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Health delivery system continues to collapse
The Independent (Zimbabwe)
October 03, 2008

http://www.thezimbabweindependent.com/local/21298-health-delivery-system-continues-to-collapse.html

It is around 3am and 30-year-old Kudzanai Toziva cannot endure anymore the excruciating pain in his body.

His legs are swollen and he is shivering despite a high body temperature, his breathing is heavy and he is gasping for air.

His 24-year-old wife Nokhutula looks on helplessly and does not know what to do except to call close relatives to take Toziva to hospital.

On their way into town they debated on which hospital to take Toziva to. One relative suggested Parirenyatwa Hospital, but everyone turned down the proposal arguing that the health institution had serious drug and staff shortages.

They later settled for a private hospital.

They drove to Westend Clinic and were confident that Toziva would be attended to and relieved of his pain.

However, things did not happen as they expected. Instead of Toziva being admitted they were told that the hospital had no adequate staff to help them.

They carried Toziva back to their car.

With the little cash they had in their pockets they wondered where to go next as most hospitals were now demanding huge sums of money in cash and high amounts for a bank transfer or cheque.

The Avenues clinic was their next port of call, but upon arrival Toziva, who is a medical aid society cardholder, was told that beds were full and he could not be admitted.

Finally, after moving from one place to the other, Toziva was admitted at another private hospital in the Avenues area at around 4pm, more than eight hours since he started feeling the pain.

The hospital said they were ready to assist him, but they needed to decide first how much he should pay before admitting him.

The millions of Zimbabwe dollars they demanded were outrageous since the maximum daily withdrawal limit for individuals is pegged at $20 000. The Toziva family pleaded with the administration to pay in the form of a bank transfer.

After consultations they finally agree, but were told that there were hundreds of thousands of dollars they had to pay in cash.

"I had to ask a friend of mine kuti andipisirewo (do an RTGS of) US$400 into my account that I could transfer to the hospital's account," Toziva's sister said. "I was lucky the hospital agreed because we share the same bank so it was going to be an internal transfer."

The doctor who examined Toziva said there was excess water in his body, some of it having found its way into his lungs. The doctor said the excess fluid had to be removed using a catheter.

It took time for Toziva's family to raise the required money to remove the excess water and as a result he died on Wednesday. He died a bitter man.

Toziva might have succumbed to complications he experienced, but his parents still feel that hospitals could have helped him if they had attended to him earlier.

"People might say one cannot run away from the angel of death, but if they had attended to my son urgently maybe he would be alive today," said his mother, with streams of tears running down her cheeks.

The health delivery system in the country, according to a number of medical practitioners, has "gone to the dogs" as most of the country's major hospitals are out of drugs, food, functioning equipment and shortage of staff.

Parirenyatwa Hospital, for instance, is reported to have a critical shortage of medicines.

Most of the time the hospital doesn't have adequate water supplies and as a result a number of toilets have been closed down.

Posters reading, "no water, use the bucket" can be seen on toilet doors while some of the toilets are locked to prevent use.

A patient who preferred anonymity expressed disgust at the hospital's shortage of water saying it was unbelievable that such a big hospital should be left to operate without a constant water supply.

"Some toilets are said to be out of order. Honestly, how can a big hospital have toilets not working?" she said.

This week, Heath minister David Parirenyatwa was quoted by the state media saying drug stocks had improved by between 60% and 70% in the country's major hospitals. The new stocks include antiretroviral drugs and chronic ambulatory dialysis kits.

However, the president of the Hospital Doctors Association, Amon Severeki, said the supply of critical drugs was not even close to enough.

Severeki said: "It is funny because as we speak there are no drugs at Parirenyatwa Hospital and I am talking about just basic drugs like antibiotics and vial injections.

"There is a serious shortage. Patients are told to buy the vial injections at pharmacies, which might be going for $1 million each and probably one person will need about 50 of them. You can imagine, where will they get that kind of money?"

A senior medical doctor working at a private hospital who recently toured Harare Hospital, popularly known as Pagomo, said the standards at the hospital had deteriorated so badly that the hospital needs to be closed for renovation.

The doctor said: "The place is not fit to be called a hospital. The hospital's tiles have peeled off, some of them are dirty to the extent that you can't believe that they used to be white. Most of the equipment is not working and there is no adequate food for patients. That hospital needs to be closed for renovation. It is in a sorry state."

While women on maternity are given a list of items they have to bring so that they can be helped to deliver. The list includes 10 pairs of gloves, a needle, wool or thread, three candles, matches, blanket, sheets, syringe, surgical blade, BCG injection and umbilical pin.

A lot of people now pin their hopes on the deal that was signed by President Robert Mugabe and leaders of the two MDC formations -- Morgan Tsvangirai and Arthur Mutambara -- to address the problem of poor health delivery in the country.

However, people have to wait a little longer as the principals to the deal are yet to agree on the formation of a cabinet tasked with revamping the country's social, political and economic state.

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