Africanews October 2000 -Zimbabwe: Health system is a nightmare

[Africanews <ramalkandy@iol.it>]

AFRICANEWS - News and Views on Africa from Africa
Issue 55 - October 2000
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Zimbabwe
Health  system is a nightmare

The country's health delivery system has deteriorated over the past
decade.  Lack of essential drugs, a brain drain from the health
sector, corruption and misplaced priorities by government are some of
the problems.

Health care
by Rodrick Mukumbira
(935 Words)

Patients anxiously cram the hospital corridor. Despair is written all
over their faces as they wait for the doctor, who, a smiling nurse
assures, will be available soon.

But this is too much for 30-year-old Tirivanhu Mukoma.  He waited all
day yesterday but no doctor attended to him.  Hopefully today he will
be fortunate. But when he finally sees the doctor, Tirivanhu will only
get "hope" and a dose of low cost painkillers.

The hospital where Mukoma waits is packed with people. One has to move
with care to avoid stepping on patients sleeping on the floor. Yet
other wards are closed for reasons those sleeping on the floor can not
understanding.

A shortage of doctors, along with equipment breakdown and lack of
essential drugs are several of many problems plaguing Zimbabwe's
health care system. This crisis could turn Zimbabwe's once impressive
health care gains of the early years of independence in the 1980s into
a major disaster.

Zimbabwe has more than 2,000 registered doctors, but many are leaving
after being attracted to better working conditions and remuneration in
neighbouring countries, mainly Botswana and South Africa.

As a result, patients sometimes hardly see doctors as the
doctor-patient ratio is now estimated to have reached one doctor to 50
patients. Nurses used to move patients from one examination room to
the other. Relatives of the sick are now doing this.

"I can't blame health personnel for leaving this country," says
retired medical doctor, John Wessels.  "The conditions are just
unbearable and the situation is deteriorating".

Wessels acknowledges that Zimbabwe's doctors and nurses are competent
and well trained, but the situation at home has left them with no
other alternative but to seek employment in other countries.

The critical shortage of doctors in most hospital departments has
resulted in nurses performing doctors' duties to arrest the situation.

Former ruling Zanu PF party parliamentarian Moses Mvenge blames the
exodus on the salary structures being offered by the government.

A government nurse earns at least Z$ 15 000 (US $ 288) and a doctor is
given Z$ 30 000 (US$ 576) a month far less than that being offered in
other countries. "This is disservice to the professionals and yet the
government is doing nothing to control the mass exodus." says Mvenge

Corruption, deeply rooted in the public service, has also contributed
to the poor health services. Recently newspapers reported that
Government Medical Stores, a parastatal responsible for sourcing
drugs, had been looted and tender regulations in purchasing drugs had
not been followed, resulting in the government losing million of
dollars.

Zimbabwe was named World Health Organisation (WHO)'s best health
service provider in 1985 because of its efficient health delivery
system. During that period it managed to eradicate polio. Health care
was fully subsidized at that time. The government upgraded 550 health
centers and built 321 new ones all over the country, which now stand
empty due to shortages of staff and equipment.

Zimbabwe's adoption of economic reforms in 1991 resulted in the
removal of subsidies to all social sectors including health. But the
government still provides free health care to low-income earners, who
still have to pay for medication.

But, ironically, in the 1999-2000 national budget health care was
allocated Z$6.1 billion  (US$11 million ) while defence received Z$ 9
billion (US$17 million  ).

The country has brushed aside the call to withdraw its forces from the
Democratic Republic of  Congo where it is fighting in aid of besieged
President Laurent Kabila. The ministry of finance revealed recently
that it is spending Z$10 billion (US$19 million ) per month in the
two-year old war.

"The defence budget is bloated; health is under funded," says
opposition member of Parliament, Gibson Sibanda. "If the government
can cater for the war in the DRC, it  should cater for the health
needs of Zimbabwe."

"We are fast turning into a country of misplaced priorities," says
Masipula Sithole, a political science lecturer at the University of
Zimbabwe.

A visit to Zimbabwe's hospitals reveals that most equipments are
either broken down or not available.

A senior official at a Harare Hospital said equipments prone to
breakdown are x-rays, theatre equipment, ventilators, incubators, and
cardiograph machines.

"Most breakdowns are due to overuse, carelessness and inadequate
training of the operators,"  he said.

The situation has been made difficult by the HIV/AIDS pandemic. The
Ministry of Health reports that one in four adults is either living
with the virus or has HIV, and 1,200 people are dying each week from
the disease.

Hospitals also report that mortuaries are full to capacity and in need
of upgrading to accommodate more bodies. Economic hardships, cites
hospital superintendent Doctor Innocent Hove, are forcing people to
neglect collecting dead bodies.

In the face of this impending crisis, the government has introduced a
cost-recovery method that has seen health care fees increase by more
than 110 percent in  nine months.

The cost of drugs has also increased by 60 per cent, although in an
effort to arrest such increases, the government has imposed tariff
reductions on essential drugs and raw materials used by the
pharmaceutical industry.

In the face of foreign currency shortages, the health ministry reports
that foreign drug suppliers are demanding payment before supplying the
raw materials and drugs.

Free medication continues to be found in rural clinics. However, upon
being referred to major hospitals, one is given a prescription to buy
drugs, thus directly affecting the health of the poor.

Says Health and Child Welfare Minister Timothy Stamps: "Essential
medicines are in short supply  and our  stocks can run out of supply
anytime. But this all has to do with foreign currency."