By Hughes Makoni
ONCE again junior and middle level doctors in Zimbabwe are on strike, demanding a “ludicrous monthly salary of $30 million a month”. The authorities have called this a black market salary. B
ut, considering that these young professionals have to get basic commodities from the black market, are they not only asking for what is a realistic salary? After all it is a black market economy we live in!
The doctors are ethically wrong to go on strike, that is true but why do ethics have to be selectively applied? Are the authorities not ethically bound to ensure that doctors are well paid and hence do not go on strike? It is all equally unethical for the doctors to strike as it is for the government to underpay them.
There are high ethical standards in the medical profession. The Hippocratic oath is a mere summary of these ethics. Doctors are expected to be dedicated, compassionate, diligent, enduring. They are supposed to represent all that is good. Circumstances in Zimbabwe’s hospitals test these human qualities to the limit. Drugs are scarce, even the most life saving of them. Patients have to buy most drugs from the private sector and a significant number cannot afford these drugs.
Diagnostic equipment is rundown, obsolete or simply not available. Paramedical and nursing departments are short-staffed, workers are overworked, underpaid and demoralised. How then can they provide coordinated and efficient patient care? Add to all this the usual plagues of government institutions: corruption, inefficiency and bureaucracy. Doctors are demoralised and frustrated.
All around them is the greatest plague of our day: Aids. I am not so sure about the Minister of Health’s statements that HIV infection rates are falling. Hospitals are teeming with HIV positive patients. Aids is incurable but there are drugs that improve the quality of life for these patients. Our hospitals hardly ever have these drugs. If the country’s doctors were well paid would they not be motivated to research and find a cure for this disease?
After five difficult years in a medical school undergoing vigorous training, young doctors come face to face with the collapsed health care system. Our state hospitals are in ruin and working in them is a gloomy experience. Everyday doctors face the realistic chance of accidental infection with the HIV at work. Our hospitals constantly run out of gloves, antiseptics, needle bins and protective clothing. Accidental needle pricks are a reality doctors face.
Besides HIV, there is also the deadly Hepatitis B virus and many other infections that can be transmitted this way. The prophylactic antiretroviral drugs are hardly ever available. So our underpaid, traumatised young doctors go through life trying to dodge HIV infection both at work and in their own private lives! How are doctors supposed to cope with all this and then struggle with the daily routine of shortages in the black market economy?
Despite being ready and willing to negotiate, the doctors have been ignored or intimidated by the authorities. There have rarely been negotiations with the Public Service Commission to preempt strikes. If the authorities use the same logic that allowed them to conclude that the cabinet deserved a 1 000% salary adjustment earlier in the year, then why not let the same laws of logic hold true for its downtrodden doctors?
* Hughes Makoni is a junior doctor based in Bulawayo.