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Zimbabwe's hospitals suffer with economy
Washington Times
October 09, 2008

http://washingtontimes.com/news/2008/oct/09/hospitals-suffer-with-economy/

The advice of doctors to Zimbabweans is, don't get sick. If you do, don't count on hospitals: They're short of drugs and functioning equipment.

As the economy collapses, the laboratory at a main 1,000-bed hospital has virtually shut down. X-ray materials, injectable antibiotics and anticonvulsants have run out.

Emergency-resuscitation equipment is out of action. Patients needing casts for broken bones need to bring their own plaster. In a country with one of the world's worst AIDS epidemic, medical staff lack protective gloves.

Health authorities blame the drying up of foreign aid under Western sanctions imposed to end political and human rights abuses under President Robert Mugabe. A power-sharing agreement aimed at bringing the opposition into the government could open the gates to foreign aid. But negotiations have stalled over how much power rests with Mr. Mugabe.

Meanwhile, the economic meltdown is evident in empty store shelves, long lines at gas stations - and hospitals where elevators don't work and patients are carried to upper wards in makeshift hammocks of torn sheets and blankets.

Jacob Kwaramba, an insurance clerk, brought his brother to Harare's Parirenyatwa hospital, once the pride of health services in southern Africa. Emergency-room doctors sent Mr. Kwaramba to a private pharmacy to buy drugs for his brother's lung infection. He returned two hours later to find his brother dead, he told the AP in the emergency room.

"I couldn't believe it. It wasn't a fatal illness," he said.

Another family said a relative dying of cancer was sent home, and no painkillers could be found in Harare pharmacies. Relatives abroad were able to pay for morphine, but by the time import clearance was obtained from the state Medicines Control Authority, the man had died in agony, the family said, requesting anonymity for fear of government retribution.

A report by six independent Zimbabwean doctors indicates the scale of the collapse.

"Elective surgery has been abandoned in the central hospitals, and even emergency surgery is often dependent on the ability of patients' relatives to purchase suture materials from private suppliers," it said.

A power-sharing agreement aimed at bringing the opposition into the government could open the gates to foreign aid, which could help hospitals recover from shortages. "This is an unmitigated tragedy, scarcely conceivable just a year ago," says a report by six doctors.

"Pharmacies stand empty, and ambulances immobilized for want of spare parts ... this is an unmitigated tragedy, scarcely conceivable just a year ago."

The doctors who compiled the six-page report for circulation among aid and development groups withheld their names because comments seen as critical of Mr. Mugabe are a punishable offense.

In an interview this year, Health Minister David Parirenyatwa said lack of foreign currency owing to sanctions was hindering efforts to maintain equipment. But political violence has added to the burden. The human rights group Amnesty International said hospitals ran out of crutches for victims of attacks blamed on Mr. Mugabe's forces.

The independent Zimbabwe Human Rights Forum, an alliance of human rights campaigners, said doctors and medical staff were chased from rural clinics to keep them from helping opposition supporters, while many city hospitals couldn't cope with the number of patients' injuries sustained in beatings and torture blamed mostly on militants of Mr. Mugabe's party and police and soldiers.

The opposition Movement for Democratic Change says at least 200 of its supporters died in the violence, with thousands more beaten and made homeless.

No data is available on how many lives have been lost because of the medical crisis, but the report said hospital admissions declined sharply because of the cost of treatment and transportation over long distances to clinics and hospitals.

In recent years, 70 percent of births took place in health facilities. Now it's under 50 percent, the report said.

It is said that a decade ago, Zimbabwe had the best health system in sub-Saharan Africa. But with the economic crisis worsening, 10,000 Zimbabwean nurses are employed in Britain alone, and 80 percent of Zimbabwean medical school graduates are working abroad.

The main Harare medical school, once renowned for the quality of its graduates, has lost 60 percent of its complement of lecturers, and an unprecedented 30 percent of its students failed this year's final examinations.

The report said despite the troubles, health professionals still manage to run clean and well-ordered facilities.

"The pharmacy may be empty, and most equipment out of order, but they will be striving to provide some sort of service," it said.

Mr. Parirenyatwa, the health minister, estimated the public sector had only half the doctors it needed. The main Harare hospital is named after his father, one of the first blacks to qualify as a doctor before Zimbabwe won independence from Britain in 1980.

The elite go for care abroad, mostly to South Africa, but also to Asia. Mr. Mugabe regularly has checkups in Malaysia.

But the doctors said that if there was a plane crash or similar disaster, victims who might otherwise be saved by prompt and well-equipped care would likely end up as "dead meat."

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