The Sunday News
Cherifa Sururu
After finishing Ordinary levels in the small farming town of Karoi, my friend Jimmy and I were amongst the very few who had obtained grades good enough to proceed for Advanced Levels. Jimmy was a very close friend of mine. We were of the same age and shared the same cultural and social background. We had known each other since we were toddlers. We were tired of having to be pioneers of schools having gone to new schools from Grade One. The reason was that I went to school just after independence and we were pioneers in the newly established schools by the newly independent Zimbabwe. We also wanted also to “see” the world and we would talk about better opportunities in City of Sunshine, Harare. We were told people were so busy in the big city that they did not have time to sleep.
On arrival in the big city, we were really shocked that people cared so little about each other when compared to the Karoi community. We moved in with my father who was not employed and relied on a small market stall to make ends meet. Occasionally, we would be thrown out of our room for failure to meet rental obligations and we would find ourselves on the street. On the streets, it became clear that it was the survival of the fittest and we came face to face with unimaginable behaviours. It was helpful that I was with Jimmy and the two of us would talk about our vision and goals whenever were not studying. We would encourage each other to keep ourselves out of trouble. Frequently we would see close friends and relatives developing symptoms which were difficult to link to one disease. They would start with a history of frequent visits to the clinics with Sexually Transmitted Infections, Tuberculosis or chronic diarrhoea. We even knew then that those that had severe headaches would not make it. In a bid to cut on costs of transporting a body, arrangements would be made for these to be sent to the village as it was instinctively concluded that the hospitals and doctors would not be of much help.
We would just imagine the life in the villages with so many young people going back in very advanced stages of what we later learnt was Acquired Immune Deficiency Syndrome (Aids), caused by Human Immunodeficiency Virus (HIV). It was mostly the young that had left the villages or smaller towns in search of better future, who come back in despair and very bad state of health. I was told that they would be moved from place to place in wheel barrows and those of a better social status used scotch carts in search of treatments which ranged from faith to traditional treatments.
Accusations and counter accusations because of the non-healing nature of the illness were common. These would further fragment the families that were already torn by internal and external displacements and migration. These stories would haunt us. Many of us including close relatives were succumbing to the virus and its complications. Besides the few posters on the street that linked the disease to prostitution and alcohol abuse, we had very little other sources of information. We did not have a television or radio and at school, our curriculum did not cover the disease.
I have been trying to piece the HIV/Aids puzzle together since I started practicing in1998 in the City of Kings. So many years later in practice as a primary care practitioner, the story seems to be the same. The poorer areas in urban areas, border towns, farming and mining compounds and growth points seem to be hot spots for HIV/Aids. There is even knowledge and information that certain populations, for example prisoners, commercial sex workers, youths and adolescents, orphans, people living with physical and mental challenges, men who have sex with men and intravenous drug users are more affected than the general population .
HIV/Aids seem to be more prevalent in those who may be displaced for one reason or another. My friend Jimmy and I had to move to a bigger town in search of better living conditions. Many years’ later people continue to move from one place to the other and now more frequently go to neighbouring countries in search of work and better living conditions. These factors have mean families are having to be split and in some cases having child-headed homes which themselves are known increased risks of getting HIV/Aids.
Jimmy acted as a pillar of support as I ventured into new, unknown and unpredictable territories. We would sit down, discuss, evaluate and appreciate that we were a population at risk. Words of advice from our elders about different dangers that were associated with busy and crowded big cities like Harare formed the basis of our discussions and we would look after each other. Whatever bond we had had back then in Karoi, we kept and even strengthened it. We felt we needed each other more than ever before. It was a case of the big city and us.
At this juncture we need to do some self introspection. How many of us sit down and take stock of our risk of getting infected with HIV as we move up with our intentions of pursuing our dreams and visions? How many of us make adequate arrangements for evaluation and monitoring if we are infected and are on ART as we pursue our dreams and visions? How many of us are driven to the “wall” and we have to compromise on our values and expose ourselves and the ones we love?
Remember Jimmy and I felt isolated and yet our population was bearing the biggest brunt of HIV/Aids. This is so true for many other populations that are at higher risk for example, the prisoners, commercial sex workers, youths and adolescents, orphans, people living with physical and mental challenges, men who have sex with men and intravenous drug users. How can we reach out to these populations to empower them to access HIV treatment, prevention and evaluation services?
What services are available for our elders who have to look after our ill young ones who have to return to the village for nursing care? What is the world we want to see to reduce the risk of getting infected with HIV/Aids or passing infection to our loved ones? The world that is associated with decreased risk of getting or decreasing the chances of passing HIV seem to be associated with better living conditions with the associated chances of better education, housing and recreational facilities. Our government has a role to play, so do we.
The government of Zimbabwe through the Ministry of Health and Child Care has an inclusive vision to make sure we all play our part in conquering HIV/Aids. In its National Health Strategy, 2016 to 2020 whose theme is Equity and Quality in Health: Leaving no one behind, the government has set ambitious targets of 90:90:90 by 2020. This means that 90 percent of the population should have tested for HIV by the year 2020. Of those who have tested positive for HIV, 90 percent should be on Anti-Retroviral Treatment (ART). These are drugs that are known to suppress the multiplication of HIV in the infected people. HIV/Aids patients can live long health lives with ART. Lastly those who are on ART, 90 percent of them should be virally suppressed. With 2020 fast approaching, we therefore need act swiftly. The suppression of the HIV would then translate into less and less virus in the infectious fluids , semen, vaginal fluids, breast milk and blood, thereby decreasing chances of passing infection from one person to the other.
Finally, we are optimistic that come 2030, we would have no infection passing from one person to the other. This is more so if all populations are given equal opportunity to access prevention, treatment and evaluation services.
As communities we could sit down and brainstorm over social determinants of health related to the prevention, treatment and evaluation of HIV services with a vision of not “leaving anyone behind.”
