Where are we going wrong as a nation, healthwise?

Johannes Marisa

THE World Health Organisation (WHO) believes that unsafe patient care is among the leading causes of both morbidity and mortality in the world.

The Montroux Charter on patient care was recently endorsed in Switzerland.

The charter seeks to strengthen patient safety and thus eliminate preventable deaths in hospitals.

In 2007, WHO came up with an analytical framework to describe health systems and the strength of a particular health delivery service depends on the integration of the building blocks which are health workforce, service delivery, information systems, medical products, financing and leadership.

The unavailability of one of the building blocks surely leaves a shaky and unstable building.

Recently, WHO red-listed Zimbabwe’s health workforce to safeguard it and the nation that is now exposed to a major health disaster.

The red-listing is based upon a WHO workforce Support and Safeguard List, which is updated alongside scheduled progress reports on WHO Global Code Implementation and reported to the World Health Assembly every three years.

Brain drain has terribly hit Zimbabwe in the last three years, with at least 6 000 healthcare workers having left the country for greener pastures.

Experienced doctors, nurses, radiographers and scientists are leaving the country en masse as the country continues to lose high calibre workers on a daily basis.

Our country trains some of the best healthcare workers in the world and has thus become a hunting ground for health personnel.

Healthcare workers are leaving in huge numbers for greener pastures.

The United Kingdom (UK) has immensely benefited from the brain drain and between 2019 and September 2022, the number of Zimbabweans granted work visas to work in the UK jumped from 499 to 8 363.

Economic meltdown has been cited as the major push factor and if it remains unabated, there is a risk of a serious worker turnover in the near future.

Many people may interpret the WHO move as a ban on the recruitment of Zimbabwean nationals seeking healthcare jobs in countries such as the UK, Australia, France, the United States, et cetera.

It is true that our country has the density of doctors, nurses and midwives below the global median of 48,6 per 10 000 population.

Health institutions are grossly understaffed in our country, so it is imperative for government to put in place measures that improve the working conditions of the remaining workers.

While the nation can celebrate WHO red-listing of Zimbabwe’s health workforce, it is prudent for our government to motivate healthcare workers so that the brain drain is curtailed.

The following can be considered:

lThe general living conditions of healthcare workers are deplorable.

Many of them are tenants who cannot even afford to pay their monthly rentals, yet government is the owner of all State land.

Land barons are busy parcelling out land to many people for self-aggrandisement, yet critical workers are in desperate need of accommodation.

Why not assist critical staff with stands, houses or housing loans as part of a staff-retention strategy?

  • Remuneration has not been up to standard in our country with workers being forced to engage in corrupt activities.

Botswana, Namibia, South Africa have all outdone Zimbabwe in terms of remuneration, so the country continues to lose experienced health workers to these countries.

If Botswana thrives on diamonds, why not Zimbabwe that has at least 23 types of the most precious minerals?

  • Political will should improve if the country is to achieve universal health coverage for its people.

How can our hospitals function with limited workers, yet we are known to be competent trainers?

The policymakers should consider the plight of the populace who cannot seek treatment out of the country because of financial limitations.

  • Upgrading our healthcare facilities should be done in line with the latest technologies. The state of some of our hospitals is deplorable and there should be major facelifts.

Basic investigative facilities should be available, for example an Ultrasound Scan, X-ray facility, Computed Tomography scans, laboratories et cetera.

Why does a whole hospital run in darkness yet a generator costs less than US$20 000 to install?

  • Availability of power back-ups at public hospitals.

It is calamitous if there is a power outage at a health facility without a reliable back-up.

Imagine having patients on theatre tables, intensive care units, elevators and a sudden power cut occurs when there is no back-up.

Hospitals and clinics should have reliable stand-by generators or solar systems to sustain the entire facilities in times of power outage.

  • Availability of simple sundries to use like gloves, syringes, needles, cannulae and bandages should be a priority.

Why are we shaming ourselves by not stocking such small items as a nation?

Those who are calling the shots in administration should prove their mettle.

Zimbabwe has potential to deliver quality health. The health workforce and its welfare should be a priority.

Johannes Marisa is president of the Medical and Dental Private Practitioners Association of Zimbabwe. He writes here in his personal capacity.

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