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ZIMBABWE: 'Cheaper to die than to get treated' as health system
fails
IRIN News
January 27,
2004
http://www.irinnews.org/report.asp?ReportID=33736
When Jasper
Simalie suffered from severe respiratory complications two years
ago, his family had no reason to fear for the worst. They had their
hopes pinned on Zimbabwe's affordable health care service, which
enjoyed the reputation of being one of the best in Southern Africa.
And it delivered. After two months' recuperation, Simalie returned
to his job with one of Zimbabwe's leading cement manufacturers.
The condition
returned to haunt him last year, and this time the family made frantic
but futile efforts to find affordable treatment. Simalie's illness
forced him to stay at home for three months. He was retrenched,
and left with only enough money to pay his way back to his rural
home in the northwestern province of Binga.
He has been
bedridden for the past eight months. "For the pain I feel,
I wish I had died two years ago. Eight months of suffering is worse
than all the pains of a lifetime. If I had the money, I would seek
private medical service and buy myself the necessary drugs. But
I don't," he told IRIN.
Hospitals, according
to Simalie, "are now a place to die - they refer everyone to
a filthy deathbed under a hardworking but underfunded home-based
care system."
Simalie's predicament
mirrors that of many other Zimbabweans, suffering as a result of
public health sector inefficiencies. The astronomical increase in
the cost of private and public services has aggravated the situation.
Plagued by a
scarcity of drugs, dilapidated medical equipment and persistent
strikes over poor remuneration by health sector professionals, the
public health care system is on the verge of collapse. Over the
past two years, people have been forced to turn to private medical
practitioners for services no longer offered by government clinics
and hospitals.
The last straw
came this month when private medical doctors increased their consultation
fees. General practioners hiked their rates from an average of US
$5 to US $13 per consultation, while specialists began charging
up to US $32. Doctors cited an official inflation rate of around
600 percent as the reason for the increased fees, and stopped accepting
medical aid schemes, demanding cash upfront.
State hospitals
also raised their consultation fees this month, while public sector
clinics in Bulawayo, the country's second city, now charge US $2
per consultation - last year they were charging only 28 cents.
Drug suppliers,
feeling the pinch of the high inflation rate, increased the cost
of drugs by 1,000 percent in October last year - 500 ml of children's
cough mixture rose from 12 cents to US $1.80, while a full course
of common antibiotics now costs around US $11. A month's supply
of antiretrovirals to control HIV cost more than many people earn
in a year.
Pharmacy managers
and health consultants say inflation cannot be ignored in a sector
that relies heavily on imports, and foreign exchange is hard to
find.
"At this
rate, no ordinary Zimbabwean worker can afford to buy drugs at these
prices. But, as drug retailers, we have no choice but to pass the
increases on to the patients," said a manager with one of the
city's major pharmacy chains.
Isaiah Shoniwa,
the secretary-general of the Zimbabwe Medical Wholesalers Association
(ZIMWA), said price increases in the drug sector were unavoidable
because importation costs had risen by the same margin of 1,000
percent. "We find the cost of importing drugs highly prohibitive.
In fact, most of us are not sure if we will remain in business because
of the costs involved," Shoniwa said, adding that another hike
was imminent this year.
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