Inside Zimbabwe’s healthcare collapse

BY PHYLLIS MBANJE

A TWO-MONTH standoff between doctors and the government has brought the health delivery system in the country virtually to its knees, exposing the government’s non-commitment to guaranteeing universal healthcare.

Government’s “command” response of firing over 300 of the doctors further perpetuated the crisis which has reached unimaginable proportions, and this has opened the door for other countries — with Britain reportedly at the forefront — to snatch the doctors.

This is likely to pave way for another massive brain drain typical of the one witnessed at the turn of the millennium when thousands of highly experienced and qualified professionals left Zimbabwe for other countries.

The corridors of Parirenyatwa Group of Hospitals, one of Zimbabwe’s largest referral hospitals, are now virtually empty and devoid of the mad rush of human feet and the squeaky sound of stretchers loaded with patients.

There are no white-coated doctors with stethoscopes dangling from their necks, as they dash from one ward to the next exchanging easy banter with the youthful nurses tending to their patients.

The hive of activity has been replaced by an eerie silence.

Instead, an occasional security guard prances about the casualty section whistling softly, as his baton stick hangs from his belt and swings with each step he takes.

A few patients make enquiries at the open small window and, after a few minutes, walk away in dejection. This scenario is replicated at most public health facilities scattered across the country.

Over the years, the public health system has slowly disintegrated largely due to lack of funding to sustain the growing base of patients.

Earlier this year, officials from the Health ministry, including minister Obadiah Moyo, witnessed a rare and sad moment when the head of the paediatric unit, Azza Mashumba, broke down in tears as she recounted how they were losing babies due to avoidable reasons.

She said patients were dying from treatable diseases at government hospitals, owing to the shortage of basic medical equipment, medicines and other accessories.

“A pregnant mother comes here at Mbuya Nehanda. I can hear the foetal heart. The baby is in distress. We come here to the main theatre, but the foetal heart is dwindling, it’s going. We get into theatre and I am ready to receive the baby, but I am given a stillbirth,” she said. “I come to work to certify dead bodies, that’s not why I am here … We are not working, we are not helping patients.”

Her shocking revelation was one of the first big signs that the heartbeat of the medical system was slowly fading away in the country’s public health facilities.

The video trended for months and helped bring into perspective just how badly the healthcare system had deteriorated.

When the junior doctors announced that they were incapacitated and could no longer come to work, the situation took a nastier turn.

Patients were turned away and those already admitted discharged and sent home.

The misery has been growing ever since and now the private health facilities are bulking under the huge influx of patients who are coming from the public hospitals. They, too, are struggling.

There is now a stampede for mission hospitals like Karanda, which are still offering better services.

Over the years, Karanda has remained resolute in providing quality and affordable healthcare.

The dedicated staff continue to prioritise patients, striving to give the best of care to restore health and preserve life.

But the numbers are now becoming too much for them and slowly, the staff is getting overwhelmed.

This is the last line of defence and if it crumbles, disaster will strike again, harder this time.

There are reports that student doctors are now tending to patients at major hospitals and although officials at Parirenyatwa have refuted these allegations, it is only a matter of time before the hospitals completely shut their doors.

But how did the country get here?

One of the main thrusts of the new government at independence in 1980 was to increase access to quality healthcare to citizens who had been kept at bay by the colonial regime, which provided the barest of health services to the black population.

It is no wonder the then President Robert Mugabe’s government made great strides to improve health delivery and with determination, solidified the grassroots healthcare facilities, which mostly serviced the poor.

Throughout the 1980s, the government worked hard to ensure that pregnant women received the best care along with their babies.

The country’s immunisation programme was ranked among the best in southern Africa.

The health personnel then were well equipped as well as remunerated.

Nurses and doctors were highly revered in their respective communities and their parents could openly brag, with almost every child in school desiring to become a doctor.

Patients were given first class treatment and indeed hospitals were healing homes.

The malaise

But the beginning of the 1990s witnessed an abrupt change. The economic challenges that besieged the country did not spare the hospitals, which bore the worst brunt.

Suddenly, there were reports of drug shortages and nurses and doctors leaving for greener pastures.

Many relocated to the United Kingdom, where they have remained to date.

As the political situation played out, the situation in the hospitals further deteriorated.

Consistently, the national budget failed to honour the Abuja Declaration, which urges governments to commit at least 15% of the national cake to health. Without adequate funding except from the international donors, the healthcare system took a further nosedive.

This was worsened by corrupt practices of senior government officials, who dipped their fingers in the funding pools from the donors, resulting in reduction of financial support.

Stakeholders and activists made repeated calls to government to seriously re-consider its funding mechanism for health, with domestic funding becoming a critical topic.

While the healthcare collapsed, the government officials and their families became medical
tourists, shunning the local facilities which have become death traps for many people of no means.

India is one of the countries that have been besieged by well-to-do patients from Zimbabwe.

With state-of-the-art hospitals and dedicated teams of well-motivated health personnel, it remains a lure for those who can afford, or those who publicly ask for donations.

The broken promises

The Zanu PF election manifesto makes wide-ranging promises on health and President Emmerson Mnangagwa towards the 2018 elections pledged that the health infrastructure would be improved, that he would create more posts for health personnel as well as accessible affordable medicines.

The manifesto also promised free medical care for cancer patients; at least one hospital per district, improved health services in resettlement areas, reduction of hospital fees by 50% and pursuing the health for all policy, among others.

Community Working Group on Health executive director Itai Rusike once wrote an open letter to the President, reminding him of the promises he made.

“Zimbabwe needs sustained investments in primary healthcare to revitalise the health system to close gaps in access to services and to address the causes of ill health,” he said.

The new Health minister, Moyo, also promised world-class facilities soon after he was appointed to head the ministry, but this, too, is proving to be an elusive dream.

The empty wards and empty drug shelves all testify to the failure by government to prioritise this fundamental human right.

There are no painkillers and people living with HIV and Aids are still struggling to get their drugs on time.

1 Comment

  1. What percentage is 2020 health budget ?

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