Zimbabwe’s aggressive efforts and investment towards eradicating tuberculosis (TB) could all be in vain if nothing is done to ensure screening and continuous treatment of Mozambique nationals fleeing from civil unrest into Zimbabwe.
Mozambique has since the beginning of 2017 been plagued by civil and political unrest stemming from conflicts dating back to the 80s when the ruling party Mozambique Liberation Front (FRELIMO) and the main opposition party Mozambican National Rennaisance (RENAMO) clashed over alleged marginalisation of the northern and southern regions by the central government where the latter is stronger.
While the war has been going on, some Mozambican nationals have retreated into Zimbabwe, illegally settling in border areas such as Chipinge, Nyanga and Chimanimani.
In the absence of proper coordination between Mozambique and Zimbabwe, especially around the continuation of screening and TB treatment for those who desert their country, all the efforts invested could count to nothing.
Global estimates put Mozambique TB incidence at 551/100,000 population which is considered one of the highest in the world.
In an interview with 263Chat, Zimbabweans in the Mabee area- Chipinge confirmed that they are indeed housing Mozambican nationals who escaped civil unrest.
“They are always here and in most cases, they come looking for piece jobs and we accept them, they are part of us,” said Jerry Moyana from Matikwa.
He added that they have not been educated on how to deal with people affected by TB and other infectious diseases, “No one has told us what to do when we get in contact with TB patients.”
James Muyambo from Mariya village in Chipinge noted that they not not well versed with TB issues to enable them to take preventive measures, “I know that TB is spread through the air but I am not able to identify the symptoms from a person infected, and for that reason, I cannot do anything, if anything we are at risk of being infected.”
A Village Head in Chisumbanje, Farai Ndimandi said they have since time immemorial enjoyed cordial relations with their Mozambican counterparts, strengthened during droughts as they barter trade food for other essentials for survival.
“When we have drought this side, Mozambican nationals help us with grain in exchange for clothes, soap and other items on demand. So when they encounter problems in their country, they are not hesitant to come to us, some of them have become our relatives, so we live with them,” said Ndimandi.
Asked if they are not worried about the spread of diseases such as TB, Ndimandi said the absence of information on the disease makes them vulnerable, “We do not know what should be done,
“We do not even know that Mozambique is a high TB burden country.”
Charles Dhliwayo, a businessman at Checheche Growth Point called on government to roll out TB education campaigns to save people from contracting the disease.
“The government should come and educate people on basic things like signs, symptoms and prevention measures so that we are able to protect ourselves,” said Dhliwayo.
He added that health centres along the borders should be equipped with medication and incapacitated to treat TB.
According to Dr Charles Sandy, director of the Aids and TB Unit in the Ministry of Health And Child Care (MoHCC), Zimbabwe has not recorded any TB outbreak as a result of the influx of Mozambicans into the country.
“As to anyone else in the whole country people in the borders with Mozambique are being educated on TB and how it spreads. Armed with that knowledge they are able to protect themselves from TB,” said Sandy.
Zimbabwe hosts more than 17000 registered refugees who are living at the Tongogara Refugee Camp of which 9 percent are Mozambican nationals.
According to Vice President Emmerson Mnangagwa an additional 6,502 Mozambican asylum seekers are living in Nyanga and Chipinge districts and are yet to be relocated to Tongogara Refugee camp.
A researcher, Alberto García Basteiro at the Barcelona Institute for Global Health, noted that the south of Mozambique which borders Zimbabwe is probably one of the hotspots for TB and HIV in the world.
Considering that the country has a mobile TB screening vans, the government could visit and extent such services to those border line communities to get an insight of the situation.
Discontinuation of TB medication often results in multi-drug resistant TB which is expensive to treat as well as dangerous to both Mozambicans and Zimbabweans.
Dr Christopher Zishiri, Director of The International Union Against Tuberculosis and Lung Disease (The Union) said under the Challenge TB support, his organisation is supporting targeted screening for TB among high risk groups in prioritised districts including areas with migrants.
“Migrants are among the high risk groups for TB that are targeted by this intervention. The refugee camp in Chipinge is on our list of areas that will be visited by our teams for screening,” said Dr Zishiri.
He added that health services including TB screening and treatment offered by the Ministry of Health and Child Care in Chipinge and other areas with refugees are on a non-discriminatory basis which means Mozambican nationals are eligible for treatment should they test positive while in Zimbabwe.
“MOHCC offers health services from community level, clinics and the district hospitals which provide free TB Services to all people of Zimbabwe and are non-discriminatory to refugees. We have all these levels of care in Chipinge and Nyanga and refugees are free to access these services,” said Dr Zishiri.
Zimbabwe is on course to end TB by 2030 in line with the Sustainable Development Goals (SDG) and the World Health Organisation (WHO) End TB strategy deadline set for 2035. With Mozambique political unrest far from over, Zimbabwe has a lot of work to do to ensure set targets are met and the country is freed from the high TB intervention costs which are largely funded by the development organisation.