Crumbling health sector leaves trail of broken lives

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Privilege Mukwaya (in coat) at the funeral of his wife who died of pregnancy complications at the Mbuya Nehanda Maternity Hospital in Harare this week. Pic: Shepherd Tozvireva.

THICK dark clouds enveloping one of Harare’s oldest suburbs Mabvuku on a humid Tuesday afternoon appeared to reflect a sombre mood along Busi Street as residents mourned one of their own.

Wongai Zhangazha

Privilege Mukwaya (in coat) at the funeral of his wife who died of pregnancy complications at the Mbuya Nehanda Maternity Hospital in Harare this week. Pic: Shepherd Tozvireva.

Privilege Mukwaya (in coat) at the funeral of his wife who died of pregnancy complications at the Mbuya Nehanda Maternity Hospital in Harare this week. Pic: Shepherd Tozvireva.

As the deceased’s body arrived at the family home late afternoon, hopelessness and anguish were painted on the faces of friends, relatives and neighbours.

With no hearse and funeral company managing the funeral, one could tell that the deceased was one of the millions of Zimbabweans who cannot afford basic medical insurance or a modest life assurance policy.

At just 23, Caroline Dube and her unborn child fell victim to Zimbabwe’s shambolic healthcare system. She left behind a three-year-old son and a husband.

Dube, whose pregnancy was almost full term, died at Mbuya Nehanda Maternity Hospital due to pre-natal complications.

Latest statistics from the World Health Organisation (WHO) show that as at 2015 Zimbabwe’s maternal mortality rate stood at 614 deaths per 100 000 live births. Maternal mortality is the death of a woman while pregnant or within 42 days of delivery or termination of pregnancy, irrespective of the duration and site of the pregnancy, from any cause related to or aggravated by the pregnancy or its management. It however should not be from accidental or incidental causes. This year the ministry of Health and Childcare was allocated only US$208 million, while the Defence and Home Affairs ministries were allocated US$340,5 million and US$364 respectively. Critics say this is a mockery to a country that once operated a decent healthcare system.

Her husband, Privilege Mukwaya, is yet to come to terms with the bereavement. For him a vibrant public health system could have saved his wife.

The country’s public health delivery system went into limbo last week when junior doctors went on strike over poor salaries and working conditions. Since then many lives have been in peril.

While doctors have legitimate reasons to demand more, questions have been asked as to whether the Hippocratic oath still means anything to health professionals or the commodification of the health sector now prevails. The public is also asking whether the government cares at all about the health of poverty-stricken citizens.

The doctors went on strike after the government failed to meet their demands for an immediate review of on-call allowances from US$288 a month for the lowest-paid doctor to US$720.

Doctors are demanding that the Health Service Board (HSB) urgently implements the agreed duty-free car imports framework for all government doctors.

A government freeze on new recruitments for doctors upon completion of their two-year internship has also triggered the doctors’ industrial action. Mukwaya recalled his wife’s final moments as her condition deteriorated last month.

“We went to Parirenyatwa at the casualty section and on the first day a doctor checked on her and just put Caroline on oxygen and said they couldn’t admit her because doctors were on strike. We were forced to go back home. But because the situation seemed to be getting worse, we just had to return the next day despite being told that there was a doctors’ strike,” a sobbing Mukwaya narrated as he sat on a boulder in the family yard.

Mukwaya said when they returned the next day Dube was admitted to the main hospital and later transferred to Mbuya Nehanda Maternity Hospital.

“We were relieved that a doctor was available to attend to her and gave her some medication. However, what worried me is for three days that she was at the maternity hospital no doctor came to see her. Only nurses attended to her.

She seemed to have done a bit well and I thought maybe an operation could have been done to either save the mother or the child,” he said.

“However, her situation deteriorated and the nurses told me that she was in labour and her contractions had started to open the cervix and she was at two centimetres. I was desperate and I felt so helpless watching her writhe in pain. The nurses just told me that an operation could not be done. I just wished I could talk to a doctor and ask how one of them could be saved,” Mukwaya said before bursting into tears.

Unfortunately, Mukwaya received the sad news that Dube died in the early hours of Sunday.

A doctor who preferred anonymity said what happened to Dube was sad and, although she had not been well, her life could have been saved had she been given the necessary medical attention.

“In pregnancy complications, first priority is always given to the mother than the unborn child. This is a decision that lies with a doctor and not nurses. If the patient is too sick to be made to fall asleep during the operation then at least spinal block should be administered where the operation can be done while she is awake,” a Harare-based doctor said.

Spinal block quickly delivers pain relief to the lower body for a limited period of time, while a procedure performed for a caesarean section will make an expecting mother completely numb below the belly button and unable to move the legs.

When this newspaper visited the hospital on Friday last week, a long queue of patients who had gone for hours without receiving medical attention could be seen. Some patients could be seen desperately seeking the attention of hospital guards but they were brusquely told to join the long winding queue.

Zimbabwe Hospital Doctors’ Association (ZHDA) president Edgar Munatsi on Wednesday bemoaned government’s lethargic response to the crisis.

“We are shocked that the minister of Health (David Parirenyatwa) is not even talking to us despite reports of avoidable deaths at our central hospitals. Does he even care about the suffering poor?” Munatsi asked.

On Wednesday, the permanent secretary in the ministry of Health Gerald Gwinji told state media that the ministry has sought the help of health professionals from the uniformed forces to minimise the impact of the strike.

Community Working Group on Health (CWGH) executive director Itai Rusike said the country’s major referral hospitals in Harare and Bulawayo have literally closed their outpatients departments and stopped attending to emergencies, a situation that could prolong suffering and lead to avoidable deaths.

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