Until a few weeks ago, Gogo Esther*, an elderly hypertensive patient at our surgery had been well controlled and enjoying good health save for the occasional aches and pains of arthritis. She was diagnosed of hypertension 20 years ago and has been on her current medication for 10 years, doing very well. She never got tired of praising her son in law who had given her “the card” that saved her life (medical aid).
Two weeks ago she walked into our rooms with a severe headache and very high blood pressure. Apparently she had not taken her medication for 3 days. I have known Gogo for many years and I have never known her to default her medication. Something had gone wrong, and she was just an unfortunate victim, not just herself but a lot more like her who suffer from all kinds of chronic illnesses.
Like every other sector of the Zimbabwean economy, the health sector was not spared the recent speculation and uncertainty in pricing that was triggered by a monetary policy released by the central bank governor. Pharmaceutical companies increased their prices by at least 400% without any warning. The original prices were maintained for those who had access to the American dollar. Medical aid cover is currently not being accepted.
In the three days that Gogo had not taken her medicine, she had walked all around town trying to get her BP pills. They were either out of stock or too expensive for her or her son in law who usually takes good care of her health needs. She had no choice but to come back for a change of prescription. In the last 2 weeks at least 10 patients have requested to have their prescriptions changed to something that is available locally or cheaper. Others have contacted their relatives in the diaspora to send them their medicine.
There is a well known rule in team sports which says you shouldn’t tinker with a winning team, and an English saying which goes, “if it’s not broken don’t fix it”. In the management of hypertension, the same rules generally apply. Save for poor control or adverse effects, we try as much as possible to keep patients on whatever is working best for them. I hope that for Gogo Esther and everyone else who has had their medication interrupted in this current moment of madness, it will not have lasting effects. A few days ago there was a message on Twitter of someone who couldn’t find their insulin for diabetes in pharmacies. It was then that I realized that while political chess was being played at the top, there were people at the very bottom at risk of dying.
For those with relatives on medication for chronic illness, it might help if you just get in touch with them. Find out if they are ok or if they need a refill. If things are tough for someone in Harare, imagine your Gogo in Tsholotsho, Muzarabani or Binga. Gogo Esther summed it up very well when she said to me, “madhora ndinomawanepi nhai mwanangu, ivo vanotonga ndovachasara vari vapenyu.” (My son, where will I find US dollars, only those in power will remain alive).