Doctors’ absence prolongs patients’ suffering

ORDINARY citizens whose pockets are not deep enough to afford private medical care continue to bear the brunt of the ongoing stand-off between medical doctors — who have been on industrial action for over two months now — and government.

People with various ailments are gambling with death as many have since stopped going to seek medical attention at public hospitals, where they are routinely turned away due to the unavailability of doctors.

Hope in the public health system recuperating and going back on its feet has been lost and the pain has been worst felt by chronically ill patients who rely on the doctors’ services from time to time.

Faina Guruuswa (not her real name), has suffered from anal cancer for 11 years, having been in and out of hospital since 2008, seeking services to at least ease her recurring ailment.

The growth is often cut, but it grows again at a slightly different spot. She has had to become a permanent resident at one of the country’s biggest health institutions, where she is being attended to.

When NewsDay visited her, she was fearful that speaking to the media would attract severe backlash from hospital authorities.

Sometime in September soon after the doctors downed their tools, she had to go for an incomplete chemotherapy treatment.

Chemotherapy treatment may be a single drug or a combination of drugs. The drugs may all be given on a single day, several consecutive days, or continuously.

Guruuswa was given three doses, instead of five, and was told it was just a favour being accorded her since doctors were on strike.

Such is the case for many in her situation. Scheduled treatment is no longer guaranteed, further worsening their situation as cancers are bound to spread rapidly.

Guruuswa said she was now living in uncertainty over how long she would be stuck at the hospital awaiting services in the face of the doctors’ prolonged strike.

“My condition started in 2008 soon after I started anti-retroviral treatment. I developed small pimples in my anal area and I sought treatment which was not entirely successful,” she said.

Five years down the line, she said it started growing again and she received medical attention, but it recurred again in 2015 and she had to go to Karoi General Hospital to have it removed.

“The growth started again and in 2016, I went to a bigger provincial hospital for another operation, but the growth wasn’t completely healed and I was in excruciating pain. I have had to live on painkillers until now. I am on morphine to help ease the pain,” she said, barely being able to conceal the pain gnawing at her as she narrated her ordeal.

She came to Harare in winter this year because she felt she was now being a burden to her sister, who had accommodated her in Chiredzi, but was also struggling.

Things turned for the worst when the doctors’ strike began and her dream of ever getting better have been shattered.

“Things have changed. Before this, we did not have problems getting treated. It was timely and straight-forward,” she recalled.

Guruuswa has had to endure the harsh economic conditions and is living off the hospital after authorities availed a shelter for those in her situation at the Annex Psychiatric Unit.

She, however, keeps holding on to the last straw of hope that the doctors will return to work and she gets her scheduled treatment before things turn for the worst.

A visit to Parirenyatwa Group of Hospitals on Thursday evening last week proved that things were far from normal.

As the NewsDay crew sat in the casualty area trying to figure out how people were being served in the wake of the ongoing doctors’ strike, one of the senior doctors finally came after close to two hours of waiting.

“Doctors are on strike, but I am here to assist you with your next step,” the doctor said.

He told one woman who had brought a young man who had drunk poison, to take him back home and force him to drink lots of water because there was no doctor to deal with his condition.

Two women who had a baby with an ulcer on the thumb were told to rush to a private practice as their case was an emergency, which, under normal circumstances, would have been quickly dealt with at the hospital.

Several others were told to go back home.

Zimbabwe Hospital Doctors Association spokesperson Masimba Ndoro told NewsDay that while they drew no pleasure in seeing their patients suffering, the onus was on government to ensure that the basic right to health was upheld.

“We really want to be with our patients. We don’t draw any pleasure from their suffering. It is quite sad that people are being deprived of their right to health as a result of the impasse.

“It is the government’s responsibility to make sure that people are accorded quality health. The government should quickly come to terms with regards to accepting that we have a problem,” he said.

Community Working Group on Health (CWGH) executive director Itai Rusike said the ongoing impasse between government and the doctors was taking its toll on patients and there was need to resolve the crisis urgently.

