ZIMBAMBWE needs to urgently address the Covid-19 vaccine hesitancy that is discouraging ordinary people from taking up the life-saving jabs at a time the number of people dying from the contagious disease continues to surge on a daily basis. The number of people dying daily, about a 100 a day, is horrific and must be stopped forthwith through proactive measures by government, communities and other able stakeholders.
The Community Working Group on Health (CWGH) is worried that people continue to die because they are reluctant to receive the free inoculations because of the widely- held myths, misconception as well as misinformation peddled mainly through the social media that the vaccines are not safe. The rate of vaccine uptake in some communities is frightening low and it calls for urgent proactive actions to encourage people to freely accept vaccination. In wake of this hesitancy and the mounting deaths, the CWGH would like to call on the government to urgently institute national Covid-19 vaccine literacy programmes to specifically debunk the myths and deconstruct the misinformation that has resulted in unnecessary deaths in the country. CWGH has established that a number of people still believe the vaccines can result in serious health complications later, death or infertility, theories that have been proven false.
This can also be achieved if the government works closely with trusted and influential sources of information which include community leaders such a traditional leaders, teachers, businesspeople, pastors and community-based organizations that have been sources of credible information for the local people for a long time. People believe what
they get from people or sources they trust. CWGH would like to call upon all influential people and community-based organizations to influence their people in their communities to accept and embrace vaccines because they are not toxic as claimed by purveyors of false information. People have a tendency to believe what they read on social media which in most cases would not be true.
This is no time to play politics or gaining religious advantages by exploiting people’s ignorance or mistrust of certain issues. One life lost is one too many as vaccines are safe, effective an save lives As an organization deeply rooted in the communities, CWGH has established that community leadership in an aspect of life is an important contributor to social development. Elected officials and community leaders play significant roles in times of disasters like the Covid-19 pandemic in both receiving and delivering messages and information. Apart from releasing regular information to the general public, CWGH would like to urge the government, through the various Covid-19 committees, to give regular briefs and updates to the community leaders, who would act as ambassadors and champions in the fight against the pandemic.
We would want to reiterate that community leaders are valuable sources of information and government agencies must always seek to create a relationship with them to facilitate the exchange of information. The Community Working Group on Health (CWGH) is a network of national membership based civil society and community based organizations who aim to collectively enhance community participation in health in Zimbabwe.
Itai Rusike (Mr)
Community Working Group on Health (CWGH)
4 O’connor Crescent, Cranborne, Eastlea, Harare, Zimbabwe
Mobile: +263 77236 3991
“Health is Your Right and Responsibility”
The Community Working Group on Health (CWGH) is gravely concerned by the current massive shortage of personal protective equipment (PPEs) for frontline health workers in the country in the wake of the infectious COVID-19 pandemic that has wreaked havoc globally. Healthcare workers rely on PPE to protect themselves and their patients from being infected and infecting others during their course of duty.
Surprisingly, the shortages come at a time when our COVID-19 cases are escalating due to the deadly second wave of transmission, spike in mortality rates and the threat of the highly contagious new strain of COVID-19. It is sad and very worrying to hear that nurses at Sally Mugabe hospital have downed tools citing the unavailability of PPE, a move that could plunge the country’s COVID-19 response deeper into the doldrums. The government should urgently equip medical staff with PPE and offering them safe transport to and from work daily.
It must be noted that shortages of PPEs have left doctors, nurses and other frontline health workers dangerously exposed and ill-equiped to take care of the increasing COVID-19 patients or suspects because of their limited access to supplies such as gloves, masks, aprons, respirators, goggles and gowns. The COVID-19 response cannot be done without valuing and protecting our health workers. It is worrying to hear that some health workers are being given just one mask for the whole week, despite the fact some are intended for one-time use and disposal. There have also been reports of some health workers sharing same gown with some reusing PPEs over prolonged periods.
The government must do everything within its means to avail PPEs to health workers because failure to do so would lead to unprecedented levels of burnout and disease. This would cripple the health system’s ability to continue caring for the sick and putting an end to the pandemic.
Itai Rusike (Mr)
Community Working Group on Health (CWGH)
BY MOSES MUGUGUNYEKI/NQOBANI NDLOVU
HEALTH experts have warned that Zimbabwe faces a fourth wave of deadly COVID-19 virus if the country fails to get more people inoculated, and that a third jab might be needed to help fight off emerging variants.
