Dr Efison Dhodho
BY MUNYARADZI BLESSING DOMA
“Success is not measured by what you accomplish, but by the opposition you have encountered, and the courage with which you have maintained the struggle against overwhelming odds,” the late American inspirational author, Dr Orison Swett Marden once wrote.
His writings were mainly focused on achieving success and the above quotation aptly describes the story of Zimbabwean public health specialist, Dr Efison Dhodho, whose dedication to service and success transcends the unimaginable.
Whilst some of his colleagues decided to opt for greener pastures outside Zimbabwe when the country was going through serious economic challenges, Dr Dhodho decided to stay behind and serve his fellow country men and women.
From being born and raised in Mwenezi where resources were constrained, to surviving pneumonia bouts and going on to become a Doctor, whose dedication to duty still echoes in the villages of Binga; Dr Dhodho’s story is one of determination.
Dr Dhodho wears many hats, as he is the Knowledge Manager for the Zimbabwe College of Public Health Physicians, Director of Strategic Information at OPHID and PhD Researcher at the London School of Hygiene and Tropical Medicine.
From Mwenezi to UZ
“I grew up in the rural areas in Mwenezi and the only time I got to Harare was when I got to UZ (University of Zimbabwe).
“In 1999, I remember dropping off a ZUPCO bus at Churchill Road, close to UZ and dragging my trunk going to the University of Zimbabwe as a student there.
“Now, this moment is still in my mind, because, it’s been a long journey that had been travelled from the extremely remote district of Mwenezi.
“So, I started off my schooling in Mwenezi, at a primary there-there were very few schools there in Mwenezi,” narrated Dr Dhodho.
Dr Dhodho narrated his journey from primary school to high school where he faced many hurdles but managed to overcome as he was determined to becoming a doctor.
He adds: “my mother was a rural nurse, and so I joined to live with her and interestingly, I joined to live with her, because I was a sickling.
“I’m kind of mama’s boy in that sense, we are 13, and I’m the fifth, so the rest of my family members they always lived close to my father, who was a teacher.
“But I was such a sickling, that I had to be moved to stay with my mother, close to the clinic, where I could at least get monthly injections of a very painful benzathine penicillin because of my frequent illnesses with pneumonia.”
The Binga challenges
Despite the challenges that he faced in the early stages of his university journey, Dr Dhodho persevered and completed his studies which led him go to Mpilo Hospital in Bulawayo for his internship. And when he was done, he decided to work in Binga District in 2007 and left in 2010 but he also continued to work in Matabeleland North Province for another two and half years.
For him working in the rural areas was a childhood dream which became a reality, but it also had its fair share of challenges.
In 2008, the antiretroviral treatment (ART) programme in Binga faced many hurdles as only 15 patients were accessing the life-saving anti-retrovirals (ARVs), travelling over 200 kilometres to Hwange for their medication.
He further adds that in the hospital wards, many patients were dying from AIDS and the situation was dire. Dr Dhodho recounted that while ARVs were coming into the country, transport to get them to the people remained a challenge.
“But how do we deliver them (ARVs) to such a population which is vastly populated, there was no transport at that time, you would get a car here and there.
“So what did I decide to do? The policy at that time was that you could only provide ARVs at a hospital, back then no clinic was offering ARVs.
“I said this does not work; people are still dying. I remember I had to meet Chiefs, because HIV had a lot of stigma. I had to meet Chiefs myself. And I told those Chiefs that I’m going to be taking care of your people. I want to give them ARVs. I need your permission and your support because we are going to do this in an unconventional way. And as for you Chiefs, you are going to lead this way.
“I want you to be tested for HIV and I’m going to test you myself, no one will know your results.
“It will just be between me and yourself,” he recounted.
As if that is not enough, Binga also posed personal challenges for him, as his wife got malaria in the first week of staying there.
“You know it’s difficult to separate one’s family experience and personal experience from your work experience.
“When I went to Binga, I had a six-month-old daughter and my wife grew up in Marondera, so she had never lived in a malarious area.
“One of the things that happened when we got there is within the first week, my wife was down with malaria.
“And so you can imagine what that meant, and so it was really a shock. So at a personal level, it was challenging, but we had a shared burden, that’s the other thing,” he narrated.
The determination to make a difference
Despite the challenges he faced in Binga, Dr Dhodho strongly believed in making a difference as he further appreciates his background, which made him to understand the living conditions of being in extreme low resource settings.
He adds that such settings push you to innovate, hence they managed to succeed.
“We had a shared burden and we said, we can make a difference here.
“So you see, one of the most powerful motivations and rewards in those settings is the fact that you see the difference that you make, like it’s so visible.
“When you operate on a pregnant woman who was going to die and you see the baby, the level of satisfaction that you get is too much.
“And for me also being able to deliver those services was very encouraging and very rewarding. The appreciation was just very loud.
“The people in Binga are so warm you know and the smiles, the joy.
“In some villages where we went for example, to one of the clinics, we found more than 500 people waiting for us with 48 Village Heads, it just gets to you. So it was overall very, very satisfying,” he added.
Dr Dhodho and his team decided to work closely with the community and they engaged Traditional Chiefs to lead from the front by getting tested for HIV and the impact was phenomenal.
The impact of a decentralised ART delivery system
While the situation was dire when Dr Dhodho arrived in Binga, he revealed that along with his team, they responded with an innovative outreach model that decentralised ART delivery, taking services directly to patients in their communities. Chiefs fully supported the team’s HIV fight as they mobilised members of the community to get tested. This received enormous support and within six months, the number of people on ART increased from 15 to 1 200 which demonstrated the impact of context-specific solutions. The loss-to-follow up rate was less than 5 percent.
“And the Chiefs were tested and after that, they mobilized their people.
“And we then made appointments to the Chiefs. So we would go to a clinic and the Chief would be waiting for us together with all the Headmen in their community. We would test people.
“We would be there at times until 9pm using the car lights. We would test people, put them on ARVs. And guess what? The wards began to empty.
“You no longer had people dying in the hospital. This attracted so much attention that I was invited back then to present at a conference on how we have been able to deliver ARVs so fast in such a remote community. And thankfully, the Ministry of Health then decided to say, you know, this model can help us to scale up ART very fast.
“So outreach became a model that managed to scale up ART very fast all around the country,” he further narrated.
Dr Dhodho’s work showcases how determination and innovation can address complex health challenges and reshape healthcare delivery.
By learning from these lessons, health systems worldwide can discover new ways to provide equitable, sustainable care for all.
And while personal struggles can be overwhelming, Dr Dhodho was not to be deterred from true dedication to service.
From a young age back then in Mwenezi, he was determined, strongly believing that one day he would become a doctor.
And not only did he achieve his childhood dream, but he also selflessly served the people of Binga and it was that determination which became a game changer not only in that community, but the nation at large.
