Mission hospitals—efficient, affordable

Joseph Chigova sits forlornly on one of the hard, wooden benches at the casualty department at Howard Mission Hospital in Chiweshe while nurses at the hospital attend to her sick relative.

Howard Mission Hospital, 60km north of the capital Harare, according to statistics obtained from the Ministry of Health and Child Welfare, is one of the 35 mission hospitals in the country.

Chigova has travelled from Mazowe, some 20km away from Howard hospital, where he says government hospitals charge $5 for admission, the same fee as the mission hospital.

At this mission hospital, however, he says service delivery is far much better and medicine is readily available as compared to government hospitals.

“We arrived here around 10am with our sick aunt, but she is receiving treatment now and this is 10.30am. If we had gone to hospitals in Mazowe, maybe we would still be struggling to get treatment because of the reluctance of doctors and nurses there.

“Treatment at these hospitals is by far better than anywhere else. The only problem here is that the nurses and doctors require someone to come and stay with their relative in the same ward, sleeping under his or her bed and assisting whenever possible,” says Chigova.

He adds that when one has a sick relative at this hospital, they work together with the nurses in caring for the sick relative every day.

The situation at Howard hospital is a replica of what is happening at many mission hospitals in the country, including All Souls Mission Hospital in Mutoko and Karanda Mission Hospital in Mt Darwin.

The mission hospitals in the country are reputed for having highly skilled doctors who offer top drawer service and are also well-resourced.

At Howard they have a health insurance system for locals who can bring in maize to the hospital and are registered in a kind of insurance that will allow them to be attended to without paying any money should they get sick.

Though a small amount like $5 can be hard to come by for villagers in the surrounding areas, it is reasonable when one gets treatment from caring staff and when compared to medical bills in other health institutions.

The hospital is headed by Dr Paul Thistle, who works with a support team of four other doctors and several nurses.

An official at the hospital who refused to be named however said the hospital is facing problems in accessing financial resources and they have to rely on donors and Salvation Army, the church that owns the hospital.

“We do not have any ambulance at the hospital currently, we are actually hiring vehicles from other people to do the day-to-day work at the hospital,” the official reveals.

He says the hospital is small to the extent that when people are many they put them on floor beds so that they are accommodated in the hospital.

To alleviate the problem, he adds, a new bigger hospital is currently under construction at the mission.

The hospital also caters for pregnant women by offering them shelter if they are coming from distance places.

Pregnant women bring in their food and clothes and are monitored by health personnel every day.

According to the permanent secretary in the Ministry of Health and Child Welfare, Gerald Gwinji, mission hospitals serve the communities and buoyed the health system at the peak of the crisis in the health industry over the past few years mainly due to shortage of manpower and medical supplies.

Gwinji says services in government hospitals resumed in 2009 and have been on the mend since.

“Government gives financial support to missions on a monthly basis in terms of salaries and allowances,” said Gwinji.“

Over and above the employment costs mission hospitals are availed with recurrent expenses that cover essentials as the management see fit.

However as is the case with all government institutions the level of support has not yet reached desired levels.”

Parirenyatwa Group of Hospitals has 8% more junior doctors than senior doctors while Harare Central Hospital has 54% more junior doctors than senior doctors.

Over the last decade the health sector experienced high levels of staff attrition through resignations and deaths, leaving huge gaps that are difficult to fill due to poor salaries and conditions of services.

“Some health personnel have resigned and settled in other countries within Africa and beyond, while others have remained, not working as health professionals, but doing other economic activities unrelated to their training,” says Gwinji.

He says a deliberate policy made years ago to increase the number of doctors is bearing fruit by producing more doctors but failing to retain senior ones.

Zimbabwe has a total of 35 mission hospitals with an established doctor or more.

“The establishment is 80% filled on average. There are still high vacancy rates for doctors, specialist nurses, radiographers, laboratory scientists and environmental health staff,” adds Gwinji.

He says the health sector currently has a weakened health management as a result of attrition rates of experienced health service and programme managers.

This has an impact on supervision and monitoring, he says, and is evidenced by reduced quality of service.

“We have limited drug availability; we use old, obsolete and non-functional equipment in making diagnoses and we also face shortage of transport.”

Gwinji bemoaned underfunding of the health system with the current budget of $19,70 per head against the World Health Organisation recommendation of at least $34.

“The above challenges will be addressed through the inclusive implementation of the National Health Strategy (2009 to 2013). The combined efforts of individuals, communities, organisations and the government will allow them to participate fully in the socio-economic development of the country,” Gwinji says.

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