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Zimbabwe health system collapses

WHEN Zimbabwe attained Independence in 1980 Prime Minister Robert Mugabe promised people universal access to healthcare.

Twenty-eight years later millions of Zimbabweans have been reduced to paupers and can no longer afford basic healthcare, even at public institutions because of the high cost of treatment.

Foreign currency shortages have resulted in the Ministry of Health and Child Welfare not being able to provide essential drugs to clinics and public hospitals, which in the past used to cater for people in the low-income group.

More than a dozen babies are born in each district of the country on a daily basis, but maternity care is no longer easily accessible as a result of the spiralling cost of living that has pushed clinic and hospital fees beyond the reach of many.

Consultation fees at public hospitals are $10 million while for maternity, a normal delivery now costs between $200 million and $300 million.

A caesarian section, which is birth by surgery, costs between $2 billion and $3 billion depending on the time you spend in the hospital after the operation.

Private hospitals are charging $3 billion for a caesarian, $1,2 billion for a normal delivery after paying a registration fee of $400 million and these are “top-up” fees for those on medical aid.

Many women of childbearing age are finding themselves in the same predicament as Juliet Nhamo, a young expecting mother who had registered to deliver at a clinic in Highfield.

Nhamo thought she was going to have a normal birth, but things did not go according to her plan as she went into labour two days before the due date.

Upon arrival at the clinic, she was told there were complications with her pregnancy and she had to be rushed to Harare hospital.

The staff at the clinic informed Nhamo that there was no ambulance to take her to the hospital and since there was no time to waste it would be wise for her husband to hire a cab.

To her horror, upon arrival at Harare hospital she was told that the only doctor qualified to operate on her only does caesarians on Thursdays.

She was admitted but told that some of the medication she required was not available and she would have to buy it from a private pharmacy.

Her husband did not have the money after paying $150 million for the car he hired to ferry his wife to the hospital.

While she lay in hospital waiting for the doctor her husband would have to raise the hospital bill which would probably be above $2 billion.

Such is the ugly picture of what many Zimbabweans are being forced to go through every time they have to seek healthcare.

To buy a drip from a private pharmacy one has to fork out $60 million while a packet of 10 painkillers costs between $15 million and $30 million depending on the brand.

For those on HIV treatment the cheapest brand of anti- retroviral drugs, Stalanev, which is locally manufactured, is now $300 million per course and only covers 30 days.

A local surgeon who specialises in male reproductive health who was contacted by the Zimbabwe Independent last week said he was charging more than $20 billion to perform corrective surgery.

It is not only the cost of healthcare which is a cause of concern but also the shortage of equipment and human resources.

Stacks of unserviceable beds, electronic equipment, leaking pipes, crumbling walls and bare dispensary shelves are a common sight at government hospitals across the country.

Year after year, bids by the Ministry of Health for more funding have been cut to basics.

This has resulted in staff from public health institutions leaving the country for greener pastures.

Recent statistics from the parliamentary portfolio show that the public health sector has a vacancy level of more than 40%. The current doctor to patient ratio is 1:12 000 while the ideal ratio should be around 1:200.

In rural areas most district and mission hospitals are being run by nurse aids without doctors.

Only 738 doctors are still practising in the country out of an establishment of 1 590 and less than 50 of them offer specialised care at public institutions.

There are only 37 registered obstetricians and gynaecologists in Zimbabwe yet there are more than four million women of childbearing age.

Harare and Bulawayo account for 60% and 30% respectively of all public-sector doctors and nurses. The rest of the smaller cities and towns share the remainder but serve larger populations as general hospitals and provincial referral centres.

The president of the Hospital Doctors Association, Amon Severegi, told the Independent this week that government should prioritise the health sector in its budget as many lives are being lost due to lack of resources at public hospitals.

“We feel as doctors working in the public sector that it is important that our health delivery systems are well resourced in terms of drugs, human resources and consumables,” said Severegi.

“These are our expectations as professionals as well as the general public,” he added.

“We hope the responsible authorities will be able to come in and assist hospitals to get drugs as it’s costing patients more to buy drugs from private pharmacies than it would cost them if they got them at hospitals,” said Severegi.

Efforts to get comment from the Ministry of Health were fruitless.

The chief executive of Parirenyatwa Hospital, the county’s largest referral centre, Thomas Zigora, said he could not comment on the condition of the hospital in terms of services.

“At the moment I cannot comment as we are still working on a statement addressing the issues that have been in the media concerning our operations that will be issued early next week,” Zigora said.

Zigora said that there had been many falsehoods about Parirenyatwa Hospital that have been peddled by people who have not made an effort to seek his office’s comment.

A state weekly newspaper two weeks ago reported that Parirenyatwa Hospital had suspended all surgical operations as a result of lack of anaesthetic, general equipment breakdowns and a shortage of painkillers used to ease pain after surgery.

An orderly at one of the hospitals said: “The situation at our public hospitals is scary, there are no drugs, some of the machines are not working and doctors are not always there. It is becoming difficult for us to bring our relatives to such hospitals which have very little to offer,” she said.–Lucia Makamure

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