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Crushing resistant TB amid struggles

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By Chancy Namadzunda, Contributor:

SURVIVOR OF MDR-TB— Ngwira

People from all walks of life flock to an uptown nightclub at Rumphi Boma. It is an hour before midnight.

After long hours of labouring in their respective trades, some are here to celebrate the fortunes of their toil; others to simply drown their sorrows.

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There even are those seeking the services of temporary companions attracted to the place by a growing collection of pubs, rest houses and merchants.

Acts of youthful imbibers in every corner of this uptown nightclub, dancing to loud South African disco music, are symptomatic of what happens in the Rainbow Nation in moments like this.

Though South African disco music has, over the years, made inroads into Malawi, it is rare to find a nightclub playing such music all night long.

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“It is because many youths from this district trek to South Africa for greener pastures. When they come back, they bring with them some bits of that country’s music,” a man, who identifies himself as Joseph, says.

His sentiments are buoyed by the outlook of these young men who are clad in Tsotsi attire from head to toe and are producing Zulu-laced Tumbuka language.

The scenario plays out in other areas including Mzuzu City and Mzimba District.

But beneath the purported glamour and happiness of some of those who return from their search for greener pastures in South Africa are tears and sorrows which project onto their relations.

They bring with them various diseases including multi-drug resistant (MDR) tuberculosis (TB) which they mostly contract in the Rainbow Nation’s dusty mines.

Thirty-seven-year-old Mose Jere from Mzimba District is one of those struggling with the communicable disease caused by bacteria spread from person to person through microscopic droplets released into the air.

He left for South Africa in 2012 where he ended up working in a mine.

“In the first years, all was well until I started falling sick regularly. I was later diagnosed with MDR-TB. We tried all we could to find medical assistance in South Africa but it did not work,” Jere, whose sisters and brothers are also working in the Rainbow Nation, said.

Health services are way far much better in South Africa than Malawi. But Jere still returned home because he could not get them anyway.

“I wholeheartedly welcomed the decision to return home because I knew that I would die in the hands of my relations and on my home soil,” he said.

On arrival in 2016, he was immediately put on an 18-month treatment arrangement.

At the time of our encounter he was two months away from completing the prescription but he was already on his feet tilling the land and building a house in his home village Majamala, Traditional Authority Mzukuzuku.

South Africa aside, Mzimba also has both formal and informal mines which continue to expose workers to physical and health hazards.

At a quarry mine in Yalede Village in the area of Inkosi M’mbelwa, workers go about their activities with little or no protective gear. They seldom afford them because sales are on the lower side.

“A mouth mask costs about K600, which is too much for earnings from this kind of business,” Henry Zgambo, a miner, says.

The situation is, however, different at Zunguzibwa Quarry Mine in Mpho Jere Village in Mzimba District where a construction company, Plem, provides protective gear to all its 80 employees thanks to site supervisor, Joseph Mzumara, who is an MDR-TB survivor.

“Workers also go for medical check-ups every six months,” Mzumara said, adding that the site has not registered any TB case for years.

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 Sputum Collection Committees and Health Surveillance Assistants who assist us with not only identifying such patients but also during treatment,” Banda said.

Some TB cases are as a result of smoking. But they, too, once treated early, vanish.

Loveness Ngwira of Karonga District was on and off treatment. After deciding to consistently take it, she is on the road to recovery.

However, one major challenge to the fight against MDR-TB is shortage of specialists and inadequate community sensitisation initiatives about the disease.

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

Cultural beliefs also play into efforts to deal with MDR-TB as some people spend time seeking help from witchdoctors before going to formal health facilities.

Such cases slow down the eradication of MDR-TB whose prevalence rate in Malawi is at 0.4 percent among new cases and 4.8 percent among previously treated populations.

In 2016, the World Health Organisation reported that about 10.4 million people were diagnosed with TB and 1.7 million died from the disease.

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.

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