Health sector yearns for more

Forward Nyanyiwa Extra Correspondent
It’s a Thursday morning at Harare Central hospital and a nauseating stench greets you as you walk in. Puffs and groans are coming from the scattered stretchers in the casualty waiting area.

An elderly man is wriggling in pain as flies hover over his septic diabetic foot, which is awaiting amputation. Three hours have lapsed, and still there is no hope that he will be attended to anytime soon.

The revenue clerks are not helping matters, they continue collecting money and sending more patients to the swelling casualty cubicles whose walls, floors and ceiling can easily be mistaken for a defunct council beer hall.

Soon, some become impatient and begin to wheel their relatives off, in hushed murmurs. It is at this time that the doctor resurfaces. However, his coming brings with it not much good news.

Most of those who get a chance to consult the doctor are told to go and look for medication elsewhere as the hospital does not have anything to offer them, from needles to medication.

“It’s very painful, I have been here since morning hoping to get help but only to be told to go and buy medication somewhere. I have wasted my time and l won’t come here again,” said one patient who  preferred anonymity. This has been the ordeal for multitudes who have paid a visit to the country’s major referral hospitals in recent years.

Public medical institutions such as Parirenyatwa Group of Hospitals, Harare Central Hospital and Mpilo Hospital, among others, have been operating on shoe-string budgets and are failing to provide for basic pharmaceutical and medicinal requirements.

Patients are having to purchase these from private pharmacies. Early this year, Harare Hospital suspended some minor surgeries due to the shortage of basic analgesics needed for the procedures.

The same is being experienced in rural areas, where after walking for several kilometres to get to a clinic or hospital, patients are often referred to the above-mentioned struggling institutions.

The health sector has been reeling due to under-funding and this has seen most people failing to access basic health care.

Zimbabwe is a signatory to the Abuja Declaration of 2001 in which African Union countries pledged to allocate at least 15 percent of their annual budgets to improving the health sector. Since then, the country is yet to meet the target. In the 2017 budget, the health sector only got 7 percent.

Presenting the 2017 national budget last week, Finance and Economic Development Minister Patrick Chinamasa announced that $281,9 million will be channelled towards the sector and this is inclusive of remuneration for the public health care personnel ($223 million), operations and maintenance ($29,6 million), as well as capital expenditure that has been pegged at $29,5 million.

According to the Minister Chinamasa, priority under the capital expenditure allocation will go towards construction and refurbishment of infrastructure and the procurement of medical and diagnostic equipments.

This has been necessitated by the fact that most hospital buildings are now dilapidated while machines are malfunctioning. To ease the shortage of drugs that has seen health care institutions failing to readily cater for patients’ medicinal requirements, the Finance Minister noted the need to capitalise The National Pharmaceutical Company of Zimbabwe (Natpharm).

Natpharm is a state parastatal which procures drugs and other pharmaceuticals for public hospitals and clinics. The government of China is complementing Government’s efforts through the extension of $13 million next year, specifically for preparatory and the expansion of the Natpharm warehouse, Minister Chinamasa revealed.

“There is urgent need for the capitalization (of Natpharm) in order to enhance supply of medicines and pharmaceuticals to public health facilities and in the 2017 budget I propose an allocation of $1 million towards improving capacity of Natpharm,” he said.

He acknowledged the assistance being rendered by development partners that include the European Union, The Department for International Development, Sweden and Irish Aid, among others who have contributed in excess of $48 million through the Health Development Fund.

The Global Fund is expected to disburse $177 million in 2017 under the Aids Grant for the procurement of anti-retroviral drugs (ARVs), medicines and training of health sector staff.

An additional $43 million from the same fund will go towards malaria control programmes, while benefit to TB-related causes will be $11,5 million.

Responding to the budget allocation, Chitungwiza Central Hospital Chief Executive Officer, Dr Obadiah Moyo said the $17,9 million proposed for the refurbishment of hospitals is inadequate.

“Considering the state of the dilapidated infrastructure, $17, 9 is not enough even for the central hospitals only.

“There are also debts which are over 180 days that need to be cleared with the same budget,” he said.

Dr Moyo is also of the opinion that the $1 million proposal for Natpharm is a far cry from what is required considering the health sector’s demands.

“The $1 million allocated to Natpharm for it to procure drugs for hospitals is very little. In fact, Natpharm needs $65 million to be able to purchase enough drugs for all the health institutions,” he said.

Harare Central Hospital chief executive officer, Mrs Peggy Zvavamwe echoed the same sentiments and said although she is yet to know the exact figures that the referal hospital will receive; $17, 9 million is a drop in the ocean that will be shared among the country’s major hospitals, down to the district level.

“It is still too early to comment because we don’t know what we are going to get as a hospital but the figure is low given that it is going to benefit the county’s major hospitals countrywide,” said Mrs Zvavamwe.

Natpharm managing director, Mrs Flora Sifeku said they are content with the $1 million proposal for recapitalisation but it could have been better had the budget addressed the issue of the debt they are owed.

“The $1 million for recapitalisation might be okay but if we could have some of the money we are owed then we could be able to buy drugs for the hospitals.

“We also got the same amount in the previous budget and we appreciate that but we need to increase our drugs stock for the benefit of the health institutions,” said Mrs Sifeku.

Health and Child Care Minister Dr David Parirenyatwa is on record saying that the budget fell far short of the demands of the sector and it has been made worse by the fact that it was reduced to $281,9 million from the $330 million extended to the ministry in the previous budget.

World Health Organisation (WHO) Sustainable Development Goal number three calls for ensuring healthy lives and promoting well-being for all.

As of now, WHO states that significant strides have been made in increasing life expectancy and reducing some of the killers associated with child and maternal mortality.

Major progress has been made on increasing access to clean water and sanitation, reducing malaria, TB, Polio and the spread of HIV.

To achieve this, Dr Moyo had this to say, “The Government should thrive to achieve the Abuja Declaration of 15 percent when allocating resources to the Ministry of Health (and Child Care).

“This is the only way hospitals can offer sustained quality service.

“The seven percent allocated in the 2017 budget means hospitals will be underfunded and won’t be able to stand on their feet.”

In an effort to cushion the troubled sector, the Government has started the Health Fund which will see a five percent levy for every dollar spent on airtime and mobile data under the theme “Talk, Surf and Save a life” going towards the fund beginning January 2017.

The resources collected will be ring-fenced for the purchase of drugs for public hospitals and clinics.

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