ZIMBABWE is facing a drought which at its peak will result in approximately 5,5 million people in rural areas and 2,2 million urban dwellers being food insecure.

The drought is a result of low rains in the 2018/19 farming season and Cyclone Idai which ravaged the eastern parts of the country.  The economic challenges have worsened the food supply situation as prices of basic commodities continue to spiral while salaries remain suppressed. 

While the environment is challenging for ordinary citizens, it is more difficult for those living with chronic illnesses such as tuberculosis (TB) and HIV and Aids as they struggle to maintain balanced diets.

HIV and Aids activist Mr Dumisani Nkomo said food shortage is a affecting some people living with HIV and Aids, resulting in some defaulting on their medication. He urged the Government to provide supplementary food to people living with HIV and Aids for effective intake of their medication.

“The tablets that we are taking demand that someone eats something before taking them. That’s why they have a prescription on them that one should take them after eating. We are now facing a serious challenge as a lot of people are now defaulting on their medication. Individuals now skip taking their tablets due to the unavailability of food. And even when there is food, it’s never enough.  People are defaulting, they are afraid to take their drugs which they have at home because of the medication’s severe side effects if administered on a hungry stomach,” said Mr Nkomo. 

National Aids Council (Nac) Bulawayo provincial manager, Mrs Sinatra Nyathi, noted that nutrition is a very important aspect in treatment although the economic challenges prevailing in the country create a challenge. 

“When you are living with HIV, nutrition is just part of the matrix. That is why we don’t talk about antiretrovirals (ARV) but ART (anti-retroviral therapy). The therapy part also includes nutrition because good nutrition also helps in the administration of the drugs. It helps the general body status. Some people living with HIV are TB patients and TB drugs require very good nutrition and a balanced diet so that they improve quality of life,” said Mrs Nyathi.

She said NAC has no nutritional programme to support those living with HIV or diagnosed with TB. 

“In terms of nutrition, we rely on donors who provide food handouts, because they are also giving grain to the vulnerable families. So when they are screening, we refer the vulnerable HIV positive people to be covered by the Social Welfare and other donors that provide food,” said Mrs Nyathi.

Bulawayo City Council Health Services Director Dr Edwin Sibanda said poor nutrition may suppress an individual’s immunity.

He said council and central Government do not have specific programmes targeting nutritional support to TB, HIV and Aids patients. He notes that without proper nutritional support, the recovery of patients can be compromised. 

 “If someone is malnourished and has TB, the obvious result is that the patient will take longer to recover from symptoms of TB even when they are taking their medication well. When the patients are taking their HIV medication and taking them well, the virus will be suppressed by the drugs but the body will not recover fully. Because if you are to test some of those patients, they will be having a viral load that is not detectable but still have a low CD4 count because the CD4 indicates the immunity competence,” he said.

Dr Sibanda said the value of nutrition in the administration of medicines should not be underestimated as responsiveness to medication is also linked to the food that patients eat.

He said without proper antiretroviral therapy, the third goal of the 90-90-90 target may be difficult to achieve. 

 In 2014, the Joint United Nations Programme on HIV/Aids (UNAids) and partners launched the 90–90–90 targets; the aim was to diagnose 90% of all HIV-positive persons, provide antiretroviral therapy (ART) for 90% of those diagnosed, and achieve viral suppression for 90% of those treated by 2020.

“The viral suppression target by and large relies on people taking their medication properly. Remember I said earlier, that when you take your ARVs properly, what goes down is the amount of virus in their body but the recovery of their immune system which is indicated by the rise of their CD4 count may then lag behind meaning that someone’s virus has almost been eliminated from the body in terms of levels but their immune system has not recovered because of other issues. So this patient may then still be prone to other infections. In other words, dying from opportunistic infections may still continue in spite of someone having a low viral load,” he said.

In light of the drought and economic challenges, Dabane Trust is providing nutritional support to communities in Gwanda, Tsholotsho, Bulilima and Mangwe districts through capacitating them through irrigation garden projects.

Dabane Trust Monitoring and Evaluation officer Mrs Nomvula Woodend said the irrigation projects augment households with nutritional support as well as generating incomes. 

 “This is where communities grow various vegetables using the GROW concept, where we encourage them to grow green, red, orange, white vegetables and legumes to enhance their nutrition and diet at household level. 

“Vegetables grown are for household consumption and for sale. The gardens work with the elderly, widows and vulnerable groups infected and affected by chronic illnesses. Gardens have led to improved wellbeing, enhanced nutrition and diet at household level,” said Mrs Woodend. 

She said the irrigated gardens provide a permanent solution to people’s nutritional challenges instead of handouts from donors. 

Mrs Woodend said in implementing the irrigation gardens, Dabane Trust was also involving Government departments which can impart their expertise while learning from them as well. 

“Nutrition gardens are empowering people. They have gone a long way in enhancing communities’ resilience to the adverse effects of climate change. Dabane Trust conducts various capacity building workshops and through knowledge gained from that, communities are able to improve their access to fresh green vegetables, for their household consumption and sale,” she said.

“This strategy enhances sustainability of development projects. On the other hand donations are once off, and communities are recipients of aid and do not actively and meaningfully participate in the change they want to bring into their lives.” – @nqotshili