Zim continues to rely on donor funds

A TOUGH and agonising year is an apt description of 2016 when it comes to health service delivery.

Wongai Zhangazha

Zimbabwe this year experienced one of its darkest periods when major referral health centres, Harare and United Bulawayo Hospitals (UBH), suspended operations as a result of lack of vital drugs such as pethidine, injectable morphine, fentanyl, adrenaline, metoclopramide, sodium bicarbonate and antibiotics.

Pethidine is used to relieve moderate to severe pain, for example, during childbirth or before and during an operation.

The country’s health sector has not been spared by the economic downturn that has led to an acute cash shortage. However, the halting of operations at referral institutions was the major pointer of how the health delivery system has failed.

The year started with doctors and nurses at public hospitals going on strike after government failed to pay their December 2015 salaries.

This resulted in skeletal medical staff reporting for duty at the country’s major referral hospitals. The hospitals only attended to emergency cases, as a result putting the lives of thousands of patients at risk as many patients were turned away, while others waited for hours to get medical assistance at the hospitals.

There was an increase in maternal mortalities during the strike – deaths which could have been avoided.

Given the state of the health delivery system, it was not a wonder why President Robert Mugabe’s daughter, Bona, chose to give birth in far-flung Singapore.

For many, the First family’s decision betrayed their lack of confidence in the country’s healthcare facilities.

Her decision to fly more than 8 000 kilometres across the Indian Ocean to give birth was however not that surprising given that her father, President Robert Mugabe, gets treated at the state-of-the-art Gleneagles Hospital and Medical Centre in Singapore.

First Lady Grace Mugabe also gets treated abroad.

Throughout 2016, major drugs were in short supply in clinics and hospitals including referral institutions such as Parirenyatwa, Mpilo, UBH and Harare hospitals.

It became common for patients to buy their own intravenous bags (drips) which cost US$1,50 each, betadine, glycerine, crepe bandages and ichthammol ointment used for minor skin injuries as they are out of stock
Drugs that were out of stock or in short supply at major public hospitals for most of the year include clexane injection (which prevents and treats blood clots), morphine injection and tablets, warfarin (an anticoagulant used to prevent new blood clots from forming and helps stop clots from worsening), and benzathine penicillin, an antibiotic useful for the treatment of bacterial infections.

Other drugs, which were in short supply included antibiotics like benzyl penicillin, ceftriaxone and rocephin, clorpheniramine which treats sneezing, watery eyes and itchy nose, amphotericin B, an anti-fungal, atropine which helps keep the heart rate stable after a heart attack or during surgery, gentamicin which treats eye infections and kanamycin used to treat a variety of infections, among many others.

The pathetic state of the health sector was not a surprise given that the sector was allocated a paltry US$330 million in the budget. However the ministry did not receive most of the money it was allocated hence the dependence on donors.

The budget failed to meet the Abuja Declaration by African countries to allocate at least 15% of their annual budget to improving the health sector.

Year 2017 however looks even bleaker for Zimbabweans as the health ministry was allocated only US$208 million.
Community Working Group on Health executive director Itai Rusike said the budget has seen the health ministry relegated to number five in terms of allocation as compared to the previous years where it would be second after education.

Rusike said: “As a country we are not prioritising the health sector, the 2017 health budget is a mockery to the sector. The year 2016 has been a bad year, in fact it has been a dark year in terms of health.

“There has been a further decline in public health service delivery. This I mean accessibility of services and quality of care in a country where staff morale is going down as was evidenced by the doctors and nurses strike early this year.”

He added that: “Zimbabwe continues to rely on donor funds. Eighty percent of drugs are donor funded. Parirenyatwa Hospital for instance has now employed full-time debt collectors. Imagine the impact on the poor population in a country where almost 10% are on medical cover.

“People have lost the little properties they have, despite they constitution stating the right to health,” Rusike said.

He said there was no political will to improve the health sector, as the political elite seek healthcare outside the country.

“They do not trust the health system because they are not putting money into them. Zimbabwe is still a long away to providing the best healthcare. Maternal mortality is unacceptably very high. Everyday, an average of six mothers die due to pregnant related causes when pregnancy is not a disease,” he said.