Spare a thought for Maidei

Spare a thought for Maidei

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By Martin Takawira

AFTER years of working on HIV/Aids matters at various National Health Service centers in the UK, I came across Maidei.

I diagnosed Maidei HIV positive in 2003. At the point of diagnosis she was very ill, had difficulties in breathing (TB ) and painful feet. She was started on treatment right away. We lost touch as she moved to another part of the country, likewise I also got a job elsewhere.

When I first met Maidei her immigration status was illegal. She saw a solicitor and applied for leave to remain in UK on grounds of her ill health and that if she were to return to Zimbabwe she would be beaten by ZANU (PF) thugs. She had lived in the UK for 18 months prior to diagnosis, a very hard working woman with three children back in Zimbabwe. What she worked for was to send money home to build a house ku Vatsomba (Mutare) and send the kids to a better school whilst supporting her aging mum. Her husband had died in 1998, we now think through an HIV related illness. Does this sound familiar or do you know someone with this kind of background?

We lost contact as said above but my wife who was related to Maidei kept in touch. She had a terrible time with TB treatment and the HIV drugs. She found herself taking a lot of drugs, maybe in excess of 20 per day and had frequent hospital visits and admissions. At this point you must surely have worked out she has completely lost all income. This is now coming to a year since diagnosis, her main problems are difficulties in walking, fatigue, and the anxieties caused by her regular visits to the home office authorities to sign. Her recovery was on course but very slow. The building project is now at stand still and there are now problems with ever rising Zimbabwe school fees.

Her immigration application was turned down so was the appeal and the second appeal but she was requested to report daily or weekly to sign. I am not sure how often people have to sign.

My on take on applications to remain on grounds of ill health is that there was a time when there was no question one would get leave granted with little fuss but things have changed. I honestly don't remember anybody granted leave to remain on this basis in the last 2 years that I have worked on HIV. The reasons given are a) there is HIV treatment in Zimbabwe b) The UK has no obligation to treat the world HIV infection, basically meaning you are an NHS tourist.

There is some HIV treatments in Zimbabwe but not all the current drugs are available. The prices of the drugs are still very high for someone working in Zimbabwe. Maidei does not have any formal qualification, she was a petrol attendant. I am told for a combination of 3 drugs you are looking at paying maybe around $400000 - $500 000, yes not a great deal of money if you have pounds or a good job.

What if there is 2/3 of people in the family infected? The cost of seeing a doctor in Zimbabwe is unbelievable. If you are on HIV drugs you have to have 3 monthly blood tests to ensure that the treatment is working how on earth is one to afford this? I admit maybe back home these don't have to be done so frequently, but why not, if that is the accepted standard in the UK?

A doctor friend of mine in Zimbabwe confess not to have the same expertise as people here due to limited experiences with the HIV drugs. What the British government chooses to ignore is the fact that due to the bad blood between Harare and London, any initiatives centered on helping Africa to fight HIV exclude Zimbabwe yet their Home Office turns round to say there is treatment in Zimbabwe. To successfully treat HIV is not dependent on throwing drugs to the patients, the rest of the infrastructure has to be right, i.e. one's ability to take the pills, availability of food and the issue of drug resistance.

"Maidei does not have any formal qualification, she was a petrol attendant. She now waits to die"

MARTIN TAKAWIRA

Maidei might be an NHS tourist, but balance that against how much we have contributed to the British economy today by working in factories, nursing homes, taxies, securities etc. In my last job we had over 250 Zimbabweans coming to the clinic, by and large very honest hard working people to the extent that there was exploitation. I knew a guy who was in security who had to work 24 hr shifts and he was required to phone his boss every hour to make sure he was awake. Who said slave trade is a thing of the past? To start jumping up and down because Mangamuripi Gumiremakore is being treated for HIV without NHS entitlement is very short sightedness on the part of the British media and the political parties. I was privileged to meet one of the top wigs responsible for sexual health funding in the UK and on asking him whether the treatment of asylum seekers /refugees made any dent to the NHS budget, his answer was "no it doesn't".

Going back to Maidei , on one of her visits to sign with the police she was bundled into a car and taken to a detention center, in no time she was back in Watsomba. This as other people would know is a fast, ruthless process. She finds herself back in Zimbabwe without any treatment, children off school, building project not finished. I have made contact with Maidei, and with her permission I wrote this article. She now awaits to die. The combination she was on is currently not available in Zimbabwe, the doctor she sees now tried to swap to a different combination but Maidei cannot afford it. I am worried that although she had her full course for TB, that might yet come back.

Now if you are faced with this situation and you are still in the UK, what do you do? I am no expert but this is my experience of working in this field for the last 12 years

a) If you don't know your diagnosis and there is a chance of being HIV have a test, it's better to know when you are healthy than when you are unwell. Maidei discovered very late despite the fact that she suspected her husband to have died of HIV.

If you have tested positive encourage a friend to have a test, support them, go with them to clinic.

b) You are entitled to treatment if you have refugee stutus. Current GUM laws allow you to use any name you can dream of, you don't have to use your real name when you attend GUM departments.

c )If there is a good possibility that you may be deported, discuss this with your consultant before you are started on any treatment. The consultant and his/her team can check what is easily available in Zimbabwe and at what cost and make sure you can afford at least 6 months treatment if you get deported. Difficult as it may be, trust at least one person with your diagnosis so they can send you the drugs once you are deported and let that person know your doctor in case you need advise etc whilst you are in Zimbabwe. There tends to be mistrust between patients and Consultants. My experience tells me that at times patients think that the doctors work hand in hand with the Home Office. This is false.

d) People can use voluntary organisations like Terrance Higgings Trust etc, inform them about these things they need to know. Case workers in HIV voluntary organisation are mostly hard working, sincere people but there is always the odd one who may not take you seriously. Ask her / him what they are going to do about the information you have just told them. They are not going to stop your deportation but it is important that these concerns are registered at the highest office.

e) The threat posed by HIV to me is at par to that caused by the current regime to democracy. With that in mind, when we highlight the threat to human life posed by Mugabe regime we should also vigorously bring the HIV menace in our country.
Martin Takawira is a Zimbabwean employed by the NHS specialising in HIV/Aids
CONTACT TAKAWIRA: takawira@hotmail.co.uk
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