CWGH@20 Annual National Meeting Report
CWGH Annual Report for 2018
Healthcare tariffs condemned
Barring of injured from emergency services slammed
Junior doctors ‘arm-twisted’ to shelve strike
More doctors report for duty
Free maternity services require solid funding
THE heavily pregnant woman lying on the floor in a maternity ward at Harare Central Hospital stretches out her hand to greet First Lady Auxillia Mnangagwa.
BY PHYLLIS MBANJE
An unidentified expecting mother at Harare Central Hospital (right) has to make do on the floor due to shortage of beds in the maternity wing
For the briefest moment, the woman forgets about the hard, cold and uncomfortable surface and basks in the glow of being in the presence of “greatness”.
A wide grin splits her youthful face and she nods her head as the First Lady whispers some congratulatory words.
But once the colourful parade and its entourage has moved on, reality sinks right back in and once again the pregnant woman and her colleagues in the overcrowded maternity ward crouch back into their makeshift beds on the floor.
Harare and Parirenyatwa hospitals’ maternity wards, just like in most public health facilities across the country, are swamped with patients and many have resorted to sleeping on the floor.
This follows the scrapping of maternity user fees in accordance with the government policy.
During a tour of Harare Hospital’s maternity wards on the side-lines of the handover of the refurbished maternity wards by the First Lady recently, there was quite a huge number of women using floor beds.
This sad scenario apparently has become the norm in public hospitals.
Harare Hospital has a carrying capacity of around 100 women, but is currently being stretched to accommodate between 150 and 200 women. This also means pressure on the ablution facilities.
The government’s policy on free maternal health has seen a lot of women seeking help at the country’s major referral centres, Harare Central Hospital and Parirenyatwa.
Council clinics are still charging maternity fees and so many women will end up at government health facilities which are offering these for free.
A tour of Parirenyatwa also revealed the same problems. Maternity wards are full to capacity with many women using makeshifts beds.
“We handle births exceeding 20 in one night and this weighs heavily on the staff that have to work extra to contain the situation,” said a nurse who declined to be named.
She said the staffing levels had not increased and the wards had not expanded to cater for the overwhelming number of women.
“This will ultimately compromise services because the staff will be exhausted from handling so many women.
The women, however, had mixed reactions. Some were quite happy to even have the floor bed as long as they were not paying for it.
“I did not have the maternity fees for the council clinic where I stay so I came here to Parirenyatwa,” said a young first-time mother showing off her baby.
However, others felt that it was dehumanising to sleep on the floor and if they had a choice they would not agree to the set up.
The hospital’s public relations manager Linos Dhire said indeed the maternity wards were overstretched but they could not turn away pregnant women.
“The floor beds have been adopted to manage the ever increasing number of pregnant women who come for the free services. It is a good policy, only that the space is not big enough,” he said.
Community Working Group on Health director Itai Rusike said the abolishment of user fees should be backed up by provision of adequate resources.
“The blanket removal of user fees for pregnant women without clear vetting mechanisms for those that can still afford to pay presents a high risk of suffocating the public health delivery system,” he said.
Rusike also said government may need to seriously look at the long outstanding issue of building district hospitals in major cities to decongest the central hospitals.
“Resources must trickle down to the primary care level to avoid the assumption that the higher levels are better funded and better equipped,” he said.
“Unfortunately, it is not clear on how the ministry is going to fund the gap as pregnant women and under five children constitute the majority of the patients.”
Since 2009, the Health ministry has not been allocating significant resources for maternal and child care services.
This has created an over reliance on donor pools which are not sustainable.
Rusike said the free user fee policy for pregnant women and children under five should not just be political rhetoric.
“The health broken institutions need support with resources from the national budget. We need to protect the dignity of patients once they are admitted in our health institutions,” he said.
Speaking on the issue, Fungisayi Dube from the Citizens Health Watch said the policy was not practicable.
“It cannot be operationalised. It is sad and I do not think there is an effort to change things yet.”
Not The Time For Blame Game- CWGH
THE Cholera outbreak obtaining in Zimbabwe is not a platform to politically outfox each other or exhibit political muscle and prowess as lives are at stake, Community Working Group on Health executive director, Itai Rusike has warned.
By Michael Gwarisa
Commenting on the prevailing Cholera outbreak, Rusike said in as much as the rising number of Cholera deaths and infections exposes the government’s poor disaster mitigation mechanisms or perhaps the lack of political will, this was no time to shift blame on each other but to work together as a progressive force against Cholera.
