A FEW days ago, I walked into one of the cholera treatment centres in Harare and what I witnessed was distasteful to the bone. There were many patients who were seeking treatment against a sluggish service that had few distinct nurses.
I waited patiently to do a physical count of the service providers, only to find 4 nurses. The nurses looked tired, overwhelmed and demotivated as more patients continued to trickle in. Questions lingered in my mind as I pondered whether all the patients would receive treatment timeously.
Cholera is a water-borne bacterial disease which can present with severe watery diarrhoea, vomiting, muscle cramps, lethargy or even death. Treatment of cholera may just involve oral rehydration therapy if the condition is mild while severe cases require intravenous fluid management to quickly rehydrate patients.
We are in the festive seasons where there is a lot of human movement. All the risk factors for cholera transmission are there today. The rains have come with further water contamination while sanitation is a serious concern with burst pipes, garbage everywhere and gatherings aplenty.
There is open space braaiing and drinking where water facilities are absent and that automatically fuels the spread of the medieval disease. If the country fails to prevent a particular disease, then we should be more radical on treatment. Failing on both prevention and treatment is a catastrophe that has potential to kill many people.
Workers are the biggest assets of any organisation and a sound health delivery system has both a competent workforce and leadership. In essence, workers and governance are the sine qua non of an efficacious health system. These are the cornerstone of an impervious health arrangement that has potential to keep the whole nation sound.
Failure to recognise health workforce when we are dealing with infectious diseases like cholera can result in increased morbidity and mortality. If only four tired nurses were serving all the cholera patients at the centre, then the country is not serious about containing the disease. The issue is health workers are not motivated enough to execute their duties amid the absence of both intrinsic and extrinsic drivers.
The government of Zimbabwe released funds in local currency to pay staff, however, the money is not enough to motivate workers on the ground considering the unbearable rate of inflation. Donors and private sector players are buying commodities to use in the fight against cholera and other diseases.
It is imperative for the Health and Child Care ministry to convince the Finance, Economic Development and Investment Promotion ministry that US$ payments are critical to health workers at this juncture given the rampant brain drain.
It is a pity that the Health ministry got only 10,8% of the national budget, 0,4% less than the previous budgetary allocation. Without serious donor funding, the health sector will find the going tougher than in previous years. The Global Fund retention scheme has been dead for the entire 2023 thus further aggravating the funding situation in the country.
Resuscitating the Global Fund Scheme is a step in the right direction and political will is a prerequisite. The country continues to lose thousands of skilled workers to greener pastures. We boast of training many nurses, doctors, pharmacists, physiotherapists, radiographers but fail to retain them resulting in a monumental loss considering the huge amounts involved in the training of health workers.
More resources need to be channelled towards the health sector sooner rather than later. We pray the COVID-19 JN.1 strain will not descend on us as it is starting to cause headaches in US, Russia, Germany, India, Poland and the United Kingdom.