By Rawlings Magede
Recently, new Health Minister Constantine Chiwenga during a press conference announced that government will no longer “export” its patients to neighbouring countries for treatment. In his address the new Health Minister bemoaned the high cost of the export bill that has in the past seen government footing bills for officials who get treatment overseas.
Exporting patients especially government officials to foreign countries for medical attention is not a phenomenon, during former President’s Robert Mugabe tenure of office, senior government officials made a beeline as they even sought medical attention even for minor ailments that our local health institutions could deal with . At the turn of the millennium as age took a toll on the former president, he made Singapore his second home as from time to time he frequented the Southeast Asian country for check-ups and treatment. The export bill during his time even ballooned to astronomical figures and set precedence for his cronies in government to snub local health facilities. Such a culture led to a neglect of our health infrastructure. The subsequent years that followed saw government crushing by every means necessary industrial action by health workers who would from time to time take to the streets to highlight the poor state of affairs within the sector. Coincidentally, it is the new Health Minister who fired striking nurses in April 2018 describing their industrial action as politically motivated and refused to entertain any of their concerns. Surprisingly, the new Minister this time has made another huge turn by singling out “exporting of patients” by government as the major cause for the poor health infrastructure.
Over the years, communicable diseases such as Cholera have wrecked havoc especially in our overcrowded high density suburbs. Public hospitals and clinics which in most cases do not have basic medication have failed to cope during times of great need. This has been made worse by governments’ decision to privatise health which has seen private surgeries mushrooming across the country. Services at these surgeries remain beyond the reach of many. The situation is worse in rural areas.
Access to health care is even worse in rural areas
Ensuring the well-being of its citizens is the primary goal of any government. Zimbabwe’s constitution in Section 76 provides for basic health care which must be enjoyed by every citizen without discrimination. In rural areas however, this right has evaded many over the years. In most cases, health care centres are far away from those they are supposed to serve, leaving people to travel long distances. Access has also been further impeded by a lack of infrastructure, such as roads that are not well maintained, resulting in poor road conditions and potholes that make it difficult for transportation of critical drugs .Due to years of neglect and derelict, bridges that have either collapsed or have not been constructed hinder travelling of patients during critical times and negatively affects the timely delivery of medical drugs and medical supplies to health centres. The situation is even difficult for women. According to a recent survey by the Zimbabwe Demographic Health Survey (ZDHS), institutional deliveries stood at an average of 77 percent. This means that about 20 percent of Zimbabwean birth over the past five years occurred at home, statistics which medical experts describe as unacceptably high. It is my view that in the wake of the COVID 19 induced lockdown, the percentage of home deliveries could be high.
Minister’s call welcome but…
In light of the structural reforms that Minister Chiwenga wants to usher in within the Health Ministry, the first stop must be in ensuring that the public health system is revamped, health workers are motivated to do their jobs by remunerating them in line with other professionals in the region and ensure that in this era of COVID 19,they have adequate Personal Protective Equipment ( PPEs).In respect to access to health care in rural areas, it is important to shorten distance travelled by people to access health care by at least building more health institutions and providing mobile clinics that can be used to visit certain areas on particular days. Mobile clinics can help scale up access to primary healthcare quickly and effectively because they are cheaper to operate and come with less costs to rural communities.
To help reduce “exportation of patients”, government must create a comprehensive referral system that ensures that even government officials get treatment locally to save resources. In cases where one seeks specialised health care abroad, it should only be after the referral system has recommended or in instances where one will use personal resources. This can help save resources that can be channeled towards resuscitating our public health care infrastructure. Closely linked to this is to close errant medical aid companies and private surgeries that continue to privatise health care by charging exorbitant amounts thereby making basic health care a luxuary. What citizens really want is quality health care services for their families at public health institutions. The privatization of social services only serve to benefit a few elites who over the years have abdicated their role of ensuring that inalienable rights such as the right to health care in enjoyed by all.
