The Sunday Mail
Dr Obadiah Moyo
I came into this post (Minister of Health and Child Care) having been in healthcare administration for a very, very long time, and especially (in) my last post I was the chief executive officer of a central hospital (Chitungwiza Central Hospital) from at least 2005, which is, you know, quite a bit of time.
And before that, I was looking after the renal and lab services for about 19 years.
So I have the administrative capability and the full knowledge of what is happening in our hospitals at the moment; so I am placed at a better position to be able to now ensure that all those problems are solved. Before, we would be sending messages; this time, I have brought the message with myself and I am going to ensure that we take the appropriate action to make sure that we get our services in order.
Root causes
Well, let’s look at the problems.
The major problem that we are facing, besides cholera which is current – but we will get over cholera, and we will be able to make sure that it is under control in a very short space of time – but the main problem we are facing as the Ministry of Health and Child Care is the shortage of essential drugs.
Why do we end up with shortage of drugs? We end up with shortages because of shortage of foreign currency. At the same time, the allocations to the ministry are not adequate.
So we are putting in place a system where we should be able to, number one, get more local funding. At the moment, we have the Healthcare Fund, through air time, which is good, but we need that supportive foreign currency.
We are talking with the Ministry of Finance and the Reserve Bank so as to increase the allocation of foreign currency for drugs. Everybody wants to live and if we don’t have drugs in the country, this is when we will end up with a problem.
At the same time, we want to create joint venture partnership arrangements with the various companies, where the drugs are manufactured outside Zimbabwe and then create bonded warehouses through our NatPharm.
NatPharm is the 100 percent-owned Government pharmaceutical company. So, we can warehouse there and NatPharm will distribute to all our hospitals.
We are going to revamp NatPharm and ensure that it is well strengthened and empowered to be able to bring in the drugs into the country, warehouse and do the logistics of distribution to the various hospitals in Zimbabwe.
We want to see a situation where NatPharm is much, much more active than it has been, after making sure that their purchasing capacity has been increased.
We want to be able to access the Indian companies, the Chinese companies, the Swiss companies. NatPharm should be able to collect and bring in all those drugs.
And we can achieve it through joint ventures.
We are going to put this in our 100-day plan; that is one of our priorities. So it works.
We have tried it at the lower end, at the hospital, as a pilot, and that is how we have managed to survive – by having private pharmacies as a joint venture.
This time we are going to do it on our own as a ministry and be able to do it through NatPharm.
The first thing is that I would like to see all our health institutions being well stocked – number one.
Brain drain
Don’t forget, we don’t want to frustrate our workers.
We don’t want to frustrate our doctors who are in Zimbabwe right now. The nurses, the lab scientists, radiographers – we don’t want to frustrate them.
We want to make sure that they are working in an environment where everything is available, where the equipment is working, the paraphernalia must be perfect for them to be able to deliver a proper service; and that is exactly what our aim is.
After we have satisfied the local professionals, at the same time you would find out that those who are outside, when they hear that things are working in Zimbabwe, they will also start coming back.
And we are going to give them very, very good conditions of service.
I want to be able to say the staff in the Ministry of Health are well looked after. I have experienced it at the lower end and now I am at the top end.
I will not let down the people I was working with on the shop floor when I know exactly how they have to be handled.
So, we are going to be working together; I am going to be consulting a lot.
I want the people who are on the ground to come up with their ideas, and we will implement the ideas that they will come up with. We will give them the chance to indicate where the problems are.
After we have done that, we assess.
After the assessment, we will be able to implement whatever we can. But we want to move away from this business of top-down management. We want to have a down-up management style, and at the same time, at the end of the day, we want to produce a system which is quality-assured, including head office.
Everyone has to work in line with standards. We have to create the best standards like we used to have before.
I have worked in England, I have worked elsewhere outside Zimbabwe, I know what the standards are.
We need to bring those standards back and ensure that our system is conducive for a perfect service.
Where are we getting it wrong?
Our problem arose as a result of the 15 to 18 years of sanctions, where there were political debates rather than economic improvement.
With our President, he is geared towards improvement. We want to develop, develop and develop; modernise, modernise, modernise until we are there.
And the starting point is to ensure that we have all the essential necessities in place and then we will look at issues of infrastructure. We look at the issues of training. We want to see more doctors being trained, more scientists being trained at higher levels.
We are going to be very innovative, we shall think outside the box. We are not going to stay inside that box and be held at ransom.
