clinic last Tuesday as part of a four-day tour of HIV prevention and mitigation media tour organised by the National Aids Council.
Mushanya, a fairly healthy-looking middle aged man, is a Community Art Refill Group (Community Art Refill Group) leader who passionately spoke of a pitiful experience of stigmatisation owing to their HIV positive status.
Undoubtedly, Zimbabwe has made strides in ART service provision and among other interventions the country has adapted the CARG model which supports self-formed groups of clients, who are stable in accessing ART.
Under CARG, groups of about 10 to 15 persons living with HIV (PLHIV) no longer need to go and get medication as individuals but a representative is sent on behalf of the group.
This goes a long way in reducing stigma that normally comes with accessing medication in queues on a given date and time of collection.
Apart from solving stigma, the defaulting rate of PLHIV is also reduced in the process while peer to peer counselling is being promoted and working effectively under CARG groups.
In the communities surrounding Namie Clinic alone, the default rate has since been reduced from 10 percent to two percent!
“We are seeing the good of CARG here in Makoni.
We are having time to encourage ourselves to adhere to medication. We are also seeing the rate of defaulters decreasing.
“Income generating projects are also on our agenda. In fact, we contribute about $5 per head per month and find ways of generating more money with the seed money we have.
This is the money that will help us to take care of those that fall ill as well as secure food stuffs that will make us lead a healthy life.
“Apart from that this CARG programme has also helped us in giving us time to do our work at home and not spent time in queues for medication,” said Mashanya.
As if that was enough, the workload for health workers is vastly reduced given that they no longer need to concentrate on each patient as an individual in administering medication.
Mr Kudzai Marongedza, a State Registered Nurse who was the only qualified nurse at the station before the recent addition of one more at Namie Clinic, spoke glowingly of the CARG programme saying it has also reduced their workload.
The clinic, which serves clients from Macheke, Weya and Mafusire areas, has now about 90 PLHIV on CARG.
“Before the advent of this CARG initiative, there was a huge workload for the limited number of staff that we have here.
I was the only qualified nurse here before I was recently joined by another one and we also have a Nurse Aid plus a general hand staffer.
“The workload was just too much given that few as we are we have to cater for emergencies, immunisation for children, escorting patients to referral hospitals among many other duties.
Therefore CARG could not have come at a better time.
“It is also imperative to note that our defaulter rate has since declined since the adoption of the CARG initiative.
Village health workers also had a torrid time following up on patients on ART but the situation has vastly improved. Before CARG we had a default rate of about 10 percent and it has since dropped to about two percent,” said Mr Marongedza.
Interestingly, CARG has also gone beyond addressing issues related to HIV as it has seen political differences being reduced as people from different political inclination are coming together to solve a common challenge of HIV under a CARG.
“It is interesting to note that Makoni is a political hotbed but since the initiation of CARG people from different political inclination are coming together to solve a common challenge of HIV under a CARG.
Today even churches are now promoting the initiative of CARG,” said the Ward Six councillor.
According to NAC documentation as well as presentations by CARG members during the media tour at Namie Clinic, the members of the groups would usually be coming from the same geographical area and the overall goal of this model is to reduce the burden and challenges for both health care workers and patients in the provision and receipt of ART and improving adherence and retention in care and treatment.
“The rationale towards the adaptation this model is the need to achieve the overall goal of the ART programme which is to: reduce HIV-related morbidity and mortality, improve the survival of persons living with HIV and AIDS, improve the quality of life for PLHIV and AIDS and reduce transmission of HIV from infected to uninfected individuals through expanded ART coverage and earlier initiation.
“The ART programme implementation in Zimbabwe continues to be undertaken in the context of a comprehensive care and support package that addresses medical, social and emotional needs of PLHIV.
The comprehensive care and support package is a compliment of an intervention package to prevent HIV infection and to mitigate the effects of HIV and AIDS.
“Zimbabwe is strongly convinced that the interventions through the CARGs model will result in the maintenance of high quality life and adherence of the 842 973 (59 %) people on ART.
Of this figure, 12,722 (1.5% of the total number of clients on ART) are currently receiving second line ARVs and the country would not like to see more people going for second line ART due to non-adherence.
“The model will also reduce the number of clients who are lost to follow which is currently at 3,961.
Through the CARGs model, the Government of Zimbabwe is working towards averting the number of AIDS related deaths which has seen a 12.8% increase from 699 from the end of 2014 to 789 in the first quarter of 2015.
The case fatality rate increased from 5 patients per 10,000 during at the end of 2014 to 6 patients per 10,000 in 2015,” reads part of the CARG background document compiled by NAC.