Rawlings Magede is a Communication for Development expert who writes here in his personal capacity. Feedback on vamagede@gmail.com
Recently, new Health Minister Constantine Chiwenga during a press conference announced that government will no longer “export” its patients to neighbouring countries for treatment. In his address the new Health Minister bemoaned the high cost of the export bill that has in the past seen government footing bills for officials who get treatment overseas.
Exporting patients especially government officials to foreign countries for medical attention is not a phenomenon, during former President’s Robert Mugabe tenure of office, senior government officials made a beeline as they even sought medical attention even for minor ailments that our local health institutions could deal with . At the turn of the millennium as age took a toll on the former president, he made Singapore his second home as from time to time he frequented the Southeast Asian country for check-ups and treatment. The export bill during his time even ballooned to astronomical figures and set precedence for his cronies in government to snub local health facilities. Such a culture led to a neglect of our health infrastructure. The subsequent years that followed saw government crushing by every means necessary industrial action by health workers who would from time to time take to the streets to highlight the poor state of affairs within the sector. Coincidentally, it is the new Health Minister who fired striking nurses in April 2018 describing their industrial action as politically motivated and refused to entertain any of their concerns. Surprisingly, the new Minister this time has made another huge turn by singling out “exporting of patients” by government as the major cause for the poor health infrastructure.
Over the years, communicable diseases such as Cholera have wrecked havoc especially in our overcrowded high density suburbs. Public hospitals and clinics which in most cases do not have basic medication have failed to cope during times of great need. This has been made worse by governments’ decision to privatise health which has seen private surgeries mushrooming across the country. Services at these surgeries remain beyond the reach of many. The situation is worse in rural areas.
Access to health care is even worse in rural areas
Ensuring the well-being of its citizens is the primary goal of any government. Zimbabwe’s constitution in Section 76 provides for basic health care which must be enjoyed by every citizen without discrimination. In rural areas however, this right has evaded many over the years. In most cases, health care centres are far away from those they are supposed to serve, leaving people to travel long distances. Access has also been further impeded by a lack of infrastructure, such as roads that are not well maintained, resulting in poor road conditions and potholes that make it difficult for transportation of critical drugs .Due to years of neglect and derelict, bridges that have either collapsed or have not been constructed hinder travelling of patients during critical times and negatively affects the timely delivery of medical drugs and medical supplies to health centres. The situation is even difficult for women. According to a recent survey by the Zimbabwe Demographic Health Survey (ZDHS), institutional deliveries stood at an average of 77 percent. This means that about 20 percent of Zimbabwean birth over the past five years occurred at home, statistics which medical experts describe as unacceptably high. It is my view that in the wake of the COVID 19 induced lockdown, the percentage of home deliveries could be high.
Minister’s call welcome but…
In light of the structural reforms that Minister Chiwenga wants to usher in within the Health Ministry, the first stop must be in ensuring that the public health system is revamped, health workers are motivated to do their jobs by remunerating them in line with other professionals in the region and ensure that in this era of COVID 19,they have adequate Personal Protective Equipment ( PPEs).In respect to access to health care in rural areas, it is important to shorten distance travelled by people to access health care by at least building more health institutions and providing mobile clinics that can be used to visit certain areas on particular days. Mobile clinics can help scale up access to primary healthcare quickly and effectively because they are cheaper to operate and come with less costs to rural communities.
To help reduce “exportation of patients”, government must create a comprehensive referral system that ensures that even government officials get treatment locally to save resources. In cases where one seeks specialised health care abroad, it should only be after the referral system has recommended or in instances where one will use personal resources. This can help save resources that can be channeled towards resuscitating our public health care infrastructure. Closely linked to this is to close errant medical aid companies and private surgeries that continue to privatise health care by charging exorbitant amounts thereby making basic health care a luxuary. What citizens really want is quality health care services for their families at public health institutions. The privatization of social services only serve to benefit a few elites who over the years have abdicated their role of ensuring that inalienable rights such as the right to health care in enjoyed by all.
Rawlings Magede is a Communication for Development expert who writes here in his personal capacity. Feedback on vamagede@gmail.com
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