The fourth wave will be “more serious” and was likely to hit the country by year end at a time when the health system is broken from years of neglect and personnel shortages.
While the country has been recording falling numbers of new infections and deaths as the end of the winter season approaches, the Health ministry statistics on COVID-19 on Saturday revealed that the country is still in the red zone after recording 445 new cases; pushing the cumulative total to 115 890. It also recorded 21 deaths on the same day, raising the national death toll to 3 826.
Zimbabwe is currently experiencing a third wave of the global pandemic, with the Delta variant, a strain of COVID-19 taking its toll. The variant has been identified in at least 85 countries in the world.
Other variants of concern include Alpha, which was first identified in the United Kingdom, Beta, which was identified in neighbouring South Africa, Gamma identified in Brazil and Delta, identified in India.
Public health expert and president of the Medical and Dental Private Practitioners Association of Zimbabwe Johannes Marisa yesterday said a more deadly wave of COVID-19 was likely hit the country by the end of the year.
He said after nine months, COVID-19 jabs would be useless, adding that by the complacent behaviour of people who relax once they see the number of infections declining the situation maybe worse. He said some countries were already advocating for third jabs to intensify immunity.
“We are likely to face the fourth wave of COVID-19 around October to December,” Marisa said.
“Look at what is happening throughout the world. The United States is already facing trouble with the fourth wave. The world is panicking with some countries advocating for third jabs in order to boost the immune system. The passive immunity we get from jabs will last for nine months, that is disastrous, it means after nine months the jabs will be useless,” he said.
Marisa said Zimbabwe was likely to miss out on the third jabs considering the way the vaccination programme was being administered.
He said countries such as the US, Bangladesh, Indonesia and Tunisia were already on the edge of the fourth wave of the pandemic.
Marisa said some of the cases likely to fuel the fourth wave would emanate from countries such as South Africa and UK, which have since eased COVID-19 restrictions and warned that Zimbabwe should not follow suit.
“With the world behaving like this, I foresee disaster. How can a country like South Africa, which is in the midst of a frightening Delta-fuelled spike in infections, relax its restrictions? How can the UK remove all the COVID-19 restrictions? Look now, there is a spike in new infections in those countries,” he said.
Zimbabwe is targeting to vaccinate 60% of its population (approximately 10 million people) to achieve herd immunity and Marisa said this should be accelerated.
“This is the time to get people vaccinated or else we might have a fourth wave. However, the exercise had been slow, politicised and communities are failing to abide by COVID-19 regulations and there is political expediency at the expense of protecting people,” Marisa said.
Community Working Group on Health executive director Itai Rusike said the fourth wave was imminent as the vaccination rates of most African countries, Zimbabwe included, remained low with less than 2% of the population having been fully vaccinated.
As of Saturday, 1 002 261 people in the country had been fully vaccinated.
“Our biggest worry is on the unvaccinated population and the schoolchildren that are not yet being vaccinated. A lot more schoolchildren that are not yet eligible for vaccination will be infected by the highly virulent Delta variant and this will be a pandemic for the unvaccinated with catastrophic consequences to the already broken and overwhelmed public health delivery services that are failing to manage the high number of people needing hospitalisation,” Rusike said.
“There is need to strengthen the health delivery services by recruiting and retaining more workers, increasing hospital beds, provision of liquid oxygen and suitable personal protective equipment (PPE) and making sure that there are reasonable incentives for the health workers who are continuing to risk their health in order to save lives.”
Zimbabwe Nurses Association president Enock Dongo said the mass exodus of health personnel, especially nurses, will further put pressure on the country’s already overwhelmed health delivery system amid new deadlier variants of COVID-19.
“We are in a war due to the COVID-19 situation, and the people that are fighting that war have to be motivated, but sadly they are demotivated and intimidated by the system. Nurses are leaving the country in numbers although we do not have ready statistics of those that have left in recent weeks,” Dongo said.
Chief co-ordinator of the COVID-19 taskforce, Agnes Mahomva yesterday said: “We are prepared for everything. We continue to analyse these pandemics, and if you recall, we quickly responded to the first and second waves of the pandemic. For the third wave, we were up to the task and measures were put in place to contain the spread of the disease, and within a month we are seeing the figures going down. We have a strategic plan to deal with the pandemic whether it is first, second, third or fourth wave.”
