One-stop clinics, a rare lifeline for the sick in Zimbabwe

Blessing Chingwaru could barely walk without support when he arrived at the Rutsanana Specialist Clinic in Harare, complaining of chest pains and fatigue.

Weighing 37 kilograms, the HIV-positive motor mechanic knew something was wrong.

He immediately pbaded several tests and announced the bad news: he also had advanced tuberculosis. The double infection with HIV and tuberculosis is a notorious killer.

"My health was deteriorating and I did not stop asking myself why," recalls Chingwaru, 29, at the clinic.

A few hours after the diagnosis, Chingwaru received free treatment and nursing care.

In a country where more than a dozen people die each day from TB-related diseases, this was a rare example of effective public health care.

The polyclinic Rutsanana in the poor suburb of Glen Norah in Harare, in which Chingwaru has returned, is one of 10 pilot clinics in the country offering free diagnosis and treatment for tuberculosis, diabetes and HIV.

Patients sit on benches in a waiting room at the Rutsanana Polyclinic in the suburb of Glen Norah, Harare, June 24, 2019. (AFP)

The clinic, which opened in 2016, has 24 nurses and currently treats 120 TB patients.

According to the World Health Organization (WHO), TB is the most common cause of death among the millions of people living with HIV in Zimbabwe.

HIV-positive people and people with weakened immune systems are particularly susceptible to infection.

After Chingwaru's first visit in February, doctors feared for his life.

But after five months of careful treatment, Chingwaru took 15 pounds.

"Everything I need, I come here," Chingwaru said, shaking his fists with both hands to show his newfound strength.

In a country where public health services have practically collapsed, the fight against the spread of tuberculosis has been a persistent struggle.

Zimbabwe has been stuck in a catastrophic economic and financial crisis for decades and its doctors are underpaid and under-equipped.

Although tuberculosis treatment is free, the annual number of TB infections in Zimbabwe remains among the highest in the world.

The contagious infection is usually found in the lungs and contracts by breathing the bacteria from tiny sneezing or coughing droplets.

As HIV-positive people are extremely vulnerable to TB, clinics have followed the advice of WHO officials to link TB screening and treatment with HIV prevention programs.

"Catastrophic costs"

Near the main door of the Rutsanana Clinic, a self-testing green HIV testing tent has been set up to encourage people to check their status.

The clinic also offers voluntary counseling on HIV and antiretroviral therapy.

Sithabiso Dube, a doctor with the International Union Against Tuberculosis (TB) and HIV Program Manager, said people with diabetes were also at higher risk of developing TB.

"Instead of going for diabetic care in one clinic and TB care in another, they are able to get those services in one place," Dube told AFP.

Because services are free "they can reduce what we call catastrophic costs for TB patients," she said.

Largely funded by a program from the United States Agency for International Development (USAID), pilot clinics have become a lifeline for the poor – but only if they live nearby.

The vast majority of the population does not have access to single-window clinics.

As a result, it is planned to expand the program on a larger scale, with 46 other similar centers to be rolled out across Zimbabwe.

Rutsanana clinic matron Angela Chikondo said the program was crucial to minimizing complications in patients with TB and diabetes.

"If you're on TB treatment, that diabetes is well controlled, the chances of recovery are very high," she said.