Of poor hospital standards and the ‘wretched of the earth’

By The Standard | Nov. 29, 2018 | 6 Min read

On September 3, 2018, I was hit by a car just as I was about to finish crossing a busy robot-controlled intersection in central Harare.

guest column: Peter Banga

Fortunate for me, the driver stopped just in time, complied with legal formalities and rendered all the necessary assistance until I fully recovered. It was a harrowing experience.

The ordeal, though terrible, gave me an insight into the state of Zimbabwe’s health sector.

On the fateful day, I was rushed to the casualty unit at Harare Central Hospital. I could not stand on my own and those assisting me were told by the security guard to get a wheelchair from those stacked at the hospital entrance.

I was shocked by what I saw.

The wheelchairs were very old. My assistants laboured to push me around. None of the wheelchairs had foot support. That meant I needed two people to help me, one pushing the chair and the other who would hold my legs!

I had challenges each time I needed to use ablution facilities. To think that Harare Hospital is long established, yet no provision has been made for those using wheelchairs to enter the toilets is shocking.

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I had to be carried all the way to various rooms because the doorways are too narrow for a wheel-chair. Furthermore, there were no assisting devices for the convenience of those with disabilities, the elderly, or the injured.

While our hospitals have urinaries in male toilets, authorities should consider having urinal bowls at wheelchair level, just like they have in some hotels.

It struck me that hospital administrators are not aware that the state of ablution facilities has a bearing on their image.

A friend of mine, Henry Kane, whom I met during one of my review visits, told me that there are no wheelchairs in the wards at Harare Hospital. He said when he was discharged, he was wheeled out on a hospital bed.

He also said in ward A1, where he was admitted to, there were no bed curtains for privacy whenever patients relieved themselves or took a bath. This problem is not confined to Harare Hospital only.

At Parirenyatwa Group of Hospitals, there are toilets for male and female patients. There are also those reserved for people with disabilities.

However, the only ones that are functional are those for people with disabilities. And everyone uses these. They are in a deplorable state.

Parirenyatwa also has old wheel-chairs with no foot supports.

In the accident, I was lucky that I did not sustain a fracture. Only the ligaments were stretched, but I was in serious pain. The X-ray was taken at 2pm and I was told to proceed to room 18 and wait for the doctor.

There was a mixture of people of all ages, including the elderly with different injuries, ranging from minor to severe. Some had severed hands, fingers or feet. You could see blood oozing out through the bandages.

We all waited eagerly for the orthopaedic doctor. Upon inquiring, I learnt some had been in the room since morning. The doctor finally came in at 11pm. He examined only three patients, including myself, and then rushed to the emergency operating theatre.

We waited another two hours before another doctor came. He confirmed that I had not sustained a fracture and prescribed a back slab — a supporting plaster for the leg with bandages wrapped around it.

Those assisting me were told to buy these from the pharmacy since the hospital had none. They went all the way to town in the early hours of the morning.

What would have happened if I could not afford to buy the requirements, or did not have the US dollars? It also follows that if we hadn’t a car with us, we would have waited until daytime for the procedure to be done.

Room 18 is in a sorry state. There are two examination beds. The screen curtains for the beds are old and have come off the rails.

Every patient in the room could see the doctor and nurses attending to patients on the examination beds. Maybe this is what is meant by “public hospital”.

There are wooden benches in the emergency room just like in other sections of the hospital.

Such benches are durable, but shouldn’t we also consider the comfort of the patient? Imagine sitting for 15 hours on such a hard structure. Is that structure suitable for people with serious injuries, that have limited mobility and cannot stand up or walk around?

This was not my first time to be attended at Harare Hospital. In the 1960s, when I was five years old, I spent three months lying on my back with a plaster that covered my right leg right up to my chest.

After the plaster was removed, I would go for regular reviews accompanied by my mother. I have a perfect memory of those years and what amazed me on this particular day was that little has changed in much of the hospital, except the addition of new structures.

Zimbabwe inherited hospitals infrastructure from our former colonisers, but has failed to maintain it. Simple things like tiling of floors and painting walls shows that we care.

At the orthopaedic clinic, patients start queuing as early as 6:30am and doctors only come in around 10am. This is despite the fact that there is a circular on one of the notice boards signed by the hospital’s chief executive officer stating that staff should report for work at 7:30am.

There is need to improve on this to lessen the agony of the patients.

Room 4 at the orthopaedic clinic needs attention; the window panes are broken, ceiling and electricity light covers are either missing or hang down perilously and cardboard boxes are used in place of metal bins.

In the main waiting area, much of the ceiling has come off. There is what appears like cast iron sewer pipes that were exposed a long time ago. It is not a pleasant sight for the patients.

The floors have chipped off and in some rooms wooden tiles have come unstuck, posing a hazard to patients and hospital staff.

I followed a friend of mine to Room 4 at the urology clinic and the situation was equally astounding.

There is no privacy. A doctor attended a patient while at an adjacent consultation desk, a patient could overhear the conversation.

One of the doctors confided in me that donated equipment at Harare Hospital is not being maintained and they have frequent breakdowns. He added that they have shortages of drugs and lubricants.

The hospital grounds are maintained at the front only.

The Red Cross kiosk was a good initiative. Staff and patients have somewhere to buy food and drinks. However, there are no ramps to facilitate access by wheelchair users.

At the time I was injured, I needed crutches. I was referred to the physiotherapy unit.

Sadly, they told me they were not sure when they would be available. I had to ask a friend to help out. The culture of taking a casual approach to issues of health care is deep-rooted.

Ministers have come and gone since independence and seemingly minor, but important aspects have been left unattended. The time for change is now.

Office holders should walk around institutions more often, and even use facilities that are used by patients. That way, authorities will be able to appreciate challenges faced by their clientele.

Another way of establishing the truth is for authorities to talk to the patients to get suggestions on how things can be improved.

The current “ivory tower” approach to the administration of hospitals must come to an end as it is creating a tale of two cities. Without such a radical change, the “chefs” and their families will continue to patronise private hospitals and flying overseas for treatment while the “wretched of the earth” are condemned to sub-standard healthcare.

Government should take the lead, and the people will surely follow with whatever assistance they can give. They will, if they are asked to. That I know for sure!

Peter Banga is a journalism lecturer at Harare Polytechnic