Fighting stigmas: drug use and healthcare

In 2020, a drug withdrawal programme was launched at Moses Mabhida Stadium, where members of the homeless community were sheltered as the Covid-19 pandemic broke out. At the time, about 260 people elected to start methadone treatment. Now, two years later, patients continue to visit the Bellhaven Harm Reduction Centre every day. In a weekly series, Berea Mail’s Danica Hansen will find out more about the programme. This week, she chats to Mandisi Manzi who works to gather data to improve healthcare facilities for drug abusers.

A DECADE of drug use tore Mandisi Manzi’s life apart. He spent time behind bars, survived a gunshot wound and braved life on the Durban streets, grappling with drug abuse with mandrax, rock and whoonga. Whoonga is a form of heroin, sometimes mixed with other substances. Today, the father of two has a new lease on life, working as a provincial key populations monitor for the national organisation, Ritshidze, which means ‘Saving Our Lives’ in TshiVenda.

As a monitor, Manzi visits various communities to gather data on access to healthcare for marginalised groups or ‘key populations’, including people who use drugs (pwuds).

“I work with groups that are stigmatised. If people are facing challenges accessing health facilities, somebody must intervene,” he said.

On a typical day, he will gather testimonies from five people, covering a wide area in the eThekwini District, spanning from Durban’s city centre to Umlazi, KwaMashu, Inanda, Phoenix, Verulam and beyond.

“I monitor patient care at facilities to find out if pwuds are facing any challenges accessing facilities because nurses sometimes give pwuds less attention,” said Manzi.

Manzi believes he was stigmatised as a drug user when he sought medical treatment after suffering a gunshot wound to his leg in 2013.

“The bullet was not removed from my leg straight away. I was given an injection and medication. I was in pain the whole night until an ambulance arrived the next day. I was taken to hospital and again waited the whole day, into the evening. I was assisted at about 5pm,” he said.

ALSO READ: Drug-free after a 15-year battle

He continues to struggle with pain in his leg, some nine years after the injury.

Access to methadone

For Manzi, a lack of access to methadone treatment is another form of stigmatisation. He described Bellhaven Harm Reduction Centre as a ‘lifesaver’, saying he heard about the centre while living on the Durban streets in 2020 after the Covid-19 pandemic broke out.

“When I was released from jail, I went back to the streets and met some friends who were smoking whoonga. I started smoking again. After a few weeks, I heard some people saying they were going to Bellhaven to take methadone. In the previous year, my family bought me methadone many times, and I knew it was costly, so I was not convinced there was a place where you could get free methadone,” he said.

Manzi said a 60ml bottle of Methadone cost R200, including the prescription, and lasted just a week – making it near impossible to sustain methadone treatment which usually spans at least a year with daily doses. He started going to the Bellhaven Harm Reduction Centre in August 2020 and continues to take a low dose of methadone today.
“Methadone gives me a guideline to straighten my path. It gives me energy to do my job,” said Manzi.

Now he is working toward a brighter future for his daughter (12) and son (10).

“My dream for the future is to leave a legacy for my children. I know I have messed up my life. Now, I have to think about those who are coming after me – to get them on the right path,” said Manzi.

Family tragedy

Tragedy struck early in Manzi’s life when his parents passed away. He was nine years old when he lost his mother and 10 when his father passed away.

“From that point, I didn’t have someone to call a mother or a father. I had a lot of anger and no shoulder to cry on. I had two younger sisters and no idea what path we were on – there was a lot of pressure,” he said.

He and his sisters were moved from their home in Avoca, north of Durban, to live with their family in Inanda – a volatile move that shook Manzi’s world.

“Inanda is a very cruel environment to raise a child in. It’s where my life started to change. I met people who were smoking weed and felt pressure to join them to earn their respect. When I moved there, they used to call me a mamma’s boy,” said Manzi.

ALSO READ: Methadone programme transforms lives

It was in 2010, as a matric learner grappling with challenges that Manzi first smoked whoonga.

“All the tragedy and the pain caught up with me. After my parents passed away, we became so poor – some nights we slept with no food in our stomachs. We went to school with nothing to eat,” recalled Manzi.

He later took rock cocaine and mandrax before turning to methadone treatment to turn his life around.

Ritshidze was developed by people living with HIV with the aim to improve overall HIV and TB service delivery in the country. Ritshidze monitoring takes place on a quarterly basis at 400 clinics and community healthcare centres, across 27 districts in eight provinces in South Africa. For more information, email ritshidze-comms@tac.org.za, call 011 100 4721 or visit the website: www.ritshidze.org.za.

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