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NewsDay

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Provision of quality healthcare in Zim hamstrung by steep costs

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THE healthcare system in Zimbabwe, which continues on a downward spiral, remains one of the most expensive in the region and out of reach for the majority of citizens who cannot afford health insurance.

THE healthcare system in Zimbabwe, which continues on a downward spiral, remains one of the most expensive in the region and out of reach for the majority of citizens who cannot afford health insurance.

BY PHYLLIS MBANJE

Only 10% have health insurance cover, which again has its own fair share of challenges including shortfalls and the longstanding disharmony between the insurers and the service providers.

The public health facilities which ideally should be catering for the majority have failed to meet the demand in terms of quality services and equipment.

Limited resource allocation to the health sector continues to put a strain on the service delivery system which has seen most public hospitals operating below capacity.

These facilities are also manned by disgruntled and demotivated staff who will not give their best.

Dissatisfied patients then seek private services which are still very expensive with many doctors (general practitioners) charging no less than $25 as consultation while specialist doctors are charging between $50 and $100.

At public hospitals it’s slightly lower at $15, but still beyond the reach of many people.

Companies have shut down and many people were stripped of medical aid cover.

For those managing chronic illnesses like diabetes, cancer, HIV and Aids and kidney complications, the disease burden is too heavy a cross to bear for many.

Specialist treatment

Most pediatricians in the Avenues area are charging from $70 for the first visit and then $50 for subsequent visits made within three months.

Pediatricians are specialist doctors in children’s health. They are trained to diagnose and treat childhood illnesses, from minor health problems to serious diseases.

The most recommended pediatricians charge more than their counterparts.

One such pediatrician based at Medical Chambers in the Avenues charges a whopping $100.

“If you come back within three months of the initial visit it will come down to $70,” the receptionist at the pediatrician’s consulting rooms, said.

Over the years, the tiff over high consultation fees charged by private doctors, especially specialist doctors, has not been wholly addressed and for patients who are dissatisfied with public health facilities they will be forced to fork out huge amounts of money for better service.

X-rays cost anything from $50 upwards with MRI and CT scans going for $500.

Dialysis for renal patients

Kidney complications, which result in renal failure, are yet another chronic condition that requires a lot of money and services like dialysis which are critical in keeping the patients alive are expensive.

Speaking at the 12th annual commemoration of World Kidney Day at Parirenyatwa Group of Hospitals in Harare last year Health minister David Parirenyatwa said only 700 of the 1 000 cases recorded every year are on dialysis.

A number of renal patients have died due to the excessive costs of treatment.

A dialysis session costs between $200 and $250 at private facilities while at public hospitals it’s around $80 and $170.

A patient requires an average of three sessions per week, making treatment one of the most expensive in the country.

Those diagnosed with chronic kidney failure require dialysis for the rest of their lives.

Besides the high costs for renal dialysis, renal patients also have to bear the transport cost burden since facilities that offer dialysis are centralised.

Only Parirenyatwa in Harare, Mpilo in Bulawayo and Chitungwiza offer these services.

The unavailability of a kidney transplantation unit in the country has led to renal patients developing complications while those who can afford have sought services in other countries.

Diabetes

Another high cost disease is diabetes.

While 1,5 million Zimbabweans are diabetic, with some of them unaware they have the condition, the drugs for managing this condition are quite expensive for the ordinary citizens.

A patient on treatment parts with at least $30 every month for drugs only.

Almost 95% of the diabetes is type two, which is mainly caused by poor lifestyles namely consumption of too much starch, which is converted to fat, leading to obesity, hyperlipidaemia, hypertension and diabetes mellitus.

Lack of exercise (sedentary lifestyle) is also a huge catalyst for this condition.

Cancer treatment

Cancer remains one of the leading killer diseases, and lately has actually overtaken HIV and Aids. Although cancer is preventable in most cases many present late when it is too late for any effective intervention.

Treatment options for this disease like chemotherapy are heavy on the pockets.

Chemotherapy works by stopping or slowing the growth of cancer cells, which grow and divide quickly.

It can be administered orally, intravenously or intrathecal (injecting medicine into the space between the layers of tissue that cover the brain and spinal cord), intraperitoneal (goes directly into the peritoneal cavity, which is the area in your body that contains organs such as your intestines, stomach, and liver) intra-arterial (chemotherapy is injected directly into the artery that leads to the cancer) and topically (chemotherapy comes in a cream that you rub onto your skin).

But sad news is that this treatment is very expensive ranging from $100 up to $1 000 per session.

The sessions per cycle vary depending on disease progression.

Organisations like Cancer Association of Zimbabwe have been advocating for lowering of prices for cancer treatment.

Medical tourists

Discouraged by the exorbitant fees and lukewarm services coupled with several medical boobs many have become medical tourists, foraging in other countries for better services. But what is so sad about the current scenario is that senior government officials and politicians have joined the band wagon of ‘medical tourists’.

Recently Vice-President Emmerson Mnangagwa was jetted out of the country after succumbing to some form of “poisoning” and sought treatment in South Africa which has a better healthcare system that Zimbabwe.

The First Lady Grace Mugabe was also in the same country seeking further treatment following an ankle injury, a clear indication that the health system is failing and people are losing faith in the services and the unjustified costs.

Many will die without medical care while others will seek alternative therapy (faith healing or herbalists).