Resistant TB smokes out husband’s devotion to his wife

When couples are joined in matrimony, they take vows to demonstrate their unending commitment to the love relationship — assuring themselves and the world that their relationship will not be shaken by any change of circumstances.

But one tends to ask: Why does one have to take the vows? Do the couples taking these vows know what they are really saying, and what they are bound to go through during the tenure of their marital life?

For richer and for poorer, in sickness and in health, is what part of the vows say.

Often when it is for richer, people tend to be getting along well, and when it comes to the poorer, many couples face challenges.

It has been realised that couples tend to stick together when it is in health, while women can cope with both in sickness and in health.

This is evidenced by the numerous stories about men who would have left their first wife of many years and only to come back home to be taken care of when they are now sick, with the wife accepting them back.

Is it so for men as well? Some men when they have a sick wife who is bedridden tend to neglect and send her away so that she can be taken care of by her family. However, it was not so for a Buhera couple which was put to the test of its vows when they got married.

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In 2012, 46-year-old Isaac Makaripe’s wife Lorraine Zemba (pictured right) (32) was diagnosed with drug resistant tuberculosis (DR-TB).

At that time, she was bedridden and could not do anything at all.

A new technology to intensify diagnosis of TB and diagnose DR-TB (GeneXpert) was introduced by Médecins Sans Frontières (MSF) in two hospitals in Buhera district in 2011.

This platform has become the first line test for any TB suspect in the district instead of the traditional sputum smear microscopy.

Patients diagnosed with confirmed DR-TB were attended through a model offering care and treatment in nearby clinics or at home with the help of mobile teams. By the end of 2013, 36 patients had cumulatively been diagnosed with DR-TB since 2011, and put on treatment.

While eight have been declared cured, 15 remained on treatment until the end of the year.

MSF is an international, independent, medical humanitarian organisation.

It was created in 1971 to provide emergency medical aid to populations affected by armed conflict, epidemics, exclusion from health care and natural disasters.

A specific focus in Epworth, a south-eastern suburb of Harare, has been on TB diagnosis and care. A new testing machine has enabled staff to obtain more reliable results, more quickly.

The machine gives results — including for resistance to the drug rifampicin — in less than two hours.

A total of 2 798 samples were tested in 2012.

Of these samples, traditional microscopy had identified 15% of results as positive, whereas the machine found 22%, thus indicating significantly improved diagnosis.

Additionally, nine new patients were enrolled in the multidrug-resistant TB (MDR-TB) programme. Treatment for MDR-TB takes up to two years and can cause severe side effects.

At the end of the year, 40 more patients were under MDR-TB treatment in MSF programmes in the country.

DR-TB can occur when the drugs used to treat TB are misused or mismanaged like when people do not complete the full course of treatment, when health care providers prescribe the wrong treatment, the wrong dose, or wrong length of time for taking the drugs and when the supply of drugs is not always available or when the drugs are of poor quality.

Makaripe (left) says when he was told his wife was suffering from DR-TB, all he thought of was to leave her and start all over again.

“At first when they told me that my wife was suffering from DR-TB, I was worried and it got me thinking about the situation,” Makaripe said.

“I said to myself, something which is resistant cannot be cured and asked myself what I am still doing with her. I thought to myself that it was better for me to take her back to her home and for me to find another woman to be with and not stay with someone who was sick.”

Makaripe said had it not been for the counselling he underwent during that time, he would have left his wife.

“MSF counsellors came here and engaged me,” he said.

“That is when I accepted my wife’s situation and started supporting her. I was also helped by my mother-in-law who came over this side to help me look after my wife.”

Makaripe had to take care of their two-year-old baby during the time his wife was sick as she had to be alone for about two months.

“Relatives would tell me to leave her, but I thought to myself that this is my wife and all I can do is to be with her through and through. She could not walk, talk or do anything. She was bed-ridden at times I would ask myself if I would wake up the following morning and still find her alive. But by God’s grace, she is still alive (and) she managed to go through the two-year treatment.”

Makaripe says because he had to be at home most of the times, they had to rely on donors for the supply of food for the family.

Zemba told NewsDay she was first diagnosed with TB in 2008, and underwent complete treatment. However, she was later diagnosed with DR-TB.

“I became sick in 2012 and that is when I saw MSF people coming after I had been screened again for TB,” she said.

“I was told that I had DR-TB and I had to be treated. Treatment this time was intense. I did not know what it was, but I accepted. During the course of the treatment, I was injected every day for at least eight months while at the same time drinking tablets.”

MSF used to go to Zemba’s place every day for 20 months so as to provide her with medication.

“It was on 20 months of treatment and I am grateful that I have been healed,” Zemba said.

“At the moment, I am still recovering although I was told it had been treated. I am now trying to regain my strength. I could not do any household chores or anything, but I can now do some house chores. Neighbours stigmatised me. I felt pity for my baby as I could not hold him. All I wanted was to be treated so that I could be able to hold my baby in the future.”