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NewsDay

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Winning TB battle against all odds

Opinion & Analysis
LOOKING at him, one will never tell that the father-of-two almost lost his life to tuberculosis (TB) infection.

LOOKING at him, one will never tell that the father-of-two almost lost his life to tuberculosis (TB) infection.

BY MARY TARUVINGA

drug-resistant-tb

Takunda Nyikadzino (32), who is originally from Zimuto in Masvingo and formerly an artisanal gold miner, is HIV positive and has a captivating TB tale to tell.

Although Nyikadzino’s story has a good ending, it is littered with several challenges associated with living with the condition in an ailing economy.

He narrated his ordeal to NewsDay recently while at his wife’s vending table outside his lodgings in Chipadze, Bindura, where he now lives with his family working as a security guard.

After dropping out of school when he was in Form Three, faced with economic hardships in the country, Nyikadzino found himself in the Chachacha area near Shurugwi, where his mother’s sister resided.

His cousin then introduced him to gold panning, which was a source of livelihood for almost every family in Svika village, where they stayed.

He mined gold for three years, using informal methods. He would go underground soon after blasting and would inhale explosive fumes. He was also exposed to mercury and other chemicals for processing and refining gold.

“We would mine gold along the river and in near-by areas. Gold panning was a source of livelihood for almost every family and people would continue to flock in and with time, the gold in the river was becoming scarce,” he said.

According to Nyikadzino, the panners would then rely on mercury, a highly toxic substance supplied by the smugglers who buy their product, to trap the precious metal from the muddy river waters.

Public health and environmental experts say the consequences are disastrous. Mercury can contaminate drinking water for miles around and causes neurological damage, especially to children.

But pushed to the brink, Nyikadzino had to continue mining in order to bring food on the table.

Asked if they were not worried about their work hazards and if they ever received any protective clothing, he responded: “We were only worried about the police and Environmental Management Agency (EMA) officials, who would try to drive us out. We never saw any health experts in the area and we didn’t use any protective clothing. In fact, we would put on vests and shorts to save our better clothes and I felt more comfortable working without even putting on my shirt.”

Like many uneducated artisanal miners, he was unaware that direct contact with silica dust exposed them to contraction of TB.

As his fortunes improved, Nyikadzino graduated from being a mukorokoza to a gold buyer.

As gold availability continued to shrink in the area, he moved to Kitsiyatota near Bindura, where there was a gold rush in 2014. There, he returned to underground mining. It was during this period that he contracted TB. Nyikadzino, fully cognisant of his exploits with women, feared he had contracted HIV.

“I was becoming very weak and would sweat during the nights. That persisted for days before I started coughing continuously,” said the survivor.

Nyikadzino soon became bed-ridden and within a month, he had severely lost weight owing to a complete loss of appetite. Nevertheless, he was still unwilling to get medical help. He gives credit to his mother, who kept on persuading him until he said “yes”.

Tests found he had active TB and was HIV positive. He immediately commenced treatment, but as soon as he got better, he started defaulting, dreading the long journey to Zimuto Clinic and Maranda, also known as Gurajena hospital, being the nearest health facilities servicing his community.

Barely three months after commencing treatment, Nyikadzino found himself back in Bindura, where he continued with artisanal gold mining.

Three months down the line, the sickness was back and this time, he almost lost his life. He was back again at his rural home, where he was placed on Directly Observed Treatment Short (DOTS) course.

The strategy emphasises the use of the most effective standardised, short-course regimen, and of fixed-dose drug combinations (FDCs) under observation to facilitate adherence to treatment.

By so doing, it stops TB at the source, and prevents the spread of the disease, the development of MDR-TB [multi-drug-resistant tuberculosis], and complications of TB, relapse and death.

“I would not have made it without the help of village health workers. Mai Muvirimi would ride her bicycle to my homestead every day and even help with making sure I was living in a recommended environment,” Nyikadzino said, paying homage to the least paid, but hardworking community cadres. After going through DOTS Nyikadzino is now back on his feet although he has abandoned gold panning.

Doctor Charles Sandy, deputy director in the Aids and TB Unit in the Ministry of Health and Child Care, says TB treatment response has been improving of late, particularly in mining communities.

“There are projects currently underway, including mass screening projects targeting most at risk populations including miners,” he said.

He, however, admitted that geographical access to diagnostic and care service is still inadequate coupled with insufficient availability of laboratory reagents and consumables.

Government, with support from Global Fund and Challenge TB, has rolled out a programme in the country’s 24 districts to target mining communities that are at high risk of tuberculosis to reduce the spread of the infectious disease.

The International Union Against Tuberculosis and Lung Disease (The Union) country director, Christopher Zishiri, said the move was aimed at ensuring that all patients with active TB in mining communities were diagnosed early and put on effective treatment.

“We will be visiting communities that have a high risk of TB, particularly areas where formal and artisanal mining activities are carried out and screen people for TB,” he said.

Recently, Zishiri also said despite the nature of artisanal mining which is associated with migrant lifestyles, the group needs to be screened because they are continually exposed to silica dust in often poorly ventilated deep mine shafts increasing their risk of pulmonary tuberculosis.

Zishiri said trucks fitted with X-ray machines and manned by a radiographer have already been deployed to various districts across the country to avail screening services to anyone willing.