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HTF bails out rural hospitals

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It’s 10:20am, but the heat is already enough to melt someone.

REPORT BY GARIKAI TUNHIRA

On a hot Wednesday morning, we get to Ndanga Rural District Hospital in Jerera, Masvingo Province, on a field trip organised by the Ministry of Health and Child Care in conjunction with the United Nations Children’s Fund (Unicef).

Had it been 2008, the year when the country suffered the worst financial crisis, we would have been met by a long queue at the reception, children crying from the long waits for service — if at all it came — and shrieking sounds of the cicadas from the blazing heat.

But on our arrival at Ndanga, a number of patients are seated at the reception and we wait for about 10 minutes more at the reception as Masvingo Provincial Hospital public relations officer Ruth Zulu debriefs the district hospital’s chief Dr Morgen Muzondo about our visit.

A sickly-looking woman lies in the truck that is at the entrance of the hospital all the time we are waiting for protocol to be observed.

There is no one at the reception desk to assist patients and we ask the latter why, to which they respond: “They have gone for tea break.”

A colleague asks for directions to the toilet from a nurse at the hospital and her attitude is somehow wayward.

How she responded to us spoke volumes of her character towards patients who visit the hospital every day.

Attitude — a subject we had discussed the previous day during our four-day media workshop in Masvingo. And the nurse had shown us exactly what I and my colleagues had condemned.

But during Muzondo’s presentation on what the Health Transition Fund (HTF) had done for the hospital, they have been receiving $1 000 per hospital since April.

“We have been receiving stockpiles from NatPharm at a push system, adding that they started receiving HTF towards the end of this year’s second quarter,” he says.

Ndanga being the district hospital gets the larger chunk of the HTF considering its catchment area of 51 630 people.

Some of the pregnant women in waiting rooms
Some of the pregnant women in waiting rooms

When we get there, three ambulances are parked at the premises and the fourth one is said to have gone out with a patient.

At the moment, the ambulances are largely catering for maternal patients, Muzondo says.

The hospital had 248 normal deliveries as at the third quarter of this year, and Muzondo says they have 25 midwives and need 15 more at the hospital.

A 2013 third quarter operational plan for Ndanga shows that the hospital still needs a lot of support in the maternal section.

The rooms are adequate there, but confidentiality is compromised as a result of torn screens.

There is running water at the health institution, but the problem is that of poor lighting since most of them are broken down and there is no back-up power.

The report also reads that there are inadequate sterile gloves and electric suction machines as well as stethoscopes, syphgnomometers, urine dip stick kits and glucometers, few ultrasound scans and dopplers.

Cord clamps and ties, gumboots, goggles and aprons as well as sanitary towels and resuscitaire for the theatre are also in short supply.

More important is that the institution needs $7 513 for drugs and medicines.

“Bedding as well is another challenge. There are 25 beds in waiting rooms, but when we get there, 43 women are waiting to deliver,” Sister-in-Charge Edith Mutikani says.

“In case the number rises, the hospital sends the other waiting mothers to the labour wards.”

Several rural hospitals in the district rely on Ndanga and in the event that there are inadequate supplies as stated above means the whole system is compromised.

On the same day, we visited Chichidza/Harava Rural Hospital, some 30km west of the Jerera growth point, in the simmering heat.
By the time we got there, the nurse-in-charge Mavis Mudzamba said they had treated all patients in the morning.

She had not even expected our visit and we caught them unawares.
The rural community is so organised as we found the village headman Alex Poterai Chikasu and other villagers going around the hospital fence checking for holes in the fence.

They had already placed a paper on the wall where they were discussing their priorities for next year.

Mudzamba said the HTF programme had come in handy for the community.

“Before the HTF programme, we used to encounter several challenges with delivering women. But now the situation is better,” Mudzamba said.

“We rely on ambulances from Ndanga that transport patients, and we always have something in our coffers in case there is no ambulance available on that day and we have to use private transporters who charge between $30 and $40 for a single trip.”

Emergencies are usually referred to Musiso Mission Hospital, which is bigger than Harava, but smaller than Ndanga. Musiso is located at Jerera growth point.

Harava’s serves about 10 300 people in ward 17, 22 and part of 16.

The-three-ambulances-at-Ndanga-Rural-District-Hospital

As the staff complement, there are four registered general nurses, three primary care nurses, two laboratory assistants, two general hands and one security guard.

With an average delivery of 16 babies a month, the hospital relies on a borehole drilled 500 metres away.

And for village health worker Tendai Kwasha, who has been in the profession for more than 10 years, she bemoans the few numbers there are owing to dilapidated conditions.

“We are now very few since many of us have deserted citing inadequate remuneration. We are not given money even to buy small things to help us as well in our homes. So now the number of village health workers has decreased,” she said.

The HTF is a multi-donor pooled fund and is managed by Unicef to support the Ministry of Health and Child Care in the country to achieve “the highest possible level of health and quality of life” for all Zimbabweans.

Severe deterioration in infrastructure, lack of investment, low wages, decreasing motivation and capacity of the civil service and absolute shortage of essential supplies and commodities resulted in the near-collapse of the health sector in late 2008 and early 2009.

The HTF was introduced to support efforts to mobilise the necessary resources for critical interventions to revitalise the sector and increase access to care through eliminating payment of fees for services for mothers and children under the age of five as foreseen by national policy.

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