Raw Deal for Zimbabwe Hospitals

Thursday, 29 November, 2012

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Paidamoyo Chipunza

Zimbabwe’s government has failed to provide adequate resources to referral hospitals, with most in a deplorable state, offering severely crippled services. Investigations by The Herald last week revealed that the major source of problems for the public hospitals is lack of money from the budget. 

Harare Central Hospital chief executive Ms Peggy Zvavamwe said it received only 958,000 US dollars from the Treasury this year, when 25 million dollars was required to operate effectively.

“Our services have been crippled severely by non-availability of funds,” she said. “Most of the time, we have had to scrounge for survival.”

Ms Zvavamwe said Harare Central Hospital was overwhelmed with close to 80 percent of the sick being assisted there. There is also a shortage of nurses at the hospital, with two serving a ward of 30 patients against the ideal ratio of one nurse for five patients.

“Because of this pressure, doctors are sometimes forced to do nurses’ work and in the maternity department, some women deliver halfway on their own because the person supposed to assist them will also be attending to other patients,” said Ms Zvavamwe.

Some patients at Harare Central Hospital, especially expecting mothers, sleep on the floor while awaiting their turn.

At Mpilo Central Hospital in Bulawayo, only 1.1 million of the approved 2.2 million dollars was released by the Treasury. The hospital requires 12 million dollars a year for it to function efficiently.

Mpilo chief executive Mr Los Mantiziba said the hospital did not have X-ray and anaesthetic machines, monitors, high blood-pressure machines and laproscopy sets.

“The challenges noted above have tremendously affected service delivery at the hospital, as the environment is not conducive for proper healthcare delivery, with challenges in infection control, health and safety,” said Mr Mantiziba. “Nurses struggle to lift patients to theatres.”

Mr Mantiziba said HIV and AID had negatively impacted the few available resources at the hospital, with close to 40 per cent of resources allocated to the deadly infection.

Ingutseni Hospital acting chief executive officer Dr Naboth Chaibva said dilapidated infrastructure affected service delivery there. He said accommodation facilities were no longer fit for habitation, while washing facilities were not functioning.

“The hospital has been seriously under-funded; and also the erratic disbursement of funds has severely affected service delivery at the institution,” said Dr Chaibva.

Ingutseni requires 1.8 million dollars a year to function properly, but only received 600,000 dollars from the Treasury this year.

Dr Chaibva said admission wards were overcrowded, each accommodating as many as 95 patients instead of the recommended 30.

Chitungwiza Central Hospital received only 450,000 dollars out of the 15 million it requested for this year. Chief executive Dr Obadiah Moyo said that although the institution was privileged to have state-of-the-art equipment in most departments, the financial crisis had not spared it.

“Chitungwiza was upgraded into a central hospital, but establishments and infrastructure were not upgraded to match demand,” he said.

The situation is the same at the Parirenyatwa Group of Hospitals, where ageing machines are always breaking down. For example, radiotherapy machines at the hospital broke down recently, leaving cancer patients stranded.

Although authorities did not respond to faxed questions on the state of affairs at the hospital, Parirenyatwa experiences a fair share of problems crippling service provision.

Power blackouts, interrupted water supplies, long and winding queues and lack of essential equipment are some of the problems the hospital cited in previous interviews.

“The machines we had been using were donated a long time ago and are constantly breaking down,” director for radiotherapy at Parirenyatwa Dr Ntokozo Ndlovu was quoted as saying.

The health and child welfare ministry’s deputy director for policy, development and planning, Stephen Banda, recently said the referral system was no longer intact.

He said this resulted in the services at central hospitals being deplorable.

According to the Ministry of Health and Child Welfare, Harare and Bulawayo need at least six district hospitals each to effectively serve their communities.

The existing infrastructure at most of the major hospitals was built in the 1950s to 1970s, although Chitungwiza is a later addition to the list, and needs expansion to match the growing burden of care.

Private health institutions are cashing in as the public hospitals refer patients to them for simple procedures like scans.

Paidamoyo Chipunza is a health sector reporter for The Herald in Zimbabwe.

This article was first published in The Herald.