Saturday, January 16, 2021

Botswana faces imported multiple drug resistant TB crisis

A High Court landmark case in which a Zimbabwean multiple drug resistant TB patient is challenging his deportation from Botswana has sparked fears that Botswana may be sitting on a major public health hazard because of its decision to exclude immigrants from government free medical services.

Immigrants are excluded from the government free public health system and the rules cannot be bent, even when they are suffering from tuberculosis, the highly infectious disease for which medication, along with housing, food and clean clothes, can mean the difference between life and death.

Zimbabwean illegal immigrants do not have work and resident permits. They live underground, fearful of being forcefully returned to Zimbabwe if found out by immigration officers and cannot access government free medical support. There are fears that hundreds and even thousands may be infected with TB and have been forced underground where their virus is festering into Multiple Drug Resistant TB which could spread to citizens.

Details emerging from the case of Mthandazo Sibanda, who is challenging Botswana’s decision to deport him because he has multiple drug resistant TB and has not been on medication, highlighted the hidden and often shocking world inhabited by destitute Zimbabwean immigrants and how their exclusion from the free public health system may spread the deadly TB strain.
Court records detail how Sibanda, who tried to pay for the TB treatment out of his pocket, ultimately gave up after he was prescribed the wrong medication and left to manage his own dosage, which is in violation of the guidelines outlined in the Direct Observation Treatment, the standard and practice for persons afflicted with TB.

Before he was bundled by police officers and put up in a Gaborone Prisons clinic, he was adrift somewhere in Mahalapye where the treatment was discontinued and it is feared may have infected others.
Health officials told Sunday Standard that Sibanda’s case is far from unique.

They explained that while Sibanda had residence papers, most Zimbabwean immigrants are illegal and have sunk out of view of normal society. They stay in crowded squats where up to 15 people share one small room and they keep their TB status underground with them.
They expressed concern the government is keen to restrict foreigners to emergency-only public health facilities use, which will simply push the TB problem further underground.
“Closing down access to public health services is a worrying development, and, particularly in terms of TB, has serious public health implications.”

There aren’t any official figures on numbers of Zimbabwean migrants with TB, but health workers say cases are on the increase. Figures from the Ministry of Health show that TB infections in Botswana are on the rise, especially on the back of the HIV/AIDS pandemic. With the number of illegal immigrants growing in the wake of Zimbabwe’s political and economic meltdown, there are fears that the imported TB virus is being kept underground where it is festering into multiple drug resistant TB posing a public hazard to Batswana who come into contact with the infected immigrants.
Sibanda has filed an urgent application before Justice Abednico Tafa challenging the Ministry of Health to show cause why he could not be released from the prison clinic to a medical facility preferably Princess Marina Hospital where he can be kept in isolation for the protection of himself and Batswana pending the outcome of his appeal against the deportation order.

He also wants the Ministry to show cause why he can not be provided with the necessary Multi drug resistance Tuberculosis treatment pending the outcome of the appeal. Sibanda also challenges the Attorney General, Ministry of Health and the Department of Immigration to show cause why they should not be ordered to pay costs of the application on an attorney client scale and that the order being prayed for be issued urgently. He has in the meanwhile appealed against the Immigration department’s decision to deport him arguing that he was improperly declared a prohibited immigrant because he was diagnosed with tuberculosis.

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