Friday, January 9, 2009

Patients Fork Out Forex, Health System Comatose

Not even the political stalemate between President Robert Mugabe and MDC leader Morgan Tsvangirai on the formation of a unity government, the cholera epidemic and food shortages can drown Towanda’s excitement.
“Very soon I am going to be a father!” he declares excitedly.
As he looks at his wife’s huge tummy, he smiles wondering who the baby whom they have already named Chido would look like — him or his wife.
Their wish is to have the baby delivered at a private clinic that they believe has the requisite resources — medicines, hospital equipment and experienced staff — but the idea of not having foreign currency to meet the bill dampens his joyous fantasies.
Towanda, an accountant, bemoans that he cannot afford to give his unborn child the best treatment he had wished for.
In December he was paid through his bank $34 billion plus a 20-litre fuel coupon which he sold at US$15.
When he consulted a private hospital in the Avenues, Harare, Towanda was asked to fork out US$500 as a maternity registering fee.
The figures send shivers down his spine. He wondered what the Goodwills Masimirembwa-led National Incomes and Pricing Commission (NIPC) was doing to keep prices of goods and services in check.
Towanda decided to register his wife with a public hospital, the Mbuya Nehanda Maternity wing at Parirenyatwa, which was last year closed for a while due to shortages of resources like drugs, equipment and staff.
The hospital reopened recently after non-governmental organisations chipped in with funds and after it was given the green light by government to charge in foreign currency.
Towanda was told to pay US$300 as registration fees and for delivery of his wife — an amount he can hardly afford.
Charging in foreign currency in public health institutions will worsen the plight of the poor.
Health minister David Parirenyatwa said the government had allowed public hospitals and clinics to give patients the option to pay in foreign currency if they so wished. He said this did not mean the health institutions were no longer accepting local currency.
“What we have said is that our patients should continue paying in local currency, but in the event that they opt for foreign currency, we are to go by the Reserve Bank of Zimbabwe regulations,” Parirenyatwa said. “The idea is meant to facilitate a smooth flow of services while the patient receives treatment from the health care provider.”
However, in reality the hospitals are not interested in local currency.
Towanda prays that his wife has a normal birth with no complications that would result in a prolonged stay at the hospital as charges are roughly pegged at US$70 per night for admissions.
He hopes that the baby will not be born through a caesarian operation as that would require an extra US$150.
At least he is assured that his baby will not be premature as it would have resulted in him forking out US$5 daily for the use of an incubator.
A recent visit to Parirenyatwa by the Zimbabwe Independent showed no signs of improvement in health delivery.
Long grass has become a common feature outside the hospital — an indication that caretakers have long since abandoned the place. Fears are high that the unkempt hospital grounds have become breeding areas for mosquitoes.
There is now little activity at the hospital that used to be very busy.
Noticeable were dark corridors with no lighting as well as dirty floors and dumped bed linen in some wards. One would be forgiven for likening the situation to a scene from a horror movie. It is very rare to bump into a nurse, more so a doctor, in the corridors of the hospital.
At Mbuya Nehanda the tiles that used to be bright and clean have lost their lustre while some of the hospital bed linen is no longer suitable for use.
Zimbabwe Association of Doctors for Human Rights (ZADHR) chairman Douglas Gwatidzo said paying in foreign currency at government hospitals showed that the government no longer had confidence in the local currency.
“The reason why the government made that announcement is that people were finding it difficult to get the Zimbabwe dollar, however the announcement to me shows that there is now a gradual acceptance of no confidence in our local currency,” Gwatidzo said. “It’s a pity that Zimbabweans are made to suffer as the foreign currency is beyond the reach of many. Life is going to be difficult. We have not seen the worst. As long as there is no manpower there is no health delivery system.”
Meanwhile, Unicef this week said as long as there is no urgent move to guarantee availability of safe water, sewage reticulation and refuse removal, the cholera epidemic was not going to disappear any time soon no matter the efforts put in place so far.Unicef information officer Tsitsi Singizi said latest statistics show that cholera has claimed over 1700 lives since its outbreak in August last year. More than 34 300 cases of the epidemic were also recorded.
Fifty-nine deaths and 731 new cases of cholera have been reported since Monday.
She said: “The cholera situation in Zimbabwe remains dire. We continue receiving reports of fresh cases and the fatality rate is still high at 5%, more than the internationally accepted threshold.
“Yet we are also happy that coordinated efforts are beginning to yield results as cases and deaths go down in some affected areas.”
International agencies like Oxfam — with partners Mercy Corps, Africare, Practical Action, Zimpro, Lead Trust, DachiCare and Christian Development Aid — have deployed engineers, public health promoters, gender and HIV specialists to seven provinces where they are responding to the cholera crisis.
An Oxfam spokesperson said assessments of water quality conducted by the organisation in Norton, Chegutu and Kadoma indicated that 75% of water samples from unprotected wells were contaminated with faecal coliforms.
The spokesperson said: “The degree of contamination is highest in Maridale and Joburg suburbs of Norton where the population draws water from wells and use a pit latrine system. Results of the analysis are being used to chlorinate water sources at the respective locations.”
The organisation has so far reached almost 250 000 people with hygiene promotion messages and distributed hygiene kits to 37 147.
Apart from constructing and rehabilitating a number of boreholes, Oxfam has delivered 245 000 cubic meters of water to Chitungwiza, Mbare, Budiriro and Glen View to ensure that communities and Cholera Treatment Centres in those areas have access to clean and safe water.
The Zimbabwe Red Cross Society has sent emergency disaster kits to hard-hit areas like Karoi and Kariba.
Some parts of Karoi are said to have gone without power for two weeks and this has greatly affected the water supply in the small town.
Magunje growth point and Bikita are some of the rural areas that have been hard hit by cholera and need immediate attention.

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