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Hospital strike compounds healthcare crisis
Institute for War and Peace Reporting (IWPR)
Florence Gobo (AR No. 115, 8-June-07)
June 08, 2007

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As Zimbabwe's major public health institutions close their doors to patients because of strike action by staff, desperate families are selling their possessions to pay for treatment at expensive private hospitals.

The strike, which began in mid-May, is over poor salaries and worsening working conditions. It is the second strike action this year, and involves virtually all hospital staff from canteen workers to nurses and surgeons. It comes shortly after the end of a period of industrial action that paralysed the healthcare system countrywide.

Patients, even those in critical condition, are being turned away from public hospitals. Accident victims are going untreated for days. When they are turned away or discharged, they are advised to seek treatment elsewhere - meaning at private institutions.

One patient who gave his name as Tendai said he had to sell two head of cattle to raise the deposit for the fees at a Harare private clinic.

"What could I do? I want to survive, and possessions become meaningless compared to life. If I had to make a choice to sell my house or allow myself to die, I would sell the house," he said.

"This is what Zimbabwe has become - a person can lose everything in just an hour or in just a day. We have learnt to value life over any other possessions."

Another patient, 30-year-old Sean Marwizi, lay on a couch in the reception area at a Harare private clinic gasping for air. He was unable to breathe properly because of lung injuries sustained in a car accident, and his lips and face were turning blue from oxygen starvation.

Marwizi begged the receptionist for urgent medical attention while his family looked for the 170,000 Zimbabwean dollars, ZWD, consultation fee and another two million ZWD for ventilating him.

It is hard to translate these sums - at the official exchange rate two million ZWD works out as 8,000 US dollars while at the widely used parallel market rate it is 80 dollars - but for comparison, it represents about six months' wages for the average teacher.

The receptionist was unmoved. She told him he could only see the doctor after paying the consultation fee.

To experience first hand the impact of a second crippling strike just a few months after the end of the first one, this IWPR reporter accompanied the Marwizi family throughout their ordeal after meeting them at the private clinic.

Fearing that he was close to death, Sean Marwizi's family rushed him to one of the city's major government referral centres, Parirenyatwa Hospital, where they were advised to seek treatment at a private health institution.

The admissions doctor at Parirenyatwa told them that even though it was a critical case, there was nothing she could do to treat him as most of the key staff members, including the nurses, were out on strike.

She said referring them to a private institution was the best advice she could give them. When they said they had already been to a private clinic and had come to Parirenyatwa as a last resort, she said it was not her fault that the government could not pay realistic salaries to its doctors and other health workers.

Marwizi's face was deathly pale as family members helped him out of the casualty department.

Just outside, two other families were wailing after losing loved ones at the hospital, one in the casualty department and the other in a ward where no doctor had visited since she was admitted three days earlier. She had received no medication.

For Sean Marwizi, this seemed like the end of the road, but his family were determined to ensure that he survived. After a few calls to friends, they were able to raise just over 2.5 million ZWD and he was admitted to the private clinic that had turned him away earlier.

However this was just the beginning of his problems. His condition meant he had to be transferred to a bigger private hospital, which required a deposit of 15 million ZWD for every five days he stayed there. The doctor told them to budget for between 60 and 80 million ZWD for hospital fees, surgery and other procedures like scans and x-rays.

This was just too much money for a family whose combined monthly income was less than 10 million ZWD.

They sold their furniture, including sofas, a television set, radio, two beds, a dressing table and a dining room suite. They are even considering selling their stove and fridge to pay the hospital bills, which after 10 days had accumulated to more than 35 million ZWD.

IWPR conducted several interviews at the private hospital where Marwizi was admitted and found that other patients have had to sell cattle or household items to pay for medical costs.

The International Committee of the Red Cross, ICRC has described the health delivery system in Zimbabwe as comparable to "a war situation".

Sebastian Brack, ICRC communication officer for Southern Africa, told a human rights workshop in Bulawayo that the crisis could no longer be ignored if lives were being lost.

The health workers' strike has only worsened an already critical situation. The system has already collapsed, there is serious understaffing, low morale, a shortage of essential drugs including anti-retrovirals, and essential equipment is old or not functioning. Doctors and nurses battle with shortages of items such as surgical gloves, saline drips, syringes, painkillers and drugs.

Health workers earn well below the official poverty line, currently estimated to be just over two million ZWD. Currently, a junior doctor at a state hospital earns a basic salary of 240,000 ZWD plus allowances amounting to about 700,000 ZWD.

The industrial action came after Health Minister David Parirenyatwa admitted that state nurses could no longer afford the bus fare to work. His ministry has since announced an adjustment in allowances of up to 332 per cent for health workers.

Doctors working at state hospitals have gone on sporadic strikes over pay issues since last year. In December, the government had to bring in health personnel from the army to cover for striking doctors and nurses, but they were unable to cope with the large number of patients.

The situation looks set to get worse as the strike, now in its third week, continues, and more lives are bound to be lost.

Florence Gobo is the pseudonym of a reporter in Zimbabwe.

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