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Health delivery in terminal decline

DYING has literally become a grave issue in the Nkayi district of Matabeleland North where the collapse of the only mortuary at the district hospital means corpses have to be collected the same day otherwise they will simply rot away — a development that mirrors the collapse of the country’s health institutions due to inadequate funding by government.

Herbert Moyo

Such is the gross failure of government that the district hospital has been forced to extend the begging bowl for a mere US$2 681 — a drop in the ocean compared to what President Robert Mugabe spent on his birthday in Victoria falls last weekend — to repair the mortuary which broke down last year in June.

According to a letter written by the district medical officer Thabani Moyo, quotations for repairs show “US$2 681 as being the least and US$3 245 being the highest” required.

Moyo was not reachable for comment as his mobile phone went unanswered.

Located 158 kilometres north of the country’s second largest city Bulawayo, the Nkayi District Hospital mortuary is said to have a capacity of only nine bodies — a dire situation for a facility that serves 30 wards with a population of about 125 000 people.

“It is a sad state of affairs; bodies now have to be collected within a day otherwise they will decompose. No body viewing can be done. Large numbers of people from this community work in South Africa and so they arrive after their relatives have been buried,” said a Nkayi villager who spoke to this paper on condition of anonymity.

A letter written last month by ward 29 councillor Kufakwezwe Ncube appealing for funding states that efforts to have the mortuary repaired by the Health ministry “have not yielded good results as it continously breaks down”.

Such is the parlous state of the mortuary that, according to Ncube, “the community is no longer holding body viewings and most members of the community are now resorting to the traditional method of preserving the corpses before burial which is also a health hazard.”

The Nkayi situation mirrors the general deterioration of hospitals and health care in the country largely due to government’s failure to provide adequate funding.

According to findings by the parliamentary portfolio committee on health and child welfare released a fortnight ago, infrastructure at most hospitals is dilapidated and the central hospitals are also overcrowded.

“The buildings are falling apart and need a facelift,” the committee stated in the report after investigating major hospitals like Parirenyatwa and Harare (Harare), Mpilo, United Bulawayo Hospitals and Ingutsheni (all last three in Bulawayo).

The committee noted that in 2014, the Health ministry submitted a budget request of US$712 million but only received US$337 million inclusive of salaries.

A further US$412 million was injected into the ministry by donors who include Global Fund (US$110 million), USAID (US$97 million), DFID (US$66 million), UNICEF (US$42 million) and the European Union (US$23 million) but this is still inadequate.

The US$337 million given to health last year represents 8,2% of the total budget allocation and is slightly less than the 9,87% allocated in 2013.

This shows that Zimbabwe is failing to meet the stipulations of the 2001 Abuja Declaration on Health that at least 15% of national budgets should go towards health.

Parliament also noted that the ministry was shooting itself by freezing posts – a development which has contributed to very low staff to patient ratios.

“The nurse patient ratio is now sitting on below 2 nurses per 1 000 population.

“Even if the posts were to be unfrozen, conditions of service are not attractive to qualified personnel because of the pathetic salaries.”

Government’s continued failure to adequately fund the health sector last year forced Mpilo to extend a begging bowl to international and local donors for a US$15-million bailout package to fund infrastructural development and operations.

Built in 1957 during the Central African Federation, which brought together the then British territories of Southern Rhodesia (Zimbabwe), Northern Rhodesia (Zambia) and Nyasaland (Malawi), Mpilo is the largest hospital in southern Zimbabwe and has referral patients who come from Bulawayo Metropolitan, the Midlands, Matabeleland North, Masvingo and Matabeleland South provinces.

According to a document by the hospital administration, “it is noted that the infrastructure and plant built in 1957 faces several challenges due to lack of preventive maintenance, resulting in infrastructure being broken down and dilapidated.”

“The hospital roofs are leaking, causing damage. Incomplete infrastructure includes the chapel, mortuary and doctors’ residence,” it adds.

The hospital chief executive officer Los Mantiziba said there were staff shortages, particularly of radiographers and consultants; there are only 11 consultants out of the required 41.

“The hospital theatres face challenges of equipment and infrastructure, as out of 12 hospital theatres only four are fairly functional; out of the 10 hospital elevators only three are functional, while three out of eight hospital autoclaves are functional, with the laundry department having no reliable equipment, forcing (us) to utilise private laundries, the document further states,” Mantiziba said.

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