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Healthcare collapses under Mugabe
Jan Raath, Times (UK)
August 19, 2006

http://www.zwnews.com/issuefull.cfm?ArticleID=15006

A system that was once the envy of Africa is devastated by drug shortages and rising charges

Faith Chirinda enjoys nothing more than joining her friends in song. The Isheanesu day centre reverberates with the sound of children singing and laughing, an oasis of fun in the heart of Harare’s squalid Glenview township. Faith and her mother are regular visitors at the centre, but soon the 14-year-old will be unable to attend these singalongs. The medication that controls her cerebral palsy has run out. Faith’s condition has been stabilised by free and regular supplies of phenobarbitone, an anticonvulsant that kept her destructive seizures in check, but two days ago the local clinic exhausted its last supplies. Now an excruciating early death looms over her. Chemists sell the drugs for the equivalent of only £1, but even that sum is beyond the reach of Virginia Chirinda, her mother. "Faith is shouting all night," Mrs Chirinda, said. "The landlord knocks on the wall and tells me to keep her quiet. It is impossible. I end up crying."

Faith is the latest victim of the plague of sickness and death that has followed President Mugabe’s wilful ruination of Zimbabwe’s robust economy and its abundant food production. With it, its healthcare system, once the envy of Africa, has quickly become moribund. Immediately after independence from Britain, in 1980, Mr Mugabe’s Government built hundreds of rural clinics and district hospitals that brought affordable medical care within reach of nearly all remote communities. Harare’s medical school and several nursing colleges produced skilled, competent doctors and nurses. Immunisation and treatment programmes checked measles, polio and tuberculosis. Even this year the Health Ministry’s prevention of mother-to-child infection treatment programme of HIV was the most efficient in Africa. Now, while Mr Mugabe continues to spend on military hardware, money for the health system has dried up. Hospitals are critically short of drugs and equipment. The state-run National Pharmaceutical Company (Nat-pharm) has admitted that in the first five months of this year it was able to supply only 49 per cent of the drugs needed by state institutions.

Disgruntled doctors and nurses have scattered all over the world in search of better-paid jobs. According to health ministry statistics, fewer than one in four posts for doctors is filled. Four out of five of the district hospitals that serve rural areas have no doctors. In April the Health Ministry increased hospital fees to the point where casualty admission charges at state hospitals went up by 300,000 per cent. All but the wealthiest have been excluded from state healthcare. At Harare central hospital, one of the country’s four largest referral institutions, gardeners have planted a new lawn outside the entrance. Inside, the floors were gleaming and the walls smelt of fresh paint. However, the reality of the institution’s collapse was made plain in a list of demands presented by Harare’s senior clinicians to the Health Ministry. The acute and emergency medicine departments, the main general surgery suite, the resuscitation room, the intensive-care unit and the radiology department were closed because of lack of equipment and maintenance; the neonatal unit and the laboratory were crippled; the tomography (CT) scanner was broken; maintenance of lavatories and lighting was abandoned.

Many parents have stopped hospital treatment for their children because they cannot afford the charges of about Z$500,000, the equivalent of ten loaves of bread. Paediatricians at Harare children’s hospital said that admissions of 25 a day have dropped to five since the new fees were announced. In response to an outcry over the new fees, David Parirenyatwa, the Health Minister, last month said that the new charges for children under five had been abolished. "That is not true," said Gregory Powell, chairman of the Zimbabwe Paediatric Association. "They get the consultation free but must pay for everything else." "I have to prescribe for patients with epilepsy and diabetes, knowing that they can’t afford [medicines] and that they will probably die without them," said a doctor who works at Parirenyatwa central hospital, Harare’s other major referral institution. "Usually it comes out of my own pocket."

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