HEALTH-ZIMBABWE: Hospitals Turn Patients Away As Strike Begins to Bite

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Chris Anold Msipa

HARARE, Dec 12 2003 (IPS) - The strike by medical doctors and nurses in Zimbabwe is crippling the public health sector, at a time when the poor cannot afford high fees that private hospitals charge.

Monica Ngwere, an asthmatic patient from Shurugwi in central Zimbabwe, was last week turned away from Parirenyatwa Referral Hospital in the capital, Harare.

“They said I should come back after the strike. But nobody told me when that would be. I had come to see the specialists. Nurses at our clinic said I should be put on different medication from what I am taking now,” she said during an interview, while waiting to board a bus back home.

Other patients in Harare and the commercial city of Bulawayo share her dilemma. Government hospitals in the two towns have reportedly closed some of their wards and are not admitting patients due to the industrial action.

Rumbidzai Mutero, a resident of Harare, said this week she witnessed the ugly face of the strike. “We boarded a kombi (commuter omnibus) with one old woman accompanying her daughter to Harare Central Hospital. They had a prematurely born baby carried by the old woman”.

What shocked Mutero on their way back from the hospital was that the two still had the baby, now wrapped in a piece of cloth like a parcel.

She said she saw the young woman’s medical papers, which read “uterus contracted normally, breasts back to normal and baby brought dead, weighing 1.8 kgs”.

Mutero said it was obvious the old woman, with the corpse strapped to her back, and her agonised daughter, had been turned away without receiving help.

The government of Robert Mugabe has ordered the arrest of the striking doctors and their union leaders. At least 12 of them had resigned in protest against a labour court ruling their industrial action was illegal.

Close to 20 doctors have been arrested and charged under a section of the Labour Relations Act, which bans public workers from taking part in strikes.

Health Minister David Parirenyatwa has condemned the strike and urged doctors to return to work, without giving them satisfactory answers. His ministry has even threatened to take action against the striking nurses, if they do not start reporting for duty.

“While it is appreciated that medical staff should not abandon patients, it is unfair to expect someone to work for peanuts in the name of patriotism,” said Maria Kanekora, a social worker in Harare.

She said, although the salary being demanded by the striking doctors was too high, the government should feel for its workers in the face of the increasingly difficult economic situation in the country. It can at least show concern and negotiate in good faith, instead of trying to use force to silence them, she said.

“The doctors’ cries have fallen on deaf ears over a long period. They have been harassed, threatened and fed on false promises like kids. It’s high time this matter is solved once and for all, if the health sector is to start functioning normally again,” Kanekora said.

Junior and middle-level doctors have since October been striking, for the fourth time this year, to demand better salaries and working conditions. They want monthly pay of 30 million Zimbabwe dollars, which is 6,000 U.S. dollars on the thriving parallel market and about 37,500 dollars at the official exchange rate.

Sources within the health sector say Cuban doctors working in Zimbabwe are earning 6,000 U.S. dollars per month, and their Zimbabwean colleagues want similar remuneration because they do the same job. Minister Parirenyatwa says the government cannot pay such amounts.

The striking doctors say their take-home pay is not enough to meet their basic needs such as food, accommodation and transport. This happens in a country where inflation, which now hovers at more than 600 percent, is expected to reach 700 percent early next year.

A spokesperson for the Zimbabwe Congress of Trade Unions, Mlamleli Sibanda, is quoted as saying his organisation expects the conditions in the hospitals to worsen, prompting more medical professionals to resign due to the heavy-handedness of the government.

Dr. Phibion Manyanga, president of Zimbabwe’s Hospital Doctors’ Association, said the striking doctors fully appreciate, and that it is in their conscience, that they are guided by their professional ethics. “But everyone has a breaking point,” he said.

Manyanga said one cannot professionally consider another person’s wellbeing if one cannot fend for oneself.

Dismissals and resignations of medical staff have left Zimbabwe with only around 900 instead of the required 2,200 doctors.

The striking doctors complain about poor pay, working long hours without rest, shortages of soap, towels, gloves, x-ray films and other equipment needed daily in wards, theatres and laboratories.

Acute foreign currency shortages have caused deficiencies in equipment and medical supplies in the hospitals. Parirenyatwa Referral Centre in Harare, the biggest in the country, has shortage of ambulances.

“The hospital uses old pick-up trucks as ambulances. But most of the vehicles are parked due to shortages of spare parts and money to maintain or repair them,” said one security guard, a former labourer at the institution.

A recent report, financed by the United Nations Development Programme (UNDP), shows Zimbabwe has lost about 125,000 doctors, nurses and pharmacists, who have left for greener pastures to escape the depressing economic, political and social crises at home.

Two years ago, the British Medical Journal said Zimbabwe was graded last out of 191 countries the World Health Organisation, WHO, had surveyed. It even performed worse than the struggling Democratic Republic of Congo, Lesotho, Malawi, Swaziland and Zambia.

The WHO study says Zimbabwe’s public health delivery system was once a shining example to Africa, but it is now bleeding from years of neglect and inadequate funding by the government.