Online Reporter
Rumbi Zinyuke-Health Buzz
In Zimbabwe, access to quality healthcare remains a vital component of a thriving population.
Yet for many living in rural areas, this goal remains out of reach. With 67 percent of the population residing in rural communities, limited infrastructure and scarce resources have created barriers to healthcare access.
In some areas, the challenges are further compounded by the vast distances patients must travel to seek care, often through difficult terrain.
As many communities face such challenges, innovative solutions are critical tools which can bridge the gap and transform rural healthcare delivery.
This is being done through a combination of Government initiatives, international aid, and the tireless efforts of individuals dedicated to improving the lives of underserved communities has become a beacon of hope for millions.
Among such people is Dr Efison Dhodho, a public health specialist who has made a difference in rural communities over the years.
He is the knowledge manager for the Zimbabwe College of Public Health Physicians, director of strategic information at OPHID, and PhD Researcher at the London School of Hygiene and Tropical Medicine.
Dr Dhodho’s work shows that tackling tough problems through innovation can lead to big, positive changes.
His journey began in Mwenezi, where he lived with his mother, a nurse at a small rural clinic.
Being able to witness the difference made by his mother; a midwife, in the lives of many women who delivered at the clinic drove his resolve to work with underserved communities.
“There was no doctor in Mwenezi at that time because there was no hospital. But seeing the work my mother and other nurses did ignited a desire to say I want to make a difference here,” he recalls.
His determination saw him thriving in schools that were remote and under-resourced. He even had to teach himself at one point as his school did not have a biology teacher.
In 1999, he set his foot in Harare for the first time as a medical student at the University of Zimbabwe.
Despite the many setbacks he faced during this period, Dr Dhodho successfully completed his training.
“I was deployed to Bulawayo for my housemanship. This sent me to Mpilo Hospital, which catered for rural Matabeleland. On one hand I was happy that I was going to serve the rural people as was always my wish, on the other hand, I did not know the language. But just the happiness that I would be able to meet with people from all the rural areas was enough and in a few months the isiNdebele was kicking in,” he said.
In 2007, he was done with his housemanship, and had to make another decision: “where to from here?”
Half of his class had left the country to go and practice in Namibia, Lesotho and other countries but for Dr Dhodho, the universe had already made the choice for him.
He remembered his earlier commitment to bring better healthcare to rural communities.
His next destination was Binga.
What he discovered when he got there was that despite being remote, Mwenezi was even more advanced than Binga.
“Binga had 11 clinics for a population of 140 000 and the furthest clinic was 230 km away from the hospital. Every clinic was not reachable, there was no network and for one to call using a cell phone, he/she needed to get a Zambian line. So we used to communicate using the Save the Children radios. This was a low resource setting and that is when I began to learn to innovate, push boundaries and think outside the box for to succeed in such areas,” Dr Dhodho recalls.
In 2008, the ART programme in Binga District faced significant hurdles.
Only 15 patients were accessing life-saving antiretroviral (ARVs), travelling over 200km to Hwange for their medication. Hospital wards were full of patients dying from AIDS, and the situation seemed dire.
That is when he decided to break new ground.
“The policy at that time was that ARVS were only provided at a hospital, so no clinic was offering the drugs and for me it did not work. So with my team, we decided to engage. I remember meeting chiefs because HIV was surrounded with stigma in those days. I told them I would be taking care of their people, giving them ARVs and I requested their permission and support because we were going to do this in an unconventional way.
“I told them I wanted them to lead and get tested for HIV and I would test them myself. I assured them that no one would know their results, it would just be between me and them. The chiefs were tested and after that, they mobilised their people. We would go to a clinic and find the chief, the headman and the people waiting for us. Sometimes we would work until 9pm using the car lights testing people and putting them on ART. And guess what, we no longer saw that many people dying in the hospital,” he said.
Within the first month, the number of people on ART had increased from 15 to 1 200 with a loss-to-follow-up rate of less than 5 percent.
This model was so successful that it was showcased at the 2010 SAfAIDS Regional Conference and adopted by the Ministry of Health and Child Care as a national approach. It exemplified how tailoring solutions to local realities could address even the most pressing health challenges.
Besides the innovations in HIV response, Dr Dhodho also successfully spearheaded the Matabeleland North provincial malaria response.
The province recorded one of its worst malaria outbreaks in 2010 where 42 children under the age of 14 died within a period of two weeks.
At the centre of it all was limited access to care.
“Some villagers had to travel 42 km to reach a clinic. We decided to train village health workers(VHWs)to diagnose and treat malaria. We trained the first batch of VHWs, and the results were remarkable and immediate. I was asked to present at the National Malaria Management subcommittee meeting in Harare and again our intervention was adopted as national policy, to say let us allow village health workers to treat and manage malaria,” added Dr Dhodho.
His journey led him to the Organisation for Public Health Interventions (OPHID) where he is currently working on designing systems that work for the most remote and unreachable communities in support of the Ministry of Health.
His leadership at OPHID resulted in the creation of the Community T-MIS system, a geospatially enabled tool that optimises healthcare delivery for underserved populations. Recognised internationally, the system now supports over 300 000 people living with HIV.
“These innovations prove that technology, when aligned with community needs, can break down barriers and ensure equitable healthcare access. All this comes from my understanding of how healthcare is delivered in extremely low resource settings and how you have to tailor anything you do to fit not just what the people need but to work with them.
“It is different when you go and get a system designed in other countries where they know nothing about what is happening in those areas. But we see it, we have lived there, worked there, so when we develop things there, it makes a huge difference,” said Dr Dhodho.
The story of healthcare innovation is one of resilience, ingenuity, and hope.
Dr Dhodho’s work stands as a testament to the impact community engagement can have on a nation’s vulnerable communities.
His efforts not only saved lives but also inspired hope and set an example for others to follow. As Zimbabwe continues its journey toward universal healthcare, his contributions remain an integral part of the story.
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daniel chigunwe
