EXCITEMENT gripped Tapiwa Chitoro (a nurse but not his real name) when he graduated as a nurse 10 years ago. Just like the many colleagues he graduated with, he hoped to fully abide by the nurses’ pledge to the service of humanity and undertake to practice with conscience and dignity.
By Wongai Zhangazha
In any given week, Chitoro, who works for one of the biggest referral hospitals in Harare, toils eight hours on day duty and 12 hours night duty. He works under poor conditions as he has to contend with the old dilapidated infrastructure at the institution.
The hospital, like many other public health facilities, is consistently lacking basic drugs, including 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.
At times betadine, glycerine and ichthammol ointment also run out.
What Chitoro deals with on a day-to-day basis is not for the faint hearted.
“Some patients die because there are no diagnostic machines to investigate. We are forced to nurse patients who are very ill without knowing the real diagnosis. We handle patients without protective clothing. This puts our health at risk and we pay medical bills for ourselves; the risk allowance is only US$40. But we feel it is not fair for us because if I contract a disease it can be for the rest of my life,” Chitoro said.
“Depending on the seriousness of the patient, we also bathe and feed them. We take doctors’ orders, order drugs and stationery. We are responsible for drug and intravenous fluids administration, health education to patients on admission and discharge, damp dusting, teaching students theory to practical writing and documenting every procedure done on a patient. During night duties usually there will be three nurses on duty: one qualified, one student and one nurse aide.
“These three will be nursing about 30 patients most of the time with inadequate oxygen and resuscitation drugs. We end up moving from one ward to another borrowing drugs, crepe, bandages and stationery. Rendering total patient care is impossible. The worst part is the ratio is one nurse is to 10 patients who are critically ill because the hospital is a referral centre. There is also a lot of pressure on midwives, and due to the lack of facilities some pregnant women are admitted on the floor because of overcrowding. We improvise all the time for government.”
While doctors should be a phone call away in instances of emergency, the day-to-day pressures of running a health centre fall on nurses, the backbone of the public healthcare system.
Due to the massive pressures of the job and poor working conditions with the majority getting a gross monthly salary of US$280, the nurses downed their tools last month demanding basic essential tools to carry out their duties. They also demanded a payment of salary arrears dating back to 2010.
Government, in turn, claimed that it had paid a total of US$17 million in the backdated allowances and therefore advised the striking nurses to return to work. They refused.
However, their grievances were met with a heavy hand after Vice-President Constantino Chiwenga, the former Zimbabwe Defence Forces commander, who also serves as defence minister, fired the nurses claiming that the strike was politically motivated. He threatened to hire retired nurses in order to replace the fired ones.
The Zimbabwe Nurses’ Association (Zina) then filed an urgent High Court application challenging the legality of the matter. Zina however withdrew its urgent court application amid allegations of victimisation.
While Chiwenga’s decision could be informed by Treasury’s limited fiscal space, analysts say his failure to observe workers’ constitutional rights and labour laws raised alarm.
To show government’s dictatorial tendencies, the nurses have since returned to work after bowing to pressure although their issues have not been addressed. Last week, Health and Child care minister David Parirenyatwa said government has permitted the nurses to resume duty pending final approval from the employer, the Health Service Board.
While the nurses’ strike crippled the already struggling national health delivery system and placed many innocent lives at risk, it remains their democratic right and that of other health staff to undertake industrial action, particularly when faced with an insensitive employer.
President Emmerson Mnangagwa last week told thousands of apostolic faith members in Madziwa that the striking nurses should learn that the country has vene vayo (owners).
However, on Workers’ Day Mnangagwa said: “We must also protect our workers and ensure that they cannot be taken advantage of.”
But the reality is as Zimbabwe joined the rest of the world in celebrating Workers’ Day this week under the theme “Uniting Workers for Social and Economic Advancement”, the intimidation of the nurses and forced the apology to Chiwenga for going on strike have left labour rights activists worried about the situation.
Activists have raised concern that the plight of workers has moved from a phase of repression of the worker through coercion to a phase of bullying and brazen intimidation, as demonstrated by Mnangagwa’s statements.
This year’s Workers Day came soon after medical doctors went on a 31-day industrial action demanding an improvement of their working conditions. The doctors’ month-long strike only ended after the Health Service Board agreed to review their on-call allowances and to provide equipment needed in hospitals as well as essential medicines and drugs.
Teachers have also threatened to go on a nationwide strike as schools open next week. The teachers are demanding better welfare despite recent intimidation by Primary and Secondary Education minister Paul Mavhima. Mavhima warned the teachers against going the nurses’ route.
Social commentator Stanley Tinarwo described government’s reaction to the nurses’ plight as disdainful and arrogant.
“The ‘Zimbabwe is Open for Business’ mantra of government is in no way designed to work closely with labour but capital, hence the disdain for the nurses and their industrial action,” Tinarwo said.
“Where the government has countered the Zina action with arguments about the sanctity of human life and dismissed issues of working conditions, it is being ridiculously dishonest. Government is responsible for the disastrous state of hospitals and services they offer. And where such a parlous state of affairs continues to obtain, including poor working conditions for hospital staff, government is also to blame.”
ZCTU secretary-general Japhet Moyo said the struggle for workers was far from over, even under the so-called new dispensation.