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Covid-19 response can be improved in many ways

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AS Zimbabwe registers a decline in Covid-19 cases, healthcare workers remain exposed to a disease that has claimed nearly 1 500 lives in the country. More than 300 health professionals have tested positive for Covid-19, with a senior resident medical officer at Mpilo Central Hospital, Dr Misheck Ruwende (pictured), being one of them.

Our correspondent Lizwe Sebatha (LS) met Ruwende for a one-on-one interview on his experiences as a Covid-19 survivor and to discuss, among other issues, Zimbabwe’s response to the pandemic and the efficacy of traditional home remedies such as Zumbani. Ruwende is also the chief executive officer and founder of Health and Longevity, a start-up initiative aimed at providing evidence-based health information for the betterment of people’s health.

LS: What was your initial reaction after you were told you had tested Covid-19 postive? How did you feel, what came to your mind?

MR: I had mixed feelings. I got tested for positive on the 2 January 2021. The first few minutes, obviously, I was afraid because I started having flashes of other patients who I saw dying from Covid-19 but, minutes after, I then said to myself, I am not really in the risk of people who can have severe disease.

And also, since the first case of Covid-19 in Africa, I have always had an interest in following cases of Covid-19 in Africa. I have been making various videos and giving information to people, so I was quite aware about Covid-19.

That gave me solace and peace, and I was a bit happy also that I knew exactly what I had than to be in the dark. So to me, it was really okay to know that I had Covid-19, I knew exactly how to handle myself as a healthcare worker.

LS: If you may take us back, prior to testing for Covid-19, had you developed any symptoms, were you sick or it was just a random test? What had happened?

MR: I developed symptoms. The first three days I felt like I was developing flu, you know that common flu where you feel sort of a sore throat.

But that common flu never got to fruition because I was not sneezing; there was no coughing to talk about, and that was the first three days.

And thereafter, I started feeling weak and the weakness got severe; I had general body weakness, severe general body pains, joint aches and that happened for the next three days and that was later associated with headaches.

It was moderate though and feeling feverish and then later I had a serious sore throat.

I actually discovered that I had some throat ulcers and those ulcers and severe sore throat are what convinced me to get tested.

Those symptoms were there for about 10 days, and on the 7th day I remember that was the time when I was cooking maguru (tripe) when my friends visited and said maguru smells all over the place yet I never sensed the smell.

I could not smell it but I was in the room the whole time. And whilst I was eating them, it felt like I was eating rubber. There was no taste at all and that is when I discovered I had lost my sense of taste and smell and that happened for about five days.

On day 10, the symptoms regressed but what was left was the sense of taste and smell but I regained it on the 12th day, meaning I was on the road to full recovery.

LS: Did you tell people, family, close friends when you tested for Covid-19?

MR: I told them way later because my friends insisted that I should tell people. In fact, some of them got it from the newspapers that I had Covid-19.

The reason why I did not want to tell people that I had Covid-19 is because they panic. They think you are dying. I know people are dying but we also have a large number of people who are recovering, and I knew that in my case it was mild to moderate.

It wasn’t much so I didn’t want to make them panic. However, a good number of my friends who are doctors gave me good support, saying we have always been exposed to Covid-19 for the past year. I didn’t really feel that much stigmatisation maybe because my friends are health workers.

LS:  You raise this issue of stigma. It seems to be a real issue.

MR: It is really an issue, even a lot of health workers, particularly those who stay outside the hospital premises, they are facing that a lot.

I have heard a good number of people, nurses, maybe they know that I am a Covid-19 survivor, they always come up with their stories.

It’s very much a big issue because when you test positive and you are living among other people, they don’t want to get around your area, worse off when you are taken by an ambulance.

Even up to now, there is that stigmatisation yet it’s because of lack of information.  Stigmatisation is real, now the problem with stigmatisation is that when people test positive they don’t tell anyone.

They would rather keep quiet because they don’t want that stigma and now the problem is that once someone does not disclose to friends, or close family, it means that there is not much protection. It’s giving us more problems than solutions.

LS: Don’t you think misinformation and disinformation are the causes of this stigma?

MR: The other reason why people panic about Covid-19 is because they don’t really have the information.

The information we always hear about is of people dying, so and so has died but we know that more than 97% of people who get Covid-19 they survive.

In fact, more than 80% have mild conditions and don’t have any symptoms in most cases. We also know the people who are at risk of dying.

We know that if you are obese, overweight or have a big tummy you are at risk of dying; people who have other chronic diseases like hypertension, diabetes, liver diseases, people who are not doing well on their HIV medication are at risk of dying.

It’s not everyone who is HIV positive who is at risk, no. But if you are not doing well you are at risk. We need to make sure that those at risk are protected from us.

And I think even for vaccines, those are the people who should run to get the vaccine. Of course, everyone should, but I am saying we have a prioritised group and if we know that we will remove such panic and also stigma.

LS: What kind of medication were you taking to fight off Covid-19?

