HEALTH-ZIMBABWE: No Cure Yet For Ailing Sector

By IPS Correspondents Reprint | | Print |

John Deng

HARARE, May 7 1998 (IPS) - For a long time after independence in 1980, Zimbabwe could point to its health sector as a success story of development. But over the past seven years, the sector has rapidly lost its glow.

Walking into a hospital or clinic for medical treatment today is more of a risk than staying away. Doctors and nurses, like drugs, are scarce.

“These patients you see now lying down in the passages have been referred to us from their clincs. But we are unable even to listen to their complaints, because of the overcrowdness in the hospital,” a nurse told IPS during a visit to one of the major hospitals in the capital Harare.

According to a report in the semi-official daily ‘Herald’, ironically on Workers Day (May 1), the Ministry of Health confirmed in a report that the country now faces a critical shortage of nurses and will have to recruit from outside.

Four wards at the country’s largest referral hospital, Parirenyatwa, have closed, because of the critical shortage of nurses. About 2000 nurses are urgently needed in the health delivery system, the ministry estimates.

In 1996, hundreds of junior doctors and nurses went on strike for better salaries and working conditions. The government took a hardline against the strikers and dismissed about 200 junior doctors and more than 300 nurses. Although the majority of the junior doctors replied for their posts, the nurses did not.

“Government is now doing nothing about the problems facing the health sector, and the general quality of service has gone down. Morale among working nurses and doctors is also low, because of the increased workload and poor working conditions in the public hospitals,” says a doctor from Harare Central Hospital, who declined to be named.

“There has been no filling of vacant posts, no review of salaries nor an improvement in working conditions in hospitals since the strike,” he told IPS.

During the recent visit of Tanzanian President Benjamin Mkapa to the country, it was decided that nurses will be recruited from Tanzania under a joint agreement between the two countries.

According to Clara Nondo, President of the Zimbabwe Nurses Association (ZINA), the health sector now lacks the sufficient “human and material resources needed for running an efficient system”.

Nondo adds that the scarcity of financial resources, lack of drugs and grossly underpaid staff, with poor conditions of service, have led to nurses seeking greener pastures in the private sector or in neighbouring countries. Nurses earn an estimated gross monthly salary of between 2500 and 3000 Zimbabwe dollars (One U.S. Dollar is now equivalent to 17.3 Zimbabwe Dollars).

“The result is increased pressure at the various medical centres and the remaining nurses are forced to do work that is supposed to be done by general hands, like pushing trolleys, which has hardened their attitudes towards patients,” Nondo says.

The shortage of nurses also has been caused by a government decision in 1992 to stop training State Certified Nurses. The training of general nurses is limited to major hospitals, and only about 350 nurses are trained each year.

Zimbabwe’s public health delivery system is comprised of four central hospitals, seven provincial, 20 district hospitals and 200 health centres and clinics nationwide. There are 16,000 nurses and 2000 doctors currently registered with the Health Ministry.

And, according to the ministry’s estimates, the current doctor/patient ratio is one doctor to 6000 patients, while that for nurses is one nurse to 700 patients.