THOUSANDS of Zimbabweans are returning home from South Africa under difficult and often traumatic circumstances.
Many are fleeing xenophobic attacks, leaving behind jobs, homes and, in some cases, the healthcare systems that have kept them alive for years.
Among them are people living with HIV, diabetes, hypertension and other chronic illnesses whose survival depends not on sympathy, but on uninterrupted access to medication.
The Health and Child Care ministry’s decision to deploy health workers at ports of entry and screen more than 100 000 returnees is commendable.
Establishing border clinics to provide emergency medication is also a positive first step.
However, these measures alone will not be sufficient if Zimbabwe is to prevent a looming public health crisis.
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For people living with chronic illnesses, missing medication is not a minor inconvenience. It can be life-threatening.
For people living with HIV, interrupting antiretroviral therapy allows the virus to multiply rapidly.
Viral loads can increase, immune systems weaken and the likelihood of opportunistic infections rises significantly.
More worrying is the increased risk of drug resistance.
Once resistance develops, first-line treatment may no longer be effective, forcing patients onto more expensive and complex second- or third-line regimens.
For patients living with diabetes, missed medication can result in dangerously high blood sugar levels, increasing the risk of kidney failure, blindness, strokes, heart attacks and diabetic emergencies.
Those with hypertension face elevated risks of heart disease, stroke and permanent organ damage when treatment is interrupted.
Every missed dose chips away at years of progress made in controlling these conditions.
The challenge, therefore, extends beyond simply handing out emergency medication at the border.
Zimbabwe requires a comprehensive national policy specifically designed to manage the healthcare needs of returning migrants.
Every returning citizen living with a chronic illness should be registered immediately upon arrival through a standardised health assessment.
This assessment should capture previous diagnoses, medications, treatment history, allergies and the healthcare facility where the patient previously received treatment.
Government should establish a dedicated Returnee Health Integration Programme that ensures every patient is linked to the nearest healthcare facility within days of arrival.
Follow-up appointments should be scheduled before patients leave border reception centres to eliminate the risk of individuals disappearing before entering Zimbabwe’s health system.
Equally important is closer collaboration with South African health authorities.
South Africa has treated hundreds of thousands of Zimbabweans over many years.
Many patient records already exist within South African public hospitals and clinics.
Instead of forcing doctors to reconstruct treatment histories from memory, the two governments should negotiate formal health information-sharing agreements that allow authorised medical professionals to verify treatment regimens quickly.
Such co-operation could operate through designated focal persons within the health ministries of both countries.
With patient consent, clinicians should be able to request verified treatment histories electronically before making changes to medication.
Southern African Development Community member states already collaborate on disease surveillance.
Expanding this co-operation to include continuity of chronic disease care would protect patients while strengthening regional public health systems.
Technology can also play a transformative role.
Zimbabwe should invest in secure electronic health records that allow patients’ treatment histories to be accessed at authorised health facilities nationwide.
Instead of relying solely on paper records that are easily lost during displacement, digital systems would enable clinicians to retrieve critical information quickly.
Information security must remain paramount.
Patient records should be encrypted, protected by strict authentication systems and shared only with authorised healthcare professionals.
Access should comply with national data protection laws and internationally accepted medical confidentiality standards.
Every patient must provide informed consent before cross-border information is exchanged, except where emergency treatment requires otherwise under applicable legal frameworks.
Governments should also explore secure regional health information exchanges capable of linking healthcare facilities across borders while maintaining privacy safeguards.
Such systems already exist in various parts of the world and demonstrate that continuity of care and data protection can coexist.
Longer term, Zimbabwe must reduce its dependence on emergency responses by adequately funding its healthcare system.
The country’s continued failure to meet the Abuja Declaration target of allocating at least 15% of the national budget to health has left the sector vulnerable to external shocks, including reductions in international donor funding.
The return of thousands of Zimbabweans presents challenges, but it also presents an opportunity to modernise healthcare delivery.
A patient should not lose years of successful treatment simply because they crossed a border while escaping violence.
Continuity of care is not merely a medical issue. It is a matter of dignity, human rights and sound public health policy.
Every interruption prevented today saves lives, reduces long-term healthcare costs and protects the progress Zimbabwe has made in combating HIV and other chronic diseases.
The country’s response must, therefore, extend beyond the border post.
It must follow every returning citizen all the way home.