Sorry state of Zim’s health delivery system

KUDAKWASHE CHIBVURI AND MOREBLESSING MARANGE

A stench of desperation engulfs the casualty section of Parirenyatwa Hospital.

Dozens of sad faces sit with their minds clearly unsettled, with pieces of paper in hand pondering their next moves.

Doctors and nurses toil up and down as if they are busy but their lackadaisical approach sells them out. They are not paying attention to the people’s desperation.

They do pay attention to only those with cash and want to strike a deal but what is evident is many in the queue do not have cash and can’t even strike a deal. All they wait for is the worst, even staring at death.

The struggling Zimbabwean economy and rising cost of living have left the general populace grappling with access to basic healthcare.

In a country where the formal sector is dead, millions have lost their jobs, getting sick comes with a huge price.

The situation has been exacerbated by the economic crisis that has also seen nurses downing tools in protest over poor working conditions as exposed last year by an investigation by the Business Times of the tragic state of affairs at Sally Mugabe Hospital.

Latest investigation by Business Times has revealed that many Zimbabweans find it increasingly difficult to access even essential health services due to inadequate salaries for civil servants and exorbitant fees charged by private hospitals.

Consultations at private facilities range between US$20 to US$50 while other services are charged separately.

A scan, usually done at the hospital is now being outsourced by nurses and doctors to their “connections” in private prices and this comes with a cost.

A snap survey at Parirenyatwa Hospital confirmed that doctors and nurses at the facility are tending to direct patients to their private surgeries for a huge fee arguing they will get adequate attention at the facility.

One of the patients said she had been directed to seek treatment from a named private facility and the doctor at Parirenyatwa Hospital would attend to her from there.

“I was referred to another facility and the doctor told me he will personally come to attend to me from there as there are no proper requirements here so I am making my way there,” she said with her eyes pronouncing pain.

Another observation was that a lot of drug dealers have camped at the facility to sell drugs that are not immediately available or are made “conveniently unavailable” by the nurses and doctors who have their “runners” to trade outside.

Again, this comes at a cost.

“You are told of the unavailability of drugs from the hospital but then they refer you to some people who have the said drugs. They demand cash and nothing else so the suspicion is it is a scheme, a well-coordinated strategy,” an informant said.

A nurse at Parirenyatwa Hospital who spoke on the condition of anonymity indicated that many medications available at the hospital are allegedly sold by doctors to private facilities or in some cases, stolen.

“Sometimes, the cost of treatment in public facilities is cheaper than in private ones, yet we struggle to find medicine in public pharmacies,” she explained.

She also noted that the number of tests required at private facilities has increased, often leading to unnecessary expenses for patients.

“We used to see one or two tests, but now it’s common to require six or seven. Many cannot afford these costs,” she said.

“This is why many poor patients are suffering. They turn to public facilities, which often lack medications, while private hospitals remain unaffordable.”

In a series of interviews with various doctors, Business Times gathered insights into treatment costs.

“In government hospitals, consultation fees range from $6 to $8, while private practices charge between $20 and $50. Specialized tests, such as X-rays and MRIs, escalate costs significantly, with the latter starting at around $350.”

“Residents in rural areas face even greater challenges.”

Residents in Hwange and Victoria Falls have resorted to crossing the border into Zambia for healthcare, finding it more cost-effective than seeking treatment in Zimbabwe.

“Healthcare costs here are exorbitant, so crossing the border, though far, makes more sense for us.”

Former Health Minister, Dr Henry Madzorera said the public health delivery system is currently dead.

 “So our public health delivery system at the moment is not functioning,” he said. “We have gone back to the pre-2008 situation. There is a serious shortage of healthcare workers and it’s not just physical shortage, it’s also the spirit to work.”

“The spirit to work is diminished because workers are not being paid properly,” he added.

He added that public hospitals are failing to provide basics requiring patients to purchase everything including cotton wool and basic medicine.

“The second thing is the provisions in the hospitals. There is nothing. When patients go there, they have to buy everything. There is nothing that the hospital provides. That’s a serious problem. What about patients who don’t have relatives who can be buying for them and bringing the stuff to the hospital?”

He said the fee-for-service system is hitting hard on patients.

“There’s no medicine. Our pharmacies are just empty shelves so everything is broken down. The other problem now is the fee-for-service system. This thing that people have to pay when they are sick, when they come to the hospital, should have ended a long time ago.

“The plans were there to end it and we’re right on course to end it but the government keeps talking about a universal health coverage plan for the population. People must pay before they are sick. Don’t ask me to pay $500 when I’m sick. Where do I get it?”