The Sunday Mail
Emmanuel Kafe
The law of the jungle seems to be the norm in some public health institutions and desperate patients seeking care have unfortunately become fair game.
It is particularly nightmarish for those lucky — or rather unlucky — to have medicines prescribed for them.
Although drug stocks have improved, most sought-after drugs such as antibiotics, vaccines and opioid drugs like pethidine and diazepam remain scarce and are often dispensed through the back-door — and not at a premium, but for a song.
Pethidine is an analgesic similar to morphine and is often used for moderate to severe pain.
On the other hand, diazepam is used to treat seizures, anxiety and alcohol withdrawal.
Personal protective equipment (PPEs), face masks and sanitisers are being sneaked out of sanatoriums for sale on the black market.
It gets worse.
Most patients prefer public hospitals to private institutions as they are relatively cheaper in terms of both consultation and drugs.
Also, elderly patients, who are more than 65, are treated for free.
However, it has since emerged that a well-knit syndicate involving rogue doctors, nurses, pharmacists, security personnel and general hands is making life considerably difficult for desperate patients.
How it works
Government and other aid organisations supply a huge chunk of medicines to public health institutions.
The drugs are distributed for free and in some cases patients are required to pay a nominal fee.
In the event that prescribed drugs are not in stock, the patient has to seek alternative sources like expensive private pharmacies.
This has created a convenient conduit that is being used to create artificial shortages of the sought-after drugs, which are, however, offered as a back-door alternative to the patients.
Most of the victims are accosted by the rogue staffers feigning concern as they are about to leave the hospital pharmacy.
The drugs scandal is happening at most public hospitals around the country and thousands are prejudiced.
However, The Sunday Mail Society managed to investigate this rot at hospitals in Harare and Chitungwiza due to the lockdown.
Unpacking the ring
The Sunday Mail Society went undercover and sought to unpack the rot at Chitungwiza Central Hospital, which is believed to be one of the referral hospitals that has been affected.
The reporter pretended to be a patient suffering from a migraine and sore throat and paid $160 for treatment (including the prescription book and stamp) just like the rest of the people who were in the queue.
Attention was given to the reporter and drugs were prescribed.
It was then that the all-too-familiar tale of corruption began unfolding.
On the prescription was an instant injection (gentamicin injection and ceftriaxione sodium) and some antibiotics (erythromycin).
Two of the drugs were said to be out of stock while one was available but expensive.
Acting like the reporter was in a fix, he moved around aimlessly — prescription in hand.
“Pane zviri kunetsa here? (Is there a problem?),” an elderly general hand asked.
We presented our case to him, to which he casually advised us to consider our problem solved.
“I have some people that can assist you. Do not worry, you will get everything you need,” he assured us before identifying himself.
We were subsequently told to contact a registered general nurse (name supplied) who works at the hospital.
“I am currently out of office, can we meet tomorrow and I will organise the order for you,” he said after we got in touch with him.
“I can provide you with any type of medication any day.
“My drugs are cheaper than what they charge you at the hospital pharmacy,” said the nurse.
It is believed that some of the drugs that are said to be out of stock at the hospital pharmacy are in actual fact later sold on the black market.
They cost less than the price charged by the hospital or other private pharmacies.
After the deal with a registered general nurse came unstuck as he was not readily available, we went for plan B at the behest of our newly-met acquaintance, office orderly.
He took our prescription book and instructed us to wait at the casualty section.
In no time, we were introduced to yet another State-registered general nurse reportedly working in Ward 4.
“Sekuru will lead you and we meet at my ward,” he said before temporarily vanishing.
We followed orders and in no time we got our drugs at a knockdown price.
The other set of drugs that was priced US$9 in the hospital pharmacy was sold to us at US$7 or equivalent in local currency.
“There is the ceftriaxone sodium and gentamicin injection, a 2ml ampoule for injection and they cost US$7. I will also give you two syringes for free. I have also added the antibiotics (erythromycin), which require an additional US$5,” he said.
The transactions are strictly in cash. We concluded the deal.
Meanwhile, the first nurse repeatedly called with a hidden number the following day, insisting we come to collect our order.
But hospital authorities said this was new.
“We are yet to hear of drug sales through the back-door at the institution. However, we will institute our own investigations and we will let you know of the outcome,” said Chitungwiza Central Hospital public relations officer, Mrs Nyadzisai Tasanarwo.
“Patients and other stakeholders should report such issues to the public relations desk or the chief executive officer. They should never allow such deals and should pay through the accounts clerks and get receipts.”
Second port of call
The following day, we visited Sally Mugabe Central Hospital, formerly known as Harare Central Hospital.
This time around we went in to purchase prescription drugs even though we did not have a prescription, which is illegal.
We linked with a nurse (name provided).
From her, we wanted pethidine to use for a patient who supposedly had “backyard abortion” and some antibiotics to treat a sexually transmitted disease.
She was not bothered about how we got to her. Instead, she only made a request that we conduct our transactions either in bond notes or United States dollars.
We got the antibiotics, minus pethidine, after we told her we would come to collect it as we had run out of cash.
Desperate patients
Chenai Gwaru said she spent days going to Sally Mugabe Central Hospital to get prescribed drugs for her child.
“I have been coming here for the past days and they kept telling me the drugs (livofloxacin) are out of stock. I just got them today after someone advised me to go for a back-door purchase,” she said.
Pregnant women are among those at the receiving end.
“I delivered my baby and went for Day three check-up because the baby was reacting, but nurses are suggesting I make use of a private paediatrician they are recommending,” said Mai Sheila.
However, Government says it is unaware of these anomalies, but is willing to investigate.
“Some of these things are just social media allegations, but if it is true, we have our team on the ground, we will investigate the issues to conclusion,” said Health and Child Care Permanent Secretary Dr Agnes Mahomva.
Antibiotics, particularly those that treat sexually transmitted diseases, are the most common type of drugs sold on the black market.
Loss mitigation
Health experts like Dr Adolf Murindagomo believe that monitoring systems and tightly guarded storage facilities must be set up in clinics and hospitals to make it difficult to steal drugs.
“This practice of medical professionals stealing and selling drugs illegally is not new — stories have been written of nurses and doctors being hauled before the courts because they stole drugs from public hospitals,” he said.
In January this year, the Zimbabwe Anti-Corruption Commission (ZACC) took over monitoring of public hospitals and clinics to curb thefts and ensure drugs are not diverted to the black market.
“The operation is meant to bring sanity to hospitals and improve service delivery and stamp out corruption that has seen patients in some parts of the country being made to pay huge amounts of money for drugs, which are sourced by Government funds or donated,” said ZACC spokesperson, Commissioner John Makamure.
