The Sunday Mail
Veronica Gwaze
Acrisis is festering in council-run clinics, most of which have largely remained shut for the past four months.
Council claims it is struggling to get resources to keep them running, while most nurses have not been reporting to their workstations since July.
Currently, at least three-quarters of the 43 health institutions run by Harare City Council (HCC) are closed, while the few that are still open are demanding bribes from desperate patients seeking medical attention.
Most patients, including expecting mothers, who cannot cough up the inducements are turned away.
The Sunday Mail Society visited some of the polyclinics in areas that include Budiriro, Mabvuku and Glen View and discovered a disturbing “well-knit” corruption ring involving nurses and security guards at health facilities.
“This place is closed. It has been for some time. The nurses are here but not on official business. Nonetheless, I can convince them to assist you if you give me US$3 since you say you have a crisis,” said a frail-looking security guard at Glen View 1 Clinic.
“However, you will need to pay the nurses US$5 for them to attend to you. If you have the money with you, I can call one of them . . .”
The deal we were offered confirmed the information we got from some of the aggrieved patients.
A pregnant Mrs B Mawire registered for maternity at Glen View 1 Clinic two months back, but little did she know that it wouldn’t be smooth sailing.
She is almost due for delivery but she has never managed to access the clinic.
She was then advised by another expecting mother to “grease the system”.
“I had no choice because this is the closest facility from which I can deliver, so I had to pay my way to the service. When I got inside there were two nurses who I paid US$5. I was immediately told that I would have to pay another US$5 to whoever would be on duty when I come for delivery,” revealed Mawire.
As is the norm, all the payments are never recorded.
In fact, a patient still has to pay the stipulated fees for the service.
For example, after a pregnant patient pays the bribe, she still has to contend with maternity registration fees, which are currently pegged at $2 000 for locals.
General consultation fees are $417 for adults and $250 for children.
All the fees can be paid using the US dollar at the prevailing auction rate.
City of Harare health director Dr Prosper Chonzi, who is the acting town clerk, confirmed that polyclinics were indeed turning away patients.
“It is true that some of our polyclinics and hospitals are turning away patients, but we are working day and night to avert the crisis.
“The situation is quite worse to those in need of emergency assistance like the pregnant mothers that you are talking about, because it is a matter of life and death,” said Dr Chonzi.
Council, however, expects all nurses to be back on duty this week.
Digging in
But nurses are singing from a different hymn.
Zimbabwe Urban and Rural Council Nurses Workers’ Union (Zurcnwu) president Simbarashe Tafirenyika said they have been on industrial action since July 14 ostensibly for failure by their employer to provide them enough personal protective equipment (PPE).
“Each nurse was only provided with surgical masks for only three days in a week and a N95 mask to be used for a week. Later, we had a meeting at Makombe Labour Offices and agreed that clinics were supposed to open on September 15 under the condition that we had signed a deed of settlement with the council,” said Tafirenyika.
“We wrote our document and submitted it to the council as per agreement but they never responded, so the position remained unchanged — nurses could not go back to work. Currently, council nurses are earning between $6 000 to $8 000 per month and that is unacceptable.
“Later, we learnt that 15 clinics were running but the council had not consulted us. In fact, they forced the desperate nurses to go to work, which is why we now have problems with some of these nurses soliciting money from patients.”
Nurses believe that the current crisis is precipitated by mismanagement of funds by council.
However, it is pregnant women that are suffering the most.
In some instances, they end up opting for home births.
The Harare Residents Trust (HRT) — a local organisation that lobbies for the rights of ratepayers — said there was need to deal with poor service delivery and corruption at council clinics.
“We have various reports regarding poor service provision and corruption at these clinics. Our survey confirmed that some health workers are not reporting for duty, while others are behaving unprofessionally,” said HRT director Mr Precious Shumba.
“There are disturbing reports of mothers giving birth outside clinics in Kuwadzana and Budiriro, and death reports due to lack of access to services.
“We need these clinics to be operating effectively, especially as the rainy season that brings water-borne diseases is now upon us.”
Harare City Council corporate communications manager Michael Chideme said investigations into malpractices at the health centres are underway.
“Following the various accusations of bribes and other issues, we are carrying out investigations as we put corrective measures in place.
“Whatever patients are made to pay at our clinics should be receipted to show that it is legitimate; this issue of soliciting for bribes is criminal and should be reported,” he said.
He insisted that negotiations with striking health workers are presently ongoing.
“At the moment, only 15 out of 43 of our health facilities are open. We are working to increase the number as we negotiate with our employers. Mabvuku Polyclinic is the largest and it offers a scope of services, including a standby doctor, 24-hour facility, caesarean sections, X-rays, dental services,” said Chideme.
Some patients are now having to travel for distances to access primary healthcare services.
“Sunningdale residents are now using Edith Opperman Maternity Centre in Mbare as their nearest clinic, while Glen Norah residents are using Highfield Clinic.
“Mabvuku nurses are taking turns to report for duty, which has resulted in nurses demanding patients to pay extra money so that they can help them deliver in their homes despite the fact that they would have paid consultation fees at clinics
“At Tafara satellite (clinic) they are not taking bookings for maternity, thus expecting mothers have to visit private hospitals for service, which are beyond the reach of many,” said HRT in its report.
HCC’s health department is ordinarily divided into Zone A and Zone B that are headed by deputy nursing managers.
The zones are further divided into eight districts that are led by district nursing officers, and under those districts are several clinics that are headed by sisters-in-charge.
