The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) would like to announce the withdrawal from the Village Magistrates’ Court the Appeal on Mthandazo Sibanda’s deportation. Whilst it was with shock and dismay that the organization learnt of this development, it respects Mr. Sibanda’s decision.
Sibanda’s decision is based on the harsh reality that being in confinement whilst receiving treatment for a minimum of two years in Botswana, means he is unable to meet his socio-economic obligations to his family. BONELA is disappointed with this decision because Sibanda has resigned himself to death when his disease is curable.
BONELA has established that there is no Multi-drug Resistant Tuberculosis (MDR TB) treatment in Zimbabwe, a fact Sibanda himself is aware of, and that the public health delivery system in that country has collapsed. This poses the risk of MDR TB finding its way back into Botswana, uncontrolled, unmonitored and opening wide a door for Extreme Drug resistant Tuberculosis (XDR TB). This is because TB is a communicable disease and there is high mobility between Botswana and Zimbabwe. BONELA hopes adequate measures will be put in place to ensure Sibanda’s deportation does not pose a risk to both Botswana and Zimbabwe.
The leadership of Botswana has a mandate to reflect on future cases and how they can handle them in a transparent and sustainable manner. There is clearly a need to strike a balance between human rights and public health considerations. Contrary to some reports in the public domain, there is evidence of negligence and medical malpractice as Sibanda’s medical records reveal that he received conflicting HIV diagnoses and his doctor ‘forgot’ to include Amicacin from Sibanda’s treatment regime, making him vulnerable to resistance in the future. BONELA has since confirmed he is HIV negative.
Whether an MDR TB patient is a citizen or a foreigner, they all face serious socio-economic challenges once a patient has to be isolated for a lengthy period of time. Government should consider stepping in to sustain the families of MDR TB patients who are in most cases the breadwinners. The Government of Botswana can consider giving grants to patients on MDR TB treatment so that they can still sustain their families and thereby not resist confinement. We therefore urge the Government of Botswana to expedite inquiry into these issues and possibly upscale its National Response to MDR and XDR TB.
Sibanda’s case is part of BONELA’s bigger campaign to raise awareness about TB and advocate for improved service delivery in TB care. The organisation remains committed to building the capacity of healthcare providers to fully understand the importance of consistent and timeous provision of TB treatment and that patients understand the consequences of treatment and adherence. BONELA therefore continues to emphasise the importance of treatment literacy, both for TB and HIV prevention and care.