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Breaking barriers: How Dr. Efison Dhodho revolutionized ART access in rural Zimbabwe for HIV treatment

FADZAI NDANGANA 

As dawn broke over the rugged landscapes of Binga, the sun painted the horizon with hues of gold and orange, casting a soft glow on the earth below. The air was crisp and filled with the promise of a new day. In a modest home nestled in the heart of this rural area, Dr. Efison Dhodho awoke with a sense of purpose that coursed through his veins like a lifeline. Today, like every day, he would step into the community, ever-ready to make a difference. 


How Dr Efison Dhodho improved ART access in rural Zimbabwe, binga


Dr. Dhodho's morning routine was a blissful conflation of ritual and reflection. He savoured a simple breakfast, his mind racing with thoughts of the patients he would meet and the challenges they faced. Each day began with a commitment to transforming the healthcare landscape in Binga—a place where access to life-saving treatments was once a distant dream for many. 

The lively beauty of the community was often overshadowed by the harsh realities of health inequities, and he felt a deep-seated responsibility to address them. 

In 2008, the Antiretroviral Therapy (ART) program in Binga faced a dire situation. Only 15 patients were accessing vital medications, many traveling over 200 kilometers to Hwange for their treatments. The wards were filled with patients succumbing to AIDS, and hope was dwindling. 

Dr. Dhodho, with his innovative mindset, spearheaded an outreach model that brought ART services directly into the heart of communities. Within six months, the number of patients on ART skyrocketed from 15 to over 1,200, a remarkable achievement that transformed the lives of countless individuals. Today, thousands of people in Binga access ART, significantly contributing to Zimbabwe’s overall progress in the fight against HIV/AIDS. 

"So when one of the things that I did is I learned a lot of lessons from. Remember, my mother was a nurse, so I knew that there was a lot of knowledge, community knowledge, which nurses have. So I sat down with the community health nurses at Binga and I said, how do we reach people? And they said, no. When we are mobilizing for epi, we use gatekeepers," Dr. Dhodho recalled. 

Understanding the nuances of the community was essential, especially when addressing the stigma surrounding HIV. Dr. And to this end he recognized the huge importance of engaging local leaders. 

He explained: "We speak to the traditional leaders. And so HIV is a different world altogether, though, so you need to destroy these layers of stigma. And so that's why I decided to say in engaging the chiefs, because there's this respect which you have as a doctor serving in a community. So if I was to send just the nurses to speak to the chiefs, there could be issues. I say, you know what? On this one, just coach me on how you engage them. Because remember, Binga, it was Tonga speaking. I was still learning the language, so they helped me."

Dr. Dhodho’s cultural humility played a crucial role in breaking down barriers. 

"I would say, when you fail to engage using language, you can engage using cultural humility. In other words, I will make it very graphic. The way I would greet an older woman when she walked into my consultation room, the way I would look up and greet her, even if I had an interpreter initially, she would feel or experience the respect such that the words would not then affect that. Now, that's different from someone who does not have an appreciation of our best Ubuntu fundamental culture. They will fail then to have that," he shared. 

With the support of community health nurses and local leaders, Dr. Dhodho's efforts were met with remarkable success. His outreach model not only increased the number of patients receiving ART but also dismantled the stigma surrounding HIV. The community began to see the value in seeking treatment and discussing health openly, a significant cultural shift that paved the way for further innovations in healthcare delivery. 

Dr. Dhodho often found himself embraced by the community he served. 

"I can tell you that when I was engaging with the chiefs, for example, I know myself from where I grew up how we would treat vana Sabhuku, know how to treat Vashe," he remarked. 

"So I would actually, in fact, they really loved me. They really loved me because one particular chief almost wanted to offer me his daughter to say, marry my daughter. You know, it's just one of those things that happen." 

His leadership at OPHID led to the creation of the Community T-MIS system, a geospatial tool designed to optimize healthcare delivery for underserved populations. This innovative approach has now supported over 300,000 individuals living with HIV, illustrating the power of technology when aligned with community needs. 

As he continues to find his way through the complexities of healthcare in Binga, Dr. Dhodho still embodies the spirit of resilience, ingenuity, and hope. 

His journey illustrates that great talent can emerge from the least expected places, fueled by a commitment to serve and empower. Each day, as he walks through the village, he carries with him the dreams of countless individuals, inspiring them to believe in a healthier future. 

Dr. Efison Dhodho remains a thread of transformation, weaving an optimistic narrative that resonates far beyond the borders of Zimbabwe. 

His story is a testament to the power of local solutions, underscoring that with sufficient doses of determination and innovation, equitable access to healthcare can become a reality for all.

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