A hot wind blows over parched land in eastern Zimbabwe on a mid-November day, as Smart Sithole walks into a clinic with some difficulty. The temperature is not the only reason that the 56-year-old is using a cloth to wipe away the beads of sweat trickling down his face.

Sithole has been struggling with dizziness and chest pain for weeks, and nurses from a rural council-owned clinic had advised him to come in and see a doctor at this private health facility in Chakohwa, about 73 kilometres from Zimbabwe’s third-largest city, Mutare.

“In the first half year of 2025 we aim to double consultations to 4,000 and screen at least 50,000 clients.”

– Dr Admore Jokwiro, chief medical officer and co-founder at ZimSmart Villages

But “seeing the doctor” has an unconventional meaning on this day. The consultation will take place online.

He was hesitant at first, Sithole says. But he was also in pain and wanted answers, so he agreed to dial in to discuss his symptoms via video call with a physician in the city. “I am not used to this,” Sithole remarked.

On the doctor’s orders, tests were carried out by nursing staff. After that, the doctor confirmed that Sithole had high blood pressure, and whisked through a prescription to treat it.

“I went to buy tablets from a nearby pharmacy. I took the high blood pressure medicines for the first time in my life,” said the father of four, adding that he was feeling better just a few weeks later.

Taking advantage of satellite internet

Zimbabwe has just 1.7 doctors per 100,000 people – less than the African mean of 2.6, and way under the World Health Organization’s recommendation, which is for a physician density of 1 doctor per 1000 people.

Sithole’s experience is not a solution – but it’s a useful patch. Telehealth or telemedicine, the use of information and communications technology to provide clinical services when a doctor and a patient are at different locations, is being rolled out across the country by ZimSmart Villages, a Zimbabwe tech organisation working together with the Health Ministry and local telecom companies.

With this technology, patients from remote areas can speak to doctors in cities like Mutare or the capital, Harare, via an online platform called BatsiHealth, at various internet-enabled kiosks, booths and centres.

Poor internet and high data costs have been barriers to telehealth in Zimbabwe, a country that has some of the most expensive internet in the region. This is changing after the government in May licensed Starlink, the Elon Musk-owned satellite network using a low Earth orbit to deliver broadband internet around the world, including in remote areas that have struggled for access previously.

ZimSmart Villages, which has been setting up e-health centres in Zimbabwe since February, now has two of its 17 centres now connected to Starlink’s high-speed internet.

Dr Admore Jokwiro, chief medical officer and co-founder at ZimSmart Villages, says his organisation is “democratising access to health care” by providing remote consultations live from telehealth kiosks, remote diagnostics through point-of-care devices and remote monitoring through a virtual hospital network led by trained nurses.

ZimSmart Villages also provides screening for conditions like stroke and diabetes.

“Through our service offering, we are enabling access to early identification of chronic illnesses and enrolment into care, which prevents medical complications and reduces morbidity and crude death rate,” Jokwiro says.

According to ZimSmart Villages, they are starting with underserved areas, dominantly including rural areas and peri-urban zones. Still, in time they will also set up kiosks in underserved locations in urban areas.

Improving health access

Stanley Mukwambo suffered a stroke in 2017, and he has been feeling dizzy and struggling with hiccups and constipation for over a year now.

Just like Sithole, 74-year-old father of four Mukwambo consulted a doctor online in the first week of November.

He was prescribed medicine and asked to come back for review two weeks later.

Mukwambo’s wife, Susan Zinyawo, 44, says the symptoms continued to be grave. “The nurses used an intravenous drip on him. He could not take some of the medicine orally so they used injections,” she tells VaccinesWork.

At the two-week review appointment, his condition had barely changed, so the doctor changed Mukwambo’s medication pending another review.

The distant doctors are not flying blind. “Nurses also speak to doctors via a video call to get instructions on what to administer to the patient,” says Otilia Mbano, a retired nurse who established the clinic where both Mukwambo and Sithole were treated.

“We do investigations and tests like a full blood count, red blood cell count, urinalysis and blood glucose levels. We also use X-rays for examinations.”

Mbano says the telehealth appointments save people time and costs of travelling to Harare or Mutare to consult doctors. Consultation fees online range from US$ 5 to US$ 10.

Systemic issues, opportunistic fixes

Zimbabwe has been struggling with sluggish economic growth that has left hospitals dysfunctional, with shortages of medicine and health workers. The southern African nation has a shortfall of 64,000 health care workers and needs to double the workforce by 2028 to meet the health care needs of its citizens, according to Health Minister Douglas Mombeshora.

Itai Rusike, executive director at Community Working Group on Health (CWGH), says telehealth can be vital during pandemics like COVID-19 to allow primary care providers to continue providing medical care to their patients.

“But the successful implementation of telehealth requires adequate data infrastructures, adequate and well-trained staff, and clear management and communication protocols in dealing with patients,” he says.

Meantime, however, telehealth is growing. In the last six months, 1,800 telehealth consultations have been conducted and over 5,000 visits for blood pressure and blood glucose checks, says ZimSmart Villages’ Jokwiro.

“In the first half year of 2025 we aim to double consultations to 4,000 and screen at least 50,000 clients,” he says.

Back in Chakohwa, Sithole – who is unemployed – is taking his daily medication for high blood pressure.

“I am getting better every day. Given my financial status I was not going to afford to travel to Mutare just for consultation,” he says.

© Copyright The Zimbabwean. All rights reserved. Provided by SyndiGate Media Inc. (Syndigate.info).