Rocinantes eases TB diagnosis, treatment in Chibombo, Chisamba

By Hlupekile Nkunika When 54-year-old Sylvester Shimukuni of Chibombo district first developed chest pains and a persistent cough in 2024, he did not pay much attention to it because he thought it was merely a stubborn cough that would eventually disappear. But instead of getting better, his condition continued to deteriorate. The cough became worse, […]

By Hlupekile Nkunika

When 54-year-old Sylvester Shimukuni of Chibombo district first developed chest pains and a persistent cough in 2024, he did not pay much attention to it because he thought it was merely a stubborn cough that would eventually disappear.

But instead of getting better, his condition continued to deteriorate. The cough became worse, accompanied by night sweats, shortness of breath and loss of appetite and weight. Within two months, Sylvester had lost five kilogrammes, and his once healthy-looking appearance had changed, leaving his skin noticeably darker.

“By this time, I had tried taking different cough syrups and antibiotics with no improvements. I was referred to Liteta hospital which is more than 30 kilometers from my village,” he explains.

Shimukuni went back home and waited for about two weeks to raise money for transport to Liteta.

“I had to start asking for money from my relatives before I could travel, so I delayed going to the hospital, a situation which worsened my condition,” he narrates.

Medics confirmed that he had tuberculosis (TB) and was immediately enrolled for treatment.

The road to treatment was not an easy one as he had to frequently travel to Liteta for other tests and reviews.

A peasant farmer without a stable income, Shimukuni missed doctor’s appointments on two occasions because he did not have money for transport to Liteta.

His story mirrors thousands of people living in rural Zambia who find it difficult to access timely TB diagnosis and treatment.

Long distances to health facilities, costly transport, limited diagnostic equipment and, in many cases, little awareness about the disease affect such communities.

For many families, these barriers delay diagnosis, prolong suffering, and continue transmission of TB within households and communities. Some patients walk for many hours in search of medical care. Others wait until their condition becomes critical before seeking treatment.

But in Chisamba and Chibombo districts of Central Zambia, the Ministry of Health has been working with Rocinantes, a Japanese international healthcare non-governmental organisation (NGO) that builds sustainable medical and health systems in rural communities to improve access to quality TB diagnostic services and maternal healthcare.

The organisation has supported the construction of a dedicated chest clinic at Mwachisompola, and the establishment of a chest clinic at Chisamba Rural Health Centre (RHC).

According to Central Province Health Director, Elijah Mutoloki, Rocinantes also supported the training of healthcare workers and Community-Based Volunteers (CBVs) at Liteta, Chikonkomene, Mwachisompola, Chisamba and Mwanjuni health facilities.

Dr Mutoloki states that the partnership between the organisation and the Ministry of Health also facilitated the procurement of mobile digital X-ray machines and two vehicles for the two districts.

“This has improved TB screening services at both facility and community levels. The facilities have adequate equipment while our outreach services have also improved. We are now able to screen within the community and advise patients on the next course of action, depending on the results,” Dr. Mutoloki explains.

He further says Rocinantes was also proactive in supporting the chest X-ray interpretation training for health facility staff and X-ray operation training to newly-deployed radiographers in Chisamba and Chibombo districts.

Driven by a commitment to strengthen health systems in underserved communities, the organisation invested in a project to improve healthcare in maternal health and TB in 2019.

Dr Naoyuki Kawahara, President of Rocinantes, says the organisation chose to work in Zambia owing it the peaceful environment.

“We realised that despite the peaceful atmosphere, the country still has challenges in delivering quality healthcare. This is why we decided to work with the Zambian government to improve health systems in maternal health and TB in Chisamba and Chibombo districts,” states Dr Kawahara, adding that the priority was to improve maternal health care.

“We started in 2019 at Mwampula where we built a mother’s shelter, then we moved to Chikonkomene where we built another mother’s shelter. We also invested in TB screening by equipping some health facilities with X-ray machines as well as providing digital ones to enhance outreach TB services,” he reveals.

Owing to the support, some TB patients in Chibombo and Chisamba districts have timely access to diagnostic and treatment services.

For Mackenzie Mweene, aged 44years of Chibombo, who developed TB symptoms in February this year, the road was smooth as help came in good time.

He narrates that a Community-Based Volunteer (CBV) noticed his deteriorating health and gently encouraged him to seek medical attention, including TB screening.

“Looking at my appearance, she advised that I get tested. She told me that she could help by collecting my sputum for testing before I get further medical guidance,” Mweene recalls.

Three days after collecting his sputum, the CBV returned with advice that would change the course of his illness. The volunteer urged him to go to the health facility for further screening and X-ray.

Mweene heeded to the advice and went to Mwachisompola first level hospital where results confirmed he had tuberculosis.

He was immediately enrolled on TB treatment, which was the beginning of his journey to recovery as the treatment soon began to make a difference.

“Within three weeks, the fever, night sweats, appetite and general strength improved,” he says.

Though many say, it takes about six months for one to fully recover from TB, Mweene says he fully recovered within three months.

“I think it is because I was diagnosed at a good time, as I started treatment before my condition got worse,” he states.

Mweene’s story also underscores the important role which CBVs play in identifying people with possible TB symptoms, encouraging them to seek testing and helping them access treatment before the disease becomes severe.

Mwachisompola first level hospital In-Charge, Mungufulwa Lichaha observes that Rocinantes helped improve TB screening at the facility through the provision of diagnostic equipment and training of both healthcare workers and CBVs.

Dr Lichaha says the facility has so far recorded an improved diagnosis and treatment of complicated TB related cases.

“The abnormal build-up of excess fluid between the thin membranes that line the lungs and the inside of the chest wall, referred to as pleural effusions in medical terms, is among the complications we are now able to screen and treat with ease,” says Dr Lichaha.

He observes that the TB cure rate in the area has improved.

“And those living with TB patients are also given medication for prevention of the disease,” he reveals.

Chibombo District Health Officer, Hendrix Yona, is equally happy to note that more and more people in the district are being screened for TB before their symptoms become severe, a situation which has increased chances for early detection and successful treatment.

Dr Yona discloses that Rocinantes procured two X-ray machines and a motor vehicle to ease the delivery of healthcare especially among TB and maternal health issues.

With better diagnostic equipment, trained health workers, mobile screening services and the support of Community-Based Volunteers, more people in Chibombo and Chisamba districts are being identified and treated before the disease becomes life-threatening.