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Wongai Zhangazha
NEWS that cabinet ministers quietly awarded themselves a salary increment of 200% will obviously anger struggling civil servants who have to contend with measly salaries of about US$200 per month.
Government health workers, especially doctors, will be even more peeved by the government’s insincerity.
Just a month ago junior doctors at Harare Hospital went on strike demanding a salary increase, but their calls were ignored by the government arguing that it did not have the money to pay them.
The doctors were demanding an increase of their hourly rate from a meagre 33cents to at least US$10.
One wonders how parties in the inclusive government, particularly the MDC, which claims to have been founded by workers, would ignore the plight of such a critical component of its workforce and decide to give priority to raising the salaries of ministers, their deputies and members of parliament and the senate.
While there have been modest improvements in the health delivery system since the consummation of the GNU, the brain drain in the health sector has not stopped and those that have remained have had to cope with heavy workloads.
On average one or two doctors at Parirenyatwa, the country’s major referral hospital, can see up to 300 patients daily at the casualty section.
The 2010 Government Work Programme (GWP) review acknowledges that the major challenges for the Ministry of Health is a serious shortage of human resources.
“The shortage of human resources remains a major challenge with the vacancy levels standing at 67% for specialist’s doctors, 57% environmental health technicians, 77% midwives, 44% nursing tutors, 59% pharmacy personnel and 59% radiography and laboratory personnel,” reads the GWP report.
The staff retention scheme for health personnel introduced in 2009 resulted in some modicum of improvement in staffing but only for lower levels.
The 2010 Millennium Development Goals (MDG) status report on Zimbabwe launched last week also cited the shortage of human resources as a major challenge and that this would affect the attainment of the MDGs in three areas by 2015.
These are combating HIV and Aids, tuberculosis, malaria and other diseases, and improvement in maternal health and reduction of child mortality rate.
“The major challenge is the unstable human resource base, arising from high staff attrition,” reads the MDG report.
While the country has battled to combat the prevalence of HIV/Aids, Zimbabwe is also ranked 17th out of the world’s 22 high-burden TB countries, according to government statistics.
TB rates stood at 782 per 100 000 people in 2007, up from 411 per 100 000 people in 2004.The report said it was likely that the country would not meet the maternal mortality ratio (MMR) that stood at 725 per 100 000 live births in 2007 “because the capacity of the healthcare system has deteriorated significantly and the MMR has increased”.
Unfortunately, such alarming figures have not been taken seriously by the government since it has failed to come up with a comprehensive health policy to deal with the attrition of key personnel.
Government has argued that there is no money and workers have had to grapple with poor working conditions, which include low salaries, heavy workloads, shortage of drugs and equipment, among other perennial problems.
What this development has indicated is that the coalition government has not seriously considered what the priorities for the country are.
The parties in the inclusive government have spent much of their time fighting over distribution of power and trading accusations of who has perpetrated more violence than the other.
The political gladiators have acknowledged this problem but do not seem to have a practical solution to it.
At the launch of the 2011 GWP, Zanu PF senator Guy Georgias said the problem in achieving targets set by government ministries was caused by political parties in the inclusive government, who spent more time fighting each other.
“People spend time strategising on how to pull each other down. If there is no respect for each other in the GNU, then we will get nowhere,” Georgias said.
Prime Minister Morgan Tsvangirai added his voice saying in order to implement the set targets, there was need for a discussion of the various fault lines in the GPA.
“We need a special focus on how to minimise competition and maximise collaboration so that we have one policy. Sometimes we mix what our political parties are doing and then when it comes to government we take different positions,” he said.
Deputy Prime Minister Arthur Mutambara put the blame on politics which he said took precedence over implementation.
“Our challenges are around our politics. GPA issues, constitutional matters, the elections, the seven matters of reform - constitution, national healing, media, electoral, political, economic and security reforms,” Mutambara said.
He criticised the percentage achievements saying some of the numbers were not encouraging.
He suggested that ministers who failed to achieve their targets and fulfill their promises should be “punished vigorously”.
Unfortunately such political talk will not stem the tide of healthcare deterioration.
Shortage of essential medicine and equipment for high level quality care continues to be a big challenge in attaining the MDGs.
In the 2010 GWP achievements, the Ministry of Health said it managed to reduce the overall unavailability of medicines from 52% to 43% in June last year while shortfalls in vital drugs have been reduced from 57% to 52%, and essential drugs were reduced from 36% to 28%.
Chairman of the social cluster Ignatius Chombo said the aim for 2011 was to increase vital medicines availability from 40% in 2010 to 60% by end of the year, as far as health was concerned.
The other target is to ensure that servicing and procurement of equipment should be undertaken so that at least 20 hospitals in the country meet minimum standards of bio-medical equipment.
Government should also find a way of addressing the concerns of the health sector. Until that is solved the health sector will deteriorate at alarming rates.
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