Health deputy minister John Mangwiro refused to comment on the mass exodus of nurses during the deadly COVID-19 pandemic, saying that that was a “human resources department matter”.
World Malaria Day 2021
We mark World Malaria Day on 25 April. The theme for this year is Zero Malaria – Draw the Line against Malaria. We draw the line against malaria by taking action to end the disease at this time when COVID-19 has made the fight to end malaria harder. On this day, we highlight and appreciate efforts that have been made over the years to control malaria and celebrate the gains made to date.
Since 2000, the world has made historic progress against malaria saving millions of lives. According to the World Health Organization’s world malaria report 2020, 7.6 million malaria-related deaths have been averted since 2000. This is a huge success resulting from concerted efforts by Governments, partners and multilateral institutions such as the Global Fund partnership, which provides 56% of all international financing for malaria, and has invested more than US$13.5 billion in malaria control programs since the year 2002. Half of the world still lives at risk of malaria. 409,000 people died from the disease in 2019. An estimated two thirds of these deaths are among children under the age of five. Every two minutes, a child dies from malaria. These statistics should make us restless, especially because malaria is a preventable and treatable disease.
As malaria continued to fight back and cause needless deaths, COVID-19 struck, complicating the efforts to end malaria. The COVID-19 pandemic and restrictions related to the response caused disruptions to essential malaria services. Initial messaging that targeted to reduce coronavirus transmission advised the public to stay at home if they had fever, potentially disrupting treatment for those who may have had malaria and needed treatment. The lock down also slowed down malaria prevention programmes such as the distribution of mosquito nets. This disruption to malaria prevention and treatment will increase deaths from the disease and potentially lead to a surge in deaths in subsequent years. Children and pregnant women particularly remain at great risk. The fight against malaria must remain a priority to protect the progress made to defeat the disease. This calls for high impact investments in education, prevention, diagnosis and treatment, including research and development. Key to fighting malaria is building stronger health systems, which have been weakened further by the onset of COVID-19. To achieve this, there is need for stronger political leadership, more funding and increased innovation. Community engagement,
robust partnerships with private sector, foundations, academia, Government, civil society, for mutual planning, execution and accountabilities.
There is need for a cross cutting approach that unites human, animal and environmental health interventions to achieve desired public health outcomes. This is because some human diseases are shared with animals, other diseases such as malaria are related to the environment while other emerging diseases such as COVID-19 are associated with wildlife. Continuing to invest in research & development and scaling up country-driven solutions as well as innovations such as real-time data and next generation nets will help us stay ahead of the mosquito and its killer tactics. Social and gender norms that present barriers to access to healthcare especially among women from poor and vulnerable households who are often primary caregivers should be addressed. These actions to beat malaria must strongly engage communities and the youth including in aspects of advocacy through participatory approaches such as peer-to-peer initiatives. Communities must be at the heart of the malaria response. In the face of COVID-19, it is time for rigorous efforts to protect everyone who is at risk of malaria and to guard the tremendous strides made in fighting the disease. There is a lot of focus to beat COVID-19 but this must not be at the expense of accelerating progress against malaria. Malaria investments can be leveraged to fight COVID-19 and emerging diseases by promoting and facilitating safe and timely treatment of fever and ensuring that health workers are adequately
protected and equipped.
Critically, malaria programmes must be integrated with broader efforts to build stronger systems for health, which are anchored on established community health systems. Further, ending endemic diseases such as malaria will contribute to strengthening fragile health systems and beating pandemics like COVID-19 because ending malaria will reduce the burden on health systems and increase capacity to detect, prevent, and respond to pandemics. Despite the added challenges by COVID-19, malaria elimination remains a viable goal towards achieving universal healthcare coverage so that every Zimbabwean has access to efficient, effective and affordable healthcare wherever they are and whenever they need it without facing financial difficulties. Malaria elimination is possible. Zero malaria is within reach. The Community Working Group on Health (CWGH) is a network of national membership based civil society and community based organizations who aim to collectively enhance community participation in health in Zimbabwe.
