CONTENTS | ANB-BIA HOMEPAGE | WEEKLY NEWS
|
Zimbabwe |
HEALTH
Some years ago, Zimbabwe was recognised as having one of the region’s best healthcare services. This has now changed mainly due to a massive brain-drain and shortage of foreign currency, occasioned by a deepening economic crisis
The quality of institutional health has deteriorated substantially during the past five years, and the country’s healthcare system is finding it difficult to cope with a barrage of challenges confronting it. For the last twenty years, competent staff have not been recruited and there’s a lack of foreign currency to replace old equipment. This means that major healthcare institutions are now being manned mostly by students supervised by a few experienced staff —thus severely compromising the quality of service delivery.
Doctors, pharmacists, nurses and physiotherapists have left in droves for better job prospects over the last three years, to countries such as the United Kingdom, Australia, New Zealand, Canada, and closer home, to South Africa, and Botswana, where salaries are much higher than in Zimbabwe. Most of those leaving are from the public sector, but of late, the private sector has experienced the same spate of resignations.
No reason to stay
Zimbabwe is suffering from shortages in every sector (until recently cash was included among the shortages). Because of this, Maria Mandina, a nurse at Parirenyatwa Hospital, the country’s biggest referral hospital, says there is no reason to stay. «I’ve tried to be patriotic and save my country, but it is no longer possible. My friends who have left became millionaires overnight, while I’m struggling at the end of each month to receive the miserable pay I’m due». Maria is shortly leaving for the UK.
According to the Hospital Doctor’s Association (HDA), there are only an estimated 750 doctors presently left in the public sector of medical care. So, the present doctor to patient ratio is around one doctor to 16,000 patients. A recent (July) civil servant pay increment of 150% has not helped matters. Junior doctors were recently on strike demanding a salary of not less than 2 million Zimbabwe dollars per month, a figure that the government says is «ridiculously high». About 32 doctors are estimated to have resigned from Parirenyatwa and Harare Hospitals alone this year. The HDA says that a typical referral hospital needs about 55 registrar doctors, 35 junior doctors, 30 senior resident doctors and 22 senior consultant doctors in order to function satisfactorily.
Only a third of an estimated 500 physiotherapists trained at the University of Zimbabwe (UZ) are still in the country, while about 50 Zimbabwean nurses are said to be leaving the country every month. About 20 physiotherapists graduate from the UZ every year. Even though a bonding system exists for both doctors and nurses, it has not been effective in stopping the brain drain. Nurses earn between Z$138 446 and Z$222 967 a month.
Zimbabwe’s Health and Child Welfare minister, Dr David Parirenyatwa, says that in order for the country’s health care system to regain its regional reputation as a centre for medical excellence, the government must re-introduce and indeed expand a training programme for nurses, doctors and pharmacy technicians. He would not say why the government has instead opted to hire doctors from Cuba and Congo RDC at the expense of improving the salaries and welfare of local medical personnel.
Reports from Harare and London indicate that up to half of Zimbabwe’s trained social workers are now working in the UK. Christopher Chitereka, the president of the National Association of Social Workers (NASW) says about 1,500 of the 3,000 workforce now resides and works in Britain.
The departure of professionals has angered President Robert Mugabe who has lashed out at the UK for recruiting from Zimbabwe, but nothing seems to have been done to stop the rot. Dr Parirenyatwa blames underfunding of his ministry, and a persistent shortage of foreign currency as a major cause for a deterioration in healthcare standards. The 2002 budget allocated Z$22 billion to his ministry, whereas he wanted Z$98 billion to ensure the adequate functioning of the country’s health services. Many drugs have now to be imported at prohibitive prices, putting mainstream medical care beyond the reach of many, forcing a number of ordinary people to seek alternative treatment, usually from traditional healers.
Dr Parirenyatwa says that Zimbabwe’s government is working tirelessly to revamp the health service’s quality, but the nation’s primary health care policy is suffering from inadequate investment.
- Tonderayi Mukeredzi, Zimbabwe, October 2003 — © Reproduction authorised, with usual acknowledgment