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Health delivery still on the ropes despite GNU

AN elderly woman lies on a stretcher bed just outside Parirenyatwa Hospital’s casualty department in the scorching summer heat waiting to be attended to. 

As the heat hits her wrinkled skin, the woman groans in pain, with tears streaming down her cheeks.  Her weary looking relatives are now slowly losing hope of ever getting assistance from the medical staff. 
Another hour passes by, but still no movement in the queue. Eventually, they slowly start pushing the stretcher bed into the hospital and join the long queue inside. They cannot believe that this was happening at one of the country’s biggest referral hospitals.
Max Mukurunyorova has gone through this before. Just two months ago, he brought a friend’s father.
“If you are not ‘jagged up’ (sic) here, your relative will die on the stretch bed,” said Mukurunyorova. “The service is very slow and frustrating. Two months ago, I came with a friend’s father who was seriously ill. We got to the casualty at 6pm only for him to be admitted at 4am.”
He added: “Doctors and nurses here are overwhelmed by the job. From the look of it there seems to be a shortage of nurses and doctors. There is not enough staff to run the casualty department. The service is pathetic.” 
The service is worse in the evenings with some of the casualty wards poorly lit and a strong stench coming from the toilets. Some of the blankets are worn out and visibly dirty, with blood stains sometimes.
The situation is not unique to Parirenyatwa, but a portrait of all government hospitals, which despite the slight improvement since the unity government was formed in February last year, are still in need of resuscitation.
Only a few doctors remain and most of these are students or interns. Hundreds of qualified health personnel left for other countries at the height of the economic meltdown.
A combination of poor remuneration and bad working conditions has frustrated the remaining nurses.
People interviewed by the Zimbabwe Independent said the principals in the government of national unity should not prioritise elections but healthcare.
One patient, who preferred not to be named, said: “We read that they are talking about having elections next year. I would prefer that they prioritise on improving health facilities at hospitals before the elections.” 
Parirenyatwa group executive chairperson Thomas Zigora in an interview last week said the workload at the hospital had increased and the staff could not meet the demand for healthcare.
Zigora said: “Right now, as of today (Wednesday) we would probably have 900 in-patients who will be admitted, we will see about 300 at the casualty area and 200 at specialist clinics that is not the workload that was there before.”
He blamed their staff woes on the failure by government to review health systems since Independence.
“For nurses right now we have filled our establishment (of 261) and that is also why we cannot employ the trained nurses who are at home.  We are now asking for a review of the establishment but it takes time because it is a process and finance is not approving expansion.”
“Yes clearly we have very few doctors and nurses because the workload has increased overtime. If we look at scientists, pharmacists, specialist doctors, specialist nurses in intensive care, theatre, and midwifery they are few.”
The Health ministry in its 2011 budget proposal presented last week proposed a review of establishments not only at Parirenyatwa but at a national level to include rural health centres, district general hospitals, central hospitals and training schools since demand has increased.
The budget proposal also mentioned that some medical equipment and facilities have outlived their lifespan and needed replacement for example at primary level care 78,3% of health facilities did not have functional sphygmomanometers (BP machine) and functional x-ray machines.    
“Government needs to continue with this phased equipping of health facilities but seriously look into accelerating this process of equipping its health facilities,” reads the proposal.
On why patients had to wait for long hours before treatment, Zigora said there was a misunderstanding.
“Pari (Parirenyatwa) will see 300 people in a day at casualty, Pari will at any given moment have at least one doctor at the casualty between 11am and 2pm, they may have two or three doctors so they will take time with each patient that they see. So delays will be there because these will be like 300 people, 50 of whom are coming at the same time,” he said. “People should try to be patient. What we have is a tragic system, that sometimes people don’t understand first come is not necessarily first served. Workloads have increased so much so that keeping pace with it is difficult.”
Health minister Henry Madzorera last week said his ministry was working very hard to improve conditions at hospitals and laboratories and hoped that money earned from Chiadzwa diamonds in Manicaland would significantly improve service and motivation of health workers.
“Conditions of service do not lie in the Ministry of Health alone. We rely also on industry and commerce and the Ministry of Finance and Mining. ”
“We have so much expectation from Chiadzwa to change our fortunes around but so far it’s just talk and nothing much has been done in the line of improvement,” Madzorera said.
United States Ambassador to Zimbabwe Charles Ray said, while announcing that his country has committed an additional $3,2 million to strengthen the quality of public health laboratories, urged the private sector to come in and assist the government to create an effective and attractive medical system.


Wongai Zhangazha

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