“CWGH is greatly worried by the incapacitation crisis and prolonged impasse between the doctors and their employer, which has resulted in untold suffering of patients and even deaths that could have been avoided under normal circumstances,” he said.

“While we acknowledge the genuine grievances of the doctors and the financial position of government, we would like to urge the two parties to put patients first and at the centre of their dialogue to save lives and stop the suffering.”

The doctors have remained adamant and have vowed not to return to work until government offered a meaningful remuneration, among other things.

Government has already fired 211 striking doctors after conducting disciplinary hearings, albeit boycotted by the medical practitioners.

At least 516 doctors face the axe as the disciplinary hearings continue.

Meanwhile, Guruuswa’s life, and that of other patients in critical conditions, remain in the balance.

Chaos as govt fires over 200 doctors

GOVERNMENT yesterday fired 211 doctors at public hospitals for going o strike to demand better pay, with another 500 at risk.

Doctors have been on strike since September 3 demanding salaries that are indexed to the United States dollar to escape triple digit inflation that has ravaged wages.

The Health Services Board fired the doctors after holding disciplinary hearings which the striking doctors did not attend and said it planned to hold another round of hearings for at least 516 out of the 1 601 doctors employed in the public sector.

The Zimbabwe Hospital Doctors Association, which represents junior and mid-level doctors, has accused government of intimidation to force its members to return to work.

Health Services Board (HSB) executive chairman, Paulinus Sikosana yesterday said the disciplinary hearings were set to continue.

“To date, 279 doctors have been served with charge letters, 213 hearings completed and 211 doctors found guilty of absenting themselves from duty without leave or reasonable cause for days ranging from five or more,” he said.
“The 211 doctors found guilty have been discharged from the health service. Three doctors appeared in person before the disciplinary tribunals and two doctors had their determinations reserved pending verification of their cases.”

Sikosana said at meetings aimed at ending the impasse, doctors had “demanded the pegging of their salaries to the prevailing interbank rate as a precondition for their return to work.”

Zimbabwe is facing its worst economic crisis in a decade, with inflation, estimated at 353% in September, playing havoc with salaries and prices.

Community Working Group on Health (CWGH) executive director, Itai Rusike said the decision by government was very frustrating considering efforts made to facilitate dialogue with hope of reaching an amicable decision that is comfortable for both parties.

“We have been facilitating dialogue for the past two weeks only to wake up to this. How do you negotiate for dialogue when on the other hand you are holding a knobkerrie? The government is not sincere and its attitude is uncalled for and unnecessary,” Rusike said.

“This intimidatory attitude is not the way to go. The Constitution gives them the right to withdraw their labour and firing the doctors in a country with poor health standards will not improve the situation.”

He said they had done their part in trying to get the two parties to dialogue in search of a solution to the impasse.

“We thought that the government was going to set aside the hearings and uphold dialogue. Without human resources we cannot achieve universal health coverage,” he said.
ZHDA executive members said they were not commenting on the latest developments for fear of victimisation.

“Senior doctors remain incapacitated and hospital drugs and equipment remain inadequate. No meaningful service is being offered at central hospitals,” the union said in a statement.

“Training of both undergraduate and postgraduate doctors has been severely impacted by lack of clinical teaching.

“Flexi-hour system remains in place as policy. This has greatly affected quality and continuity of patient care Junior and middle level doctors have been dismissed from work for not being able to report for duty due to incapacitation. Some on maternity leave and others who are training outside the country have also been served with letters accusing them of absenteeism.

ZHDA said the ‘punitive disciplinary hearings’ should stop while the dismissals must be reversed.

“Robust dialogue in good faith should take place with key stakeholders to help direct the capacitation of the workers and the public health institutions. These must be given timelines to yield results,” ZHDA said.


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Public hospital doctors have lashed out at the Health Services Board (HSB) for firing 77 doctors since Tuesday. Addressing Zimbabwe Hospital Doctors’ Association (ZHDA) members and the media at Parirenyatwa Group of Hospitals yesterday, the association’s vice-president Masimba Ndoro said the move by government was costly, especially on citizens who have no healthcare givers.