Like I said, at the institution where I was, at Chitungwiza Central Hospital, we managed to stay afloat as a result of thinking outside the box and being innovative, and ending up as the first and only ISO-certified (public health) institution in the African region.
We managed to create joint venture partnerships; where people could not initially get the relevant diagnostic tests, diagnostic X-rays, CT scans, we managed to get them all in.
High, high definition equipment, we got that in through partnerships. So, we have got a model.
We have learnt about the model in Chitungwiza and we know exactly where we have to modify it. We will have partners, but we want to be the ones who collect the funds when people pay.
There are several areas we can look at and like what I said, we need to consult and see which areas we can work on.
The model works, even in the African Union. We had more than countries coming through at Chitungwiza to look at what we were doing and how we were doing it.
But now with the New Dispensation, it is even better. We are inviting investors to come from abroad to come in with the foreign currency; they will also come in with the technology. We want to take advantage of that.
The investor must be able to work in an environment with high standards, and people often want to team up with partners who have high standards. So we are going to create high standards in our hospitals.
Customer care
There has to be quality assurance in each and every hospital. The major issue we want to see is that of customer care.
I am going to lead by example in that I am not going to take a lackadaisical approach. I am going to ensure that I deliver, I am going to make sure that everything is done timeously.
Likewise, I also expect that my members of staff and all the professionals will follow suit.
All the professionals – all the doctors, all the nurses, the scientists – they all want to see the service functional. And I want to ensure that we work together to make it functional.
So, in terms of customer care, we want to run customer care courses.
We will bring in people from all the provinces, the key persons, teachers of teachers and follow them to the provinces. And we will run competitions to see which one is better.
We want to see the ambience which is conducive to better recovery of the patient. We want better recovery of the patient.
I am coming with this knowledge about hotel services in hospitals. We want to create an environment where we would have a five-star service in hospitals; the hotel service within our hospitals.
We have done it already, so it can be done. The formula is there.
Grievances
We will have to sit down with the Ministry of Finance and make them understand that funding for the (Health) Ministry has to be at 15 percent as prescribed in the Abuja Declaration.
That will enable us to absorb the professionals we are training, who end up sitting at home, or end up being cashiers in supermarkets.
Look at it: 2 000 nurses are roaming the streets of Zimbabwe. Why did we train them? We want them to be engaged. We want to absorb those people.
If at all we have to send them out, we will have to send them for post-basic training in specialist areas.
Let’s create a situation where will be able to absorb all those we will be training.
We want to create an environment where we will not be sending patients to India and Singapore for treatment.
We want to empower our doctors so that they can be able to carry out specialist services like cardiology unit, kidney transplants, you name it.
We should be able to do everything.
The beauty of this is that we have very, very intelligent personnel in Zimbabwe. And sometimes, if you go to South Africa, you go for a specialist operation, you go and see a neurologist, for instance, you find out that the neurologist is Zimbabwean.
Those are the type of people we want to bring in. We are very capable.
Cholera, typhoid
Like I have said, I landed in a cholera environment.
The thing is, where I was working before, that was also a cholera area and we came up with solutions on how to prevent cholera.
You should never have anyone dying of cholera, it should not be allowed.
So, we need to put our systems in place. I need to work with the Minister of Water, the Minister of Local Government. We need to work with the policing agencies, the local municipalities to be able to deal with this problem.
It starts with failure to prevent. We should be able to prevent. What are the causatives?
The causatives are lack of collection of garbage, burst sewerage pipes, vendors selling their wares – fish and meat – flies all over the place.
We want to create a clean environment in Zimbabwe.
Blame game
From where I stand, I would like us to work together (with local authorities) to ensure that we also educate them. We have to educate them.
I was just discussing with the Minister of Local Government; he is very keen to ensure that we all move in one line. We are all moving in that direction.
So, it’s a matter of instilling the confidence in the local authorities. It’s a matter of being organised and being able to institute the policies.
It’s all there in our Acts. Our Public Health Act states it very clearly.
We just have to follow the Acts and be able to come up with a Zimbabwe that is clean, cholera-free, typhoid-free. We can achieve it.
What has to happen is that the water system has to be improved. We will have a system where there will be proper co-ordination of these services.
This is an excerpt of an interview that the Minister of Health and Child Care, Dr Obadiah Moyo, had with Zimpapers Television Network last week