For further information, please contact;
Itai Rusike (Mr)
Community Working Group on Health (CWGH)
4 O’connor Crescent, Cranborne
Mobile: +263 77236 3991 / 0719363991
“Health is Your Right and Responsibility” Continue reading “World Malaria Day 2021- Ending Malaria is Within Reach”
THE Ministry of Health and Child Care (MoHCC) does not encourage traditional midwives to deliver babies nor offer maternal health related services to pregnant women, a top government official has warned.
By Michael Gwarisa
The development comes in the wake of what has been described as “heroic works” of one Mbare traditional midwife, Mrs Esther Gwena who has since delivered more than 100 babies at her home. However, the babies are being delivered in the absence of critical health sundries such as, disinfectants, safe delivery kits, running water and proper waste disposal facilities a situation health experts fear could trigger an even worse health crisis.
In an interview with HealthTimes, Director Family Health in the ministry of Health and Child Care (MoHCC), Dr Benard Madzima said traditional midwives were not qualified to offer midwifery services and it was against the World Health Organisation (WHO) international guidelines.
In Zimbabwe, the program for maternal health is guided by the World Health Organisation (WHO) recommendations and the current recommendations are that traditional midwives are supposed to give health education to pregnant women and encourage them to go to established health facilities.
“This is because if a women then complicates or needs further help other than a normal delivery, traditional midwives will not be able to offer that help. For example, if a women suffers from post-partum hemorrhage, they will not be able to stop the bleeding, neither will they be able to give blood,” said Dr Madzima.
He added that Zimbabwe does not allow traditional midwives to offer services as this could result in even worse health complications.
“This is the background why it is not encouraged to have traditional birth attendants attending to pregnant women. They are not able to solve the complications which might arise. They are not able to give caesarean sections, the issues of integrating with other programs like HIV program like the immunization programs also come into play.
“So we don’t encourage traditional birth attendants delivering our women in Zimbabwe.”
In the early 80s Zimbabwe was advocating for the use of traditional birth attendants as part of the health delivery package. However, that was stopped in 1994 soon after the International Conference on Population Development (ICPD) following evidence that traditional midwives were not capable of handling birth related complications and other services that require skilled personal such as blood transfusions among others.
According to evidence based research, women who develop complications while at a traditional health attendant are most likely to lose their lives or that of the baby.
Community Working Group on Health (CWGH) Executive Director, Mr Itai Rusike said government should address concerns of doctors and stop issuing licenses to traditional midwives.
“By endorsing Traditional Birth Attendants (TBA) instead of addressing the concerns of the doctors and other health workers, the government risks losing all the gains achieved in Maternal Neonatal and Child Health programs as the TBAs are not equipped with the requisite skills needed in the event of a complication or excessive bleeding.
“This is a tragedy and the government is failing women and new-borns as the home deliveries are going to derail the country’s PMTCT programs and the postnatal care services that are supposed to be offered to both the mother and new-born. It is going to be very difficult to stop or discourage the TBAs from continuing practicing even after resolving the incapacitation crisis as they have been given a license and go ahead to operate and the long term consequences are going to be dire,” said Mr Rusike.
He added that the only noble thing to do was to get skilled health workers back in the clinics and hospitals so that the public health institutions can become functional again instead of celebrating medieval health practices that have long been forgotten in other parts of the world.
“We are not blaming the TBAs that are capitalizing and filling in the gap created by the non-availability of health workers in public health institutions but we need to hold the government accountable for sleeping on duty and failing to resolve the prolonged impasse and incapacitation crisis.”
Zimbabwe is currently battling numerous health challenges at the back of the obtaining industrial action by medical doctors and council nurses due to incapacitation. According to the latest Zimbabwe Demographic Health Survey, an estimated 614 women from every 100 000 who give birth die in the process, making it one of the highest in the world.
Public Health Expert, Mr Enock Msungwini however said engaging traditional midwives was not the best option to resolve the prevailing maternal health burden but government could capacitate them to ensure they complement qualified healthcare workers.
“It is not in the best interest of the public health context to engage traditional birth attendants. Factors like the reasons why women go there may vary. Is it about money, privacy, care, myths etc. These fall under the social determinants of health where one social system life style. Beliefs, economic status place of stay, diet and food have a bearing on health.
“The way forward however is to train them so that they complement the health system no to abruptly cut them completely,” said Mr Msungwini.
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.
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.