STRIKING senior doctors in Zimbabwe have accused the government of misleading the nation – by suggesting it had secured large quantities of essential drugs and equipment after warning the country’s public hospitals had become deathtraps with no equipment and/or medicines.
‘There was much fanfare and ribbon cutting, and images of warehouses full of drugs which turned out to be cartons of fluids. Out of an inventory of 2,000 items only 60 had been purchased.
‘The Indian consignment was a great disappointment.’ So said the doctors in a statement that had added: ‘The hospitals continue to be poorly stocked, and remain a deathtrap even in the presence of the hardworking, highly specialised workforce that Zimbabwe has.’
The Zimbabwe Senior Doctors Association said that the government should stop being vindictive and address instead ‘the serious challenges facing the health sector, where junior doctors have been on strike for 89 days demanding better wages.
‘As we speak, disciplinary letters are being handed to senior doctors, including those who have been doing their best to save lives in the hostile public sectors. The authorities are so vindictive that they went to theatre to hand a letter to a doctor who was finishing up an emergency operation,’ said the doctors.
But speaking at a Zanu PF youth convention in Kadoma, President Emmerson Mnangagwa said the government was not going back on firing doctors, saying that they were not a special breed. He accused the doctors of having a hidden agenda, claiming they were being paid money by enemies of the state to cause chaos.
‘Let doctors get this very clear. They are not special to teachers, soldiers and other civil servants who are persevering in these economic hardships,’ the President said.
And in a ministerial statement in Parliament just last night, Health minister Obadiah Moyo blamed striking doctors and nurses for the massive deaths in hospitals. But Moyo did not give specific figures of how many deaths occurred during the strike, as requested by Health Portfolio Committee chairperson Ruth Labode.
‘They were not incapacitated in terms of transport, and they were neglecting their duties and did not attend to patients. The number of patients that died at hospitals was as a result of doctors who stayed away and not government,’ said Moyo.
Doctors had taken an oath, he said, ‘and those that stayed at work stations were supposed to attend to the patients’.
Moyo said the government has always had a policy to recruit doctors from outside under bilateral arrangements, with countries like China, India and Cuba.
But MDC legislator Paurina Mpariwa said the government must consider the cost of flying and accommodation for expatriate doctors as against actually increasing the salaries of the striking local medical practitioners.
Kuwadzana MP Miriam Mushayi blasted Moyo for concentrating on disciplining the doctors instead of negotiating with them. MDC legislator Lynette Karenyi-Kore also quizzed him over a decline in maternity services – to such an extent that women in Mbare were resorting to archaic birthing methods.
But Moyo said the maternity situation had been addressed by the re-opening of the Edith Opperman Maternity Clinic in Harare.
Moyo acknowledged the health crisis in the country, saying only Chitungwiza Central Hospital was operating at 39%, while at other hospitals the situation was dire because of shortages of drugs and equipment.
But he told Parliament that development partners like the Global Fund and World Bank had volunteered to assist government to incentivise the doctors.
- Dr Johannes Marisa said: ‘In politics, the youths are said to be the vanguard of political parties while in medicine I would put it that the junior doctors are the hummingbirds that bring life to central hospitals.
‘The current medical situation in our country can be described as deplorable, lamentable, regrettable or pathetic and this requires an urgent solution if a catastrophe is to be averted.
‘It is a fact that patients fret because of poor access to medical care due to unaffordability, while doctors are also languishing in abject poverty because a majority of them cannot afford a decent meal at home. Some have resorted to walking from town to Parirenyatwa Hospital because of their tenacity to save patients.
‘The environment has become so bad that it now requires the government-doctor feud to an end.
‘While many may think that the issues raised by doctors are nothing, but a frivolity, the grievances need proper consideration if our nation is to move ahead.
‘For doubters, junior doctors offer some of the most important services in Zimbabwe and there is no alienation between central hospitals and them. They are thus both the stakeholders and stockholders of central hospitals to be frank.
‘A central hospital like Parirenyatwa has two important points of receiving patients – the casualty and emergency unit, and the outpatients department (OPD). The casualty department is supposed to receive emergency cases or cases that would have been referred from other medical centres while chronic or cold cases are seen in the outpatients department.
‘In both places, it is the junior doctors (who include both junior and senior interns) who have a first touch on the patients.
‘The initial assessment, examination and admission are all carried out by these juniors in consultation with their registrars or consultants. A lot of cases that present in the casualty department are medical and surgical cases that fall under the junior interns.
‘The phlebotomy and other investigations are done by junior doctors as patients are sent to the wards. Follow-up of results, and presentation of patients during ward rounds, is the prerogative of the juniors.
‘So without them, life becomes a double tragedy to both patients and remaining staff. This would mean no casualty attention, no OPD attention, no laboratory follow-ups, discharges impaired resulting in a serious burden on the nursing staff.
‘It will be bizarre to see a specialist doctor in the casualty clerking patients, bleeding them and running up the stairs to follow up on blood results. Without these juniors, hospital function is delegated to a white elephant that has nothing to offer.
‘Critics will tell you that junior doctors are just students or some unscrupulous elements, yet my own experience and knowledge tell me they are of great value and importance if health delivery service is to remain afloat.
‘It is unfortunate that government and its agents like the Health Services Board (HSB) see junior doctors as cantankerous interns who are always argumentative, unco-operative: yet they have genuine concerns.
‘In 1996, government fired striking doctors only to reverse the decision within a month after health delivery plummeted to unprecedented levels. In 2007, the then chief executive officer at Harare Central Hospital fired 60 junior interns for going on strike for more than five weeks.
‘The minister quickly reinstated the fired doctors and the conflict was resolved. Today, I hear that 448 doctors have been fired which is never going to benefit us as a nation, but is actually detrimental to the whole health sector considering the high morbidity and mortality associated with inadequate medical staff.
‘It is actually incredible to note that some of those in the firing line are actually renowned specialists who have helped everyone since time immemorial.
‘Some served our dear Zimbabwe when they used to be the only ones doing specific operations. It should be noted that conflict resolution includes embracing conflict, talking together, listening, finding solutions, providing guidance and forgiving rivals.
‘If such steps are observed, it would not take too much time to solve the health crisis that has ravaged the entire nation. I believe dialogue that has mutual respect is the way forward.
‘Advertising for doctors’ vacancies will only work as a temporary measure as the fundamentals have not been corrected. We run the risk of cycles of incapacitation repeating themselves.
‘The government and doctors should immediately find each other with sincerity, as heavy-handedness does not help anyone. Together, we will build Zimbabwe!’ concluded Dr Johannes Marisa.