Unsung heroes in the fight against TB

Catherine Mwauyakufa, CNS Correspondent, Zimbabwe
“Time is of essence in my job and I am conscious of it,” said Jason, who strives to see TB infection rates go down. Jaison Tarovedzera is a dedicated member of the Riders for Health team in Harare under the International Union Against Tuberculosis and Lung Disease (The Union) Zimbabwe. In an exclusive interview, Jaison told me that he rides to save lives and will ride until he is satisfied that the rate of new TB infections is minimal. I told Jaison that the initiative is to End TB by 2030, to which he replied, “Ending TB once for all would be ideal. However, for now I am focusing on lowering the rates of TB infection in the communities. No one must die of TB and that is why I ride with dedication”.

Jaison’s motor bike had gone for servicing and he was using a truck on the day I met him. “My bike has broken down and is being serviced. The City of Harare, which is a partner in the End TB programme with the Ministry of Health, and The Union, provide a car in such cases. So for today I am driving a van, but I prefer riding, as it is faster, there are fewer parking hassles and I can negotiate my way at my speed and pace,” said Jaison. Jaison collects sputum samples from council clinics and carries them to the laboratory in Beatrice Infectious Diseases Hospital in Harare. “I collect sputum samples from clinics and take these to the laboratory at Beatrice Hospital. Time is of essence because I do not only ferry sputum samples but also stools, blood samples and other related matter which spoil if not taken on time. So every minute counts and I get all the day’s specimens to the laboratory on time,” said soft spoken Jaison. He understands the importance of his work. “Earlier people had to travel a long way from their homes to get to the lab for results. But now they just drop their samples at their local clinic, and riders like me come and take them to the lab. They can go to the clinic knowing that their sample will be collected by a motorcycle and taken to the lab, and after two or three days they will get their results back.” Jaison says he not only transports sputum samples but also shares his knowledge on TB with the community he lives in. “I am not just a rider.

At family unions, if I notice that a person’s cough is just not the usual cough, I speak to them in private and inform them that there is nothing to fear if it is TB. It can be treated and that is done for free at the clinics,” he said. Jaison has noticed a lot of stigma around TB, which largely due to lack of correct information and due to poor awareness of the disease in general public. “There is a degree of fear when TB is mentioned as one usually thinks of the long treatment time and the cost. I tell them that the only cost is the initial $5 at first visit to the clinic for consultation, and after that they are assured of tests and treatment all at no cost to them. I also tell them that they will not have to travel long distances because their nearest clinic will treat them in confidence,” said Jaison. People are surprised with the above information because they have some misinformation on where TB is handled and hence the fear to seek treatment. There are confidentiality issues too. “Many people I talk to, ask me if I will come to know know their results since I will carry the samples, to which I tell them that all is done in confidentiality and I do not even get to view any sample. They are handled professionally and only the nurse at the clinic will reveal the outcome of any tests to them. Once they are assured, I usually see them warming up and asking what if they are found to be HIV positive,” Jaison added.

TB is an opportunistic infection that takes advantage of the weak immune system and so the chances of TB-HIV co-infection are high. In Zimbabwe, 75% of people on TB treatment have a compromised immune system. “Locally 75% of people on TB treatment in our clinics are HIV positive. However, I must stress that not all people with TB are HIV positive. TB-HIV co-infection is handled and managed at all our clinics. So people must be screened for both without fear,” said Dr Prosper Chonzi, the City Health Director. Jaison has been riding for years and was also part of the TB Reach programme. He has lost count of the number of people who have come back to thank him for his selfless services. “Unless it is the person who recognises me, I do not know who I helped but I have had people stopping me on the road to say ‘thank you, you saved my life’. But I tell them that is my job to save lives from unnecessary and avoidable TB deaths  and I am happy to Ride for Health,” said Jaison.

“Before Riding for Health I was a rider on the TB Reach programme. There I remember we collected samples from outreach teams under a tree and reached several hard to reach communities,” said Jaison. The rider said he does not get tired at all, even as he rides 80 km to 90 km a day. He is rather happy to be saving lives. "The Union is supporting 49 such courier riders in 8 rural provinces and urban areas in Zimbabwe including the capital city Harare and Bulawayo," said Anold Kanjanga who heads and supervises the couriers. Meanwhile MSF working in Epworth at Domboramwari Clinic now sends out text reminders to patients when their medication is due for collection. MSF has completed a pilot project to send reminders by text message to TB patients in Epworth at Domboramwari Clinic.

“Due to the above planning, missed appointments have dropped from 15% to less than 5%,” said a nursing staff who requested anonymity since she does not speak to the Press. Another partner in the health sector, Elizabeth Glaser Paediatric AIDS Foundation (EGPAF), now pays courier services for all dry blood samples (DBS) of babies to be sent to laboratories on time. “EGPAF now pays courier services for DBS so the turn-around time has drastically reduced from 3 months to 1 week in most cases,” said Dr Agnes Mahomva, the country director for EGPAF. Riders work focuses on providing effective transportation for the delivery of vital services. Their aim is to make sure all health workers in Africa have access to reliable transportation so they can reach the most isolated people with regular and predictable health care. By combining appropriate technology with new systems for looking after it, Riders have created a solution to the problem of a lack of transportation which is sustainable, replicable and scalable. Courier services, text messaging and dedicated riders like Jaison are important links in the chain of timely diagnosis and correct treatment and will help in the achievement of eliminating TB by 2030 as envisaged in one of the sustainable development goals (SDGs).

Catherine Mwauyakufa, Citizen News Service - CNS
October 24, 2016  

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