MR: Like I said, I have been covering the issues of Covid-19 since its inception. I have known quite a lot of things about Covid-19 including its treatment and what I only used is paracetamol because there was a time I was feeling feverish and chills although my temperature was quite normal but around that time I took paracetamol and also for the headache.

That was the only medication that I took for the fever and also for the headache. Number two, I was also taking lots of fluids because when you are feeling feverish you are losing lots of fluids, of course remembering that water is the healthiest beverage.

And also, you need to rest; you need to give your body time to fight off that infection. I gave myself good rest but with a bit of exercising, eating lots of fruit and vegetables.

That was what I was taking until well because we know that when you are having a mild condition of Covid-19 you don’t need all those things like antibodies; we are saying if you are breathing well, if your temperature does not go above 38 degrees Celsius for at least three days, there is no need for things like antibiotics.

LS: There is a lot of debate, even among health experts and doctors, about traditional home remedies such as zumbani (fever tea).

What are your views on a traditional home remedy like zumbani, considering it continues to generate lots of debate?

MR: I don’t have a problem with such things as zumbani in whatever way they are administered. We have always been using zumbani for decades if not centuries in Africa and our forefathers have always been using it for conditions like the common flu and we know that the common flu shares some things with Covid-19 and therefore obviously there is room for things like Zumbani to have a role to play in terms of treatment of Covid-19.

I don’t have a problem with people taking it, but what I would appreciate more though is that if we could invest in looking for the ingredients which are active or necessary in Covid-19 in zumbani then we take those ones and we make our own pills.

We make our own medicines out of that zumbani because right now we are just taking it haphazardly. We don’t know how much of the dose in zumbani is used for the treatment of Covid-19.

We do not know the side effects. We are just taking it. We need more studies. Already, our forefathers have given us a hint that this thing works but what we need now are more studies.

We need more scientific information about Covid-19 and we can have something that is more objective, and we can use it in future.

Well, that can be our treatment in Africa. That is my take but we know that some people then boil water and then cover themselves with blankets.

People just have to be careful not to burn themselves, and also to say that is not necessary in children because we know that children can fight off that infection very well so we don’t want to expose them to such things.

They are not necessary but for adults, yes we can go ahead with such.

LS: You are here at Mpilo Hospital and you have seen first-hand the government’s Covid-19 response. What is your assessment of the government’s Covid-19 response? Where do you think has been lacking?

MR: I think the ministry of Health has done fairly well in terms of responding to Covid-19.

When compared to other countries, of course there is an issue that our economy is not as vibrant and the health system is not spared but otherwise I feel the ministry did fairly well, only that around Christmas time, we were very much reluctant, and it was a super spreader.

People were going to the rural areas and so forth and that is the main reason why we had a sharp rise in cases of Covid-19. We could have done better there.

And also, recently, we have seen that in all hospitals, I am not sure about district hospitals, everyone is now getting tested for Covid-19 before they get treatment.

That is something that is commendable. Of course, we must improve in future in terms of preparation for these pandemics.

We have done fairly well, but also there is the issue of the economy that also affects the treatment of patients who get Covid-19, especially when we are looking at the public; we still need to do more.

LS: What lessons can be drawn from Covid-19 insofar as addressing other challenges facing the health sector is concerned?

MR: We need to be more prepared in the sense that in terms of our infrastructure we need more equipped hospitals. We need more staff in terms of the human resource.

We need more of such things that will help us when we face these kinds of pandemics, even during the normal days. Also, we need separate hospitals that deal with specific diseases.

I know that we have a number of infectious hospitals but I think we need more of these infectious hospitals.

Number two, those existing hospitals, we need to equip them more so that patients get the utmost care that they can.

Also, we must put hands on and focus on development, scientific development. For example, we don’t have any vaccine that is developed in Africa so far.

We are just waiting for donations. We need to develop our own things; we need to develop our own medicines; we need to develop our own machinery; we need to develop our own vaccines which are tested on our own people and when we do that we manage these pandemics and other diseases better.

LS: Government has announced the school opening date. However, some unions are raising concerns that nothing much has been done to ensure a safe learning environment for learners and educators. 

How can the Education ministry balance the need for learners to return to class vis-à-vis concerns of public health?

MR: When we say that children fight these diseases very easily, the problem now is that it doesn’t mean that these kids don’t get the disease but they can give it to the adults, to the people who are at risk of getting the severe disease.

So that is our fear. Yes, we are saying the children won’t develop symptoms but the problem is that they will give it to adults; they will give it to the next person who is at risk of dying.

Even if we are going to re-open schools or any institutions or universities, I think it’s tricky right now. Yes, we may say we will space the desks but you can’t really control the kids.

I understand also at the same time that education is very key. If children don’t go back to school for long, we are also creating another problem, but we have to strike a balance.

For me as a healthcare person, I can say let’s wait and make sure that we save lives first and resume later.

I think we can compare this situation to a war where school activities get disturbed, and that’s also where we are now. We need to give priority to the health system.

As for education, yes they have to go back to school but at what expense? We might open schools now and two months down the line there is another wave.

We have to wait and make sure that people get vaccinated. We stop this virus and start again.

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