“Other than declaring the cholera outbreak, that has so far claimed 25 lives and infected 3 700 people, a state of emergency, government response has been lukewarm and at a snail’s pace. Outbreaks of gigantic proportions like these require a very swift national response through raising awareness, treatment and restoration of basic social services. It is appalling that in 2018, people are still dying of such a primitive and preventable disease.
“The Community Working Group on Health (CWGH) calls for a concerted approach among key stakeholders that include the government, local authorities, residents associations, corporate world and the donor community to address the pandemic to save lives. It will be grossly irresponsible and dereliction of national responsibility for the government to allow the situation to degenerate to the 2008 levels where cholera claimed over 4500 lives and left several thousands affected,” said Rusike.
He added that the most worrisome aspect of the epidemic was the fact that the Cholera was that of a drug resistant strain bacteria which could hamper all the efforts if no solution is devised sooner.
“It is terrifying to hear that the strain of cholera bacteria that was isolated in patients in Harare has been determined to be resistant to first line antibiotics Ciprofloxacin and Ceftriaxone. A situational report prepared by the Ministry of Health and World Health
“Organization has painted a grim picture of the challenges facing the city of Harare at the moment saying 2 million people are in danger of co-infection of both cholera and typhoid. With resistance to first line medication it becomes imperative that the government source alternative medicine.”
He also took a swipe at government for neglecting the cholera crisis for the love of lavish lifestyles.
“The US$1m availed by government – criticized for its unquenchable propensity of spending on luxury cars for the Chiefs than important national issues – is not only paltry but an insult to relatives and friends who have succumbed to cholera, typhoid and other waterborne diseases in the past days.
“The cholera outbreak highlights the failure of government to maintain basic public health standards. It is a terrible consequence of failing to invest in and manage both its basic water and sanitation infrastructure and its health system. In most urban centres, residents go for months without tap water, forcing them to dig shallow and unprotected wells and boreholes that have been contaminated by raw
sewage flowing from burst pipes.
“Cities, once the epitome of good hygiene, have now been turned into big communal villages. Local authorities are in charge of all water delivery, sewerage, and refuse collection. They are also the recipients of all rates paid by residents who expect proper service delivery. Authorities must be held accountable to all these preventable an avoidable deaths. We have also heard with dismay, how City authorities are diverting money paid by residents to buy luxury cars and giving each other loans for personal gain,” he said.
He emphasized on the need for clean water in the short term so as to avoid new infections and reinfections in the cholera epicentre areas.
“Residents need adequate aqua tablets, they need boreholes; they need water bowsers as a matter of urgency. The MoHCC, the city fathers together with residents associations and other stakeholders must increase public health awareness programmes and improve public engagement forums to disseminate accurate information to residents.
“In the long term, Zimbabwe needs a consistent supply of clean water to all its people and in urban areas, replace the old water pipes that are letting sewage sip into the water reticulation system to permanently stop future outbreaks. Remember, most of these water and sewer pipes were laid during the colonial era and no effort has been made to replace them 38 years after independence.”
He also urged the Ministry of Health and Child Care (MoHCC), who are the custodian of the recently signed Public Health Act (PHA), to utilize the new law to deal and prevent the outbreak of preventable diseases such as cholera and typhoid. The revised Public Health Act should not just remain on paper but fully implemented and enforced to address the public health concerns.
“The network would like to applaud the corporate world and the donor community for chipping in with material and financial resources in an effort to stop the outbreak. We, however, would like to quickly point out that overreliance on external assistance is not sustainable for any country especially in Zimbabwe where, in most cases, political considerations supersedes all other considerations.
“For years now, Zimbabwe has been failing to adequately provide for the health sector resulting in the outbreak of archaic diseases. It has never met the 15% Abuja target despite acceding to the Declaration over a decade ago. The country is endowed with several kinds of mineral resources that it should not struggle to fund its health delivery system. It has gold, diamonds, platinum, lithium, nickel, chrome and several other at its disposal but surprisingly it is failing to adequately utilize them. This clearly points to poor prioritization or poor governance and lack of accountability as the resources are channeled to less needy areas to satisfy personal political needs.”
He also said that the failure, or perhaps lack of political will, to prioritise funding the health sector gives credence to the widely-held perception that government has been acting that way because most of the political elite are not treated locally but airlifted abroad, even for minor ailments, at the taxpayer’s expense.
“Only the poor are “treated” at local clinic where there are no medicines. Surely, how do you explain the “manmade deaths” to medieval diseases such as typhoid, cholera, the absence of emergency services and now the likely deaths from TB, which is treatable in this day and age”
Ncube criticised over failure to prioritise health
