Despite struggles, the fight against Multi Drug Resistant-TB rages on

It is night – around 23:00-  here at Rumphi boma. People from all walks of life are flocking into this uptown night club. They are here either to drink beer or just to have. Some of these people are here to celebrate the day’s fortune while others could be taking these hard stuffs to forget their misery.

One of the survivors for MDR- TB -Loness Ngwira
One of the quary mines

One thing that has caught my attention is the presence of many youthful imbibers in this night club and their love and dancing skill for South African disco music. At first it was as if I was watching some of those Zulu land music videos, but the reality is we are in Northern Malawi.

Though South African disco music has, over the past years made some inroads in Malawi, it is very rare to find a whole night club having a night long of such type of music. Usually it is a mixture of reggae, local and rhumba music, save for those night clubs which have multiple dancing floors.

But the situation is different in this night club – it has been all disco music -from dusk till dawn.

“It’s all because many youths from this district trekk to South Africa for greener pastures. So when they come back home, they bring with them some bits of the gold country’s lifestyles,” said a man who identified himself as Joseph.

True to his reasoning, a good number of those on the dancing floor had everything South African in them, including the tsotsi dressing.

This is also the situation in Mzuzu city and Mzimba district.

But its not everything greener that comes from the rainbow nation, there have been tears and sorrows too, burdens for mothers and relations that were left behind.

Some, bring with them different diseases, Multi Drug Resistant (MDR) Tuberculosis (TB) in particular.

A 37 years old Moses Jere from Mzimba district is one of such people.

Just like many visionary jobless young man, he left for South Africa in 2012 for opportunities which led him to be working at a mine.

“In the first years, all was well until I regularly started falling sick. I was later diagnosed with MDR TB. We tried all we could do to find some medical assistance in South Africa but to no avail,” said Jere who also has sisters and brothers also working in the rainbow nation.

After all has failed, Jere said his mother back home advised his siblings to send him back regardless that health services are better off in that country than Malawi.

“This was a decision I wholeheartedly welcomed because I knew that I will die in the hands of my relations and in my home soil,” Jere said.

Upon his arrival in 2016, Jere was immediately put on an 18 months treatment.

Two months away from completion, he is back on his feet and doing farm activities as well as building his house in Majamala Village, Traditional Authority Mzukuzuku, his home village.

South Africa aside, Mzimba has also both formal and informal mines which have exposed workers to hazards.

One of such informal mines is found in Yalede Village in the area of Inkosi Mbelwa in Mzimba district.

It is a quarry mine, mostly being used by villagers from the surrounding the area.

On this particular day, a few miners were found wearing protective gear whilst the rest had nothing.

One of the miners, Henry Zgambo told Nyasa Times that most of his colleagues fail to purchase protective gear because the sales are on the lower side.

“Again, these protective gear are somewhat expensive. A  mouth mask cost about K600 which is too hard for us in a small scale level business to buy,” he said.

According to Zgambo, two  quarry wheelbarrow cost around K6500 and during good times, they earn around K50 000 per month.

He has five children’s and other relations to look after.

A local construction company, Plem also has a formal quarry mine called Zunguzibwa Quarry situated in Mpho Jere Village in Mzimba district.

Here, all the 80 employees of the company are provided with enouph protective gear, thanks to Site Supervisor Joseph Mzumara who is also an MDR TB survivor.

“Apart from the protective gear, workers for for a medical check up after six months,” he said adding that the site has never had any TB case for some years now.

Mzimba South TB District Officer Osman Julius Banda said the number of MDR patients is declining, from 255 in 2016 to 73 in 2018.

“We are working hand in hand with Community Spirum Collection Committees and Health Surveillance Assistants who assist us with not only identifying such patients but also during treatment,” said Julius Banda.

Not all TB cases were as a result of someone working in mines whether in South Africa or back home, other had it the other way round.

On of such people is Loveness Ngwira who comes from Kachake Mhango Village in the area of Traditional Authority Mtwaro in Mzimba district.

Whilst in Karonga district, Loveness used to work in drinking joints and gradually became a chain smoker.

“I was diagonised with MDR-TB in 2017 and was immediately put on treatment,” she said.

However, due to lack of follow up by the health personnel coupled with a point that Loveness was living alone, she was on and off the treatment.

“The situation became worse, I couldn’t walk and I had no food back home. I was confined in the house just waiting for my next fate,” said Loveness adding that her neighbors couldn’t even came to her rescue for fear of contacting the disease.

The gods smiled to Loveness when her uncle, upon hearing of her suffering sent her to Ekwenden.

After she started new treatment in September 2017, Loveness’ situation has improved as she is now able to work.

Just like in Mzimba district, the situation is identical with Rumphi.

Despite the success, shortage of TB specialists and community sensitization on the disease are major set back in the fight.

“We only have about 30 percent of TB specialists in Mzimba district which has got 31 health facilities and we also have a few sputum collecting points,” said Julius Banda.

Cultural beliefs are also a major set back in the fight against MDR-TB as a lot of people take time consulting witchdoctors instead of seeking medical assistance in time.

MDR-TB prevalence in Malawi is 0.4 percent among new and 4.8 percent among previously treated TB patient populations respectively.

According to World Health Organisation (WHO), TB kills 5 000 people a day.

In 2016, the United Nations’ health organisation reported that about 10.4 million people were diagnosed with TB and 1.7 million died.

But over 95 percent of TB deaths occur in low and middle-income countries like Malawi.

The heaviest burden is carried by communities which already face socio-economic challenges, including people living with HIV, migrants, refugees, prisoners, ethnic minorities, miners, marginalised women, children and older people.

WHO, in its new ethics guidelines, discourage isolation of contagious patients and discriminatory policies against affected people.

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