Zimbabwe Reimposes a Lockdown to Contain Rising Coronavirus Cases

Credits: Voice of America

UPDATE 

Zimbabwe’s government on Monday is reintroducing a lockdown as a way to contain rising coronavirus cases in the southern African nation.

Announcing the reintroduction of the lockdown Saturday night on national television, Vice President Constantino Chiwenga said complacency had resulted in a recent spike in cases of the coronavirus responsible for the COVID-19 disease.

“Our vaccination against in COVID-19 is going on very well,” he said. “The country is however experiencing a surge in cases. The last seven days has seen 596 new cases and 26 deaths, as compared to the same period in May last year where we had 132 cases and six deaths.”

Chiwenga, who doubles as Zimbabwe’s health minister, said all gatherings except for funerals would be banned comes Monday. Only 30 people would be allowed at funerals. He did not indicate when the new measures would be reviewed.

Itai Rusike, head of nonprofit Community Working Group on Health in Zimbabwe, commended the government for tightening the lockdown to avoid a “pending third wave disaster.”

“Yes, this may look a bit draconian, but the measures are still necessary if we are to save lives. It is important that the people of Zimbabwe should embrace these measures. It is also important for Zimbabweans that are eligible for vaccination to come forward and willingly get vaccinated if the country is to move forward towards achieving herd immunity of vaccinating at least 60% of the population which translates to about 10 million Zimbabweans,” he said.

Zimbabwe’s vaccination effort against the infection has recently been hit by shortages of the shots. But officials say the country still has stocks of the 1.7 million vaccines it has received from China, Russia and India since February.

Last week, Zimbabwe received 25,000 Sputnik V doses from Russia. That was a few days after it rejected Johnson & Johnson vaccines from the African Union, financed by the African Export-Import Bank. Zimbabwe has 39,852 confirmed coronavirus infections and 1,632 deaths, according to the Johns Hopkins University, which tracks the global outbreak.

Zimbabwe Appeals for Vaccine Funding Amid Surge in COVID-19 Cases

Credits: Voice of America

Zimbabwe’s government is asking for help from the country’s corporate sector, citizens and other well-wishers to fund the import of COVID-19 vaccines. The southern African nation is falling behind in the battle with the coronavirus, despite imposing a 12-hour curfew last month as part of a lockdown to deal with the pandemic, which has infected about 35,000 people in Zimbabwe and caused 1,300 deaths, most of them this year alone.

Itai Rusike, executive director of the nonprofit Community Working Group on Health in Zimbabwe said in an interview he was shocked by the extension of the “usual begging bowl” when President Emmerson Mnangagwa’s government has been lately “bragging of a surplus budget.” He said citizens and companies in Zimbabwe are feeling the impact of the slowed economy, so they cannot donate for COVID-19 vaccine imports.

“So, let us use the budget surplus money to purchase the vaccines. We also have the 2% tax on mobile money transactions,” said Rusike. “We also have the health levy. These funds should be earmarked for the vaccine purchases for now. Even the International Monetary Fund said spend the budget surplus money as long as the financing is transparent and closely monitored.”

Zimbabwean Finance and Economic Development Minister Mthuli Ncube refused to comment Saturday on his call for assistance.

Rusike added that the call for an unspecified amount of funds to import vaccines was confusing after Mnangagwa this week said his government had sourced free vaccines – some 200,000 donated by China. In the same speech, broadcast on national television, Mnangagwa said.

“A national vaccine deployment framework has also been finalized,” he added. “The initial objective is to inoculate at least 60% of the population. Government has set aside the requisite financial resources for the purchase of vaccines.”

Rusike said Zimbabwe should not expect much assistance from its usual donors such as the U.S., Britain and the European Union.

“It will be very difficult for the international donors, to come in and support Zimbabwe at this stage,” said Rusike. “Mainly because the very same donors are having the biggest burden of COVID-19. If you look at the U.S, the U.K, these are the hotspots for COVID-19. A lot of more people [than Zimbabwe] have been infected from COVID-19 and a lot of people continue to die from COVID-19 in those respective countries.”

For years now, the country’s health sector has largely depended on assistance of aid organizations such as USAID. The country’s health workers have on several occasions been on strike – including during this coronavirus outbreak – asking for PPE and better salaries.

Traditional Midwives Not Allowed In Zim Says Gvt

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.

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.