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Report paints grim picture of health sector
Shame Makoshori, Financial Gazette (Zimbabwe)
March 20, 2008

A new report on staffing levels within Zimbabwe's crumbling healthcare system paints a dire picture of the impact of the brain drain, with vacancy rates for crucial skills in hospitals as high as 70 percent.

More than 3 500 nurses and 969 doctors had left government health institutions by September 2007 after the health professionals intensified their hunt for better opportunities in the region and abroad, a report prepared by the Nurses Council of Zimbabwe (NCZ) says. Statistics in the report show there were 3 502 vacancies for nurses and 969 vacant posts for doctors at the end of last year.

The health sector report gives an insight into the devastating impact of the skills flight from Zimbabwe. The NCZ document, prepared by the Directorate of Human Resources and entitled "Programme Performance 2008", shows an escalating crisis that has not only weighed heavily on service delivery in state health institutions, but has compromised the quality of health professionals graduating from training institutions. "Out of a total of 1 761 doctors on the whole approved establishment, 792 were in post as at September 2007, reflecting a vacancy rate of 46 percent," the report says.

However, crucially, most of this existing staff consists of trainees. "It should be noted, as in most categories, that the figures of those in post are significantly boosted by the medical cadet. Head of departments and consultants show high vacancy rates of 74 percent and 73 percent respectively." The report says the positions of department heads and consultants are critical, "as they are also responsible for the training of other doctors. With such vacancy rates, the quality of the graduating trainee could be jeopardized." Environmental Health Services had a relatively high overall vacancy rate of 51 percent. The report said there were no (Environmental Health Technician) EHT tutors, water safety, sanitation and waste managers, port health managers and environmental health training officers(100 percent vacancy rate).

NCZ president Clara Nondo said this week that as a result of the exodus of qualified and experienced health professionals, training institutions are under increased strain because they have to increase intakes to cover the gap. The council's figures showed a worsening health worker to patient population ratios, as well as the plummeting quality of service due to the loss of experienced and qualified health workers. Out of the required four radiation protection staff required in government, there were two in September 2007, while out of the required 459 radiographers, there were only 261. The government required 578 pharmacists, but only 332 posts were filled during this period, leaving 246 vacancies. The Public Service required a 35 285 staff complement to operate efficiently, but as at September 2007, only 26 347 posts were occupied, leaving about 9 000 staff vacancies.

The low staffing levels are a result of a deepening economic crisis that has rendered the Zimbabwe dollar worthless, making monthly salaries meaningless to professionals. Last year, a parliamentary committee heard that Zimbabwe's road network was crumbling because there was not a single civil engineer left in government. An estimated three million Zimbabweans are believed to be working outside the country, with 37 percent of these in the United Kingdom, 35 percent in Botswana, five percent in South Africa and 3.4 percent estimated to be in Canada. With the country's inflation rate at more than 100 000 percent, the brain drain is expected to accelerate as the quality of life deteriorates further in tandem with real incomes. Researchers said this week the brain drain is also being driven by high taxation, shortages of basic commodities, shrinking personal freedoms and rights, pessimistic views about the future and poor economic and political policies that have destroyed the middle class.

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