“This is an abnormal situation which requires solutions not to waste taxpayers’ money. It is a move we have anticipated; we knew they would take that route as we started our strike. It will not capacitate our doctors and it won’t change the situation in our health system,” he said. Ndoro said the doctors would stick to their guns even in the face of more threats from their employer until they reach a reasonable agreement.

ZHDA acting secretary-general, Tawanda Zvakada said the decision of the HSB was proof that they were not in their right senses and as an association they would wait for them to come to their senses and reach a meaningful conclusion on the matter that has been hogging the limelight for a number of years.

“We hope this is the last strike, we want a long-lasting solution to prevent these impasses and we have proposed that the salary is paid at interbank rate to avoid situations where our earnings are eroded just a month after they would have been reviewed,” he said.
ZHDA treasurer-general Tapiwa Mungofa, questioned HSB’s credibility as they have diverted from their mandate of representing them and to act on issues that pose a threat to their calling.

“The decision to fire doctors came as dismay to the doctoring profession; the HSB is mandated with a very simple task, but it’s a shock they have been barbaric, firing the few doctors the country has,” he said. Mungofa said the doctors remain open and available for dialogue.

Community Working Group on Health (CWGH) executive director Itai Rusike said the dismissals will neither address the problems affecting the doctors nor boost their morale.

“CWGH has learnt with great concern the dismissal of the doctors that are currently affected by incapacitation. We strongly urge the government to find amicable ways of dealing with the doctors’ incapacitation crisis without sacrificing the health of the masses,” Rusike said.

He said the country has a pathetic doctor-patient ratio that has left the available human resources stretched to the limit, thereby compromising quality of care.

“We implore the HSB to reconsider its decision and fully take advantage of the dialogue process being facilitated by CWGH,” Rusike said.

Rusike called on the two parties to find amicable ways of dealing with such problems while prioritising the lives of patients and the general public that depend on the public health institutions.

Trevor Chivandire, one of the fired 77 doctors, said as professionals who have their country’s interests at heart they were going to try and re-engage their employer and would try other avenues if the move does not yield results.

Dialogue needed to break doctors, govt impasse

Doctors and their employer have been urged to engage in an honest dialogue aimed at ending the current impasse which has halted operations in public hospitals and created chaos in the private sector which is being swamped by patients.

The Community Working Group on Health (CWGH), which is mediating between the Zimbabwe Hospital Doctors Association (ZHDA) and the Health Services Board (HSB), said there was need to resolve the matter urgently.

“We are saying to the government let us open the dialogue doors by setting aside the disciplinary hearings and give dialogue a chance,” CWGH executive director Itai Rusike told NewsDay yesterday.
Doctors last week snubbed disciplinary hearings by government over their refusal to go back to work after being ordered by the court to do so.

The refusal, accompanied by Information deputy minister Energy Mutodi’s threat to fire and blacklist all the striking doctors, has complicated the negotiation process.

CWGH initially met with the ZDHA executive committee last week as well as the HSB.
A meeting was then convened on Wednesday for a joint discussion and meetings are continuing even though progress is said to be slow.

This is due to mistrust and suspicion between the two parties, who have had a standoff for more than two months, with government instituting disciplinary hearings.

“Both parties should bear in mind that more than 90% of the Zimbabwe population depends on the underfunded and understaffed public health system,” Rusike said.He added that there was need to prioritise patients and the vulnerable populations in their dialogue to resolve the crisis.“We also would like to see the leadership from the HSB to ensure speedy resolution of this crisis. The general public would like to be furnished with concrete steps, including timelines the government is committing to address the current dispute,” Rusike said.

Rusike also said sadly, the issue of brain drain as a result of push factors was very worrying. “Experienced doctors are leaving and this compromises the quality of health care,” he said.

The HSB has maintained that they are sticking to the laid-down procedure and would go ahead with the hearings with or without the doctors.

The doctors, who have not been reporting for work for over 60 days, on the other hand, have said that they would not attend the hearings.

“We do not care about the hearings, all we are concerned about are the issues of incapacitation, which have not been addressed,” ZHDA acting secretary-general Tawanda Zvakada said yesterday.