Hospital horrors for Harare residents

BY SAUL DAMBAZA
HARARE - Zimbabwe's deteriorating main public hospital, Harare Central, is inspiring less and less confidence among the country's sick, lame and needy.
Its shabby exterior is pockmarked with broken windows and leaking pipes. The wards themselves are little better, epitomising

the decline of this country’s once proud health system, which until a decade ago was the best in Africa south of the Sahara.
Outside visiting hours, the relatives of patients wander the grounds. Many spend all day at the hospital, waiting from one visiting time to the next, simply because they cannot afford, in the fastest declining economy on earth, the bus fare to make more than one journey.
Susan Rugare is typical of those whiling away time before she can again visit her sick daughter, Maria. A round-trip bus ride from her home in the Harare township of Mufakose is more than she can afford, so each day she walks the 11-mile return journey to be with Maria.
Her daughter has meningitis and can no longer look after herself. “Every day I have to prepare food from home and come and feed my daughter. I also have to bath her, since she can longer do that on her own,” said Rugare.
Her daughter also cannot afford the Z$2.5 million (£13 at the official exchange rate) worth of drugs prescribed by the doctors. Even if Rugare could afford the drugs her daughter needs, there is no guarantee they would be available in the poorly-stocked hospital pharmacy because the country has barely any foreign exchange reserves.
Harare Central is where the city’s poor, who cannot afford private health insurance, are forced to come. Within its morale-sapping walls, there does indeed seem to be more dying than healing. Patients undergoing surgery have died under anaesthetic during the capital city’s frequent power cuts because the hospital has not been allocated scarce foreign exchange to import an emergency generator.
The high death rate is linked in part to AIDS. Recent estimates indicate that around 34 per cent of Zimbabwe’s 15 to 40 years age group is HIV-positive, and that more than 3,300 people die every week of AIDS-related infections. Deepening poverty and hunger have accelerated the process. According to the United Nations Children’s Fund UNICEF, 550 children under the age of fourteen die of AIDS-related illnesses each week while another 565 become infected with the HIV virus.
The morgue at Harare Central receives the daily toll of the dead. It is overflowing with hundreds of bodies and the stench is inescapable. The hospital refuses to release the dead until relatives pay hospital fees they can no longer afford. Treatment was once free, but as the country’s economy went into steep decline the government introduced charges. In May 2006 the government announced a 300,000 per cent increase in state hospital charges in an effort to shore up crumbling services, with the cost of medicines doubling or tripling every few months .
“The morgue refrigerators sometimes do not work and they also have no capacity to keep the bodies well,” one attendant, leaning on a wall outside the morgue as he ate his lunch, told IWPR. “We no longer go inside there. If you bring your relative you have to find somewhere to put them yourself, or we will charge you if you want us to do that.”
The morgue is also a place of business for undertakers who hang around waiting for clients. When relatives come to claim the bodies of their loved ones, they are immediately propositioned with offers of cheap coffins, body dressings and transport.
Commenting on the increased hospital charges, Harare physician Dr Elopy Sibanda said many of his poor patients had stopped coming for appointments because they can no longer afford the government-dictated fees. The result, he said, is a two-tier medical system similar to that which prevailed in the days of white minority rule before independence in 1980. “They’re creating a health care apartheid,” Sibanda told a visiting foreign correspondent. “We’re no longer looking at the colour of the people. We’re looking at the fatness of their wallets.”
Harare Central, like all government health institutions in the country, is in dire need of medicines and basic equipment. In addition, there is a serious shortage of professional staff, from nurses and doctors to pharmacists, who are emigrating in droves.
For more than three years, the hospital has run without an intensive care unit because of collapsing infrastructure and lack of necessary staff. The blood bank often has no blood “and several people have died as a result”, the report says. X-ray equipment has either broken down irretrievably or is obsolete. Antiquated lifts constantly break down because of lack of spares and the one in the maternity ward has not worked for years.
Elsewhere in the hospital “there is often no soap or any other antiseptic liquid to clean hands in wards. There is usually nothing to dry hands with”, say physicians.
Heaps of rubbish are mounting around the hospital, resulting in an upsurge in outbreaks of dysentery and food poisoning. To cut costs, the hospital retrenched cleaning staff and hired a private company, but the company’s workers are often on strike in protest about low wages and poor employment conditions.
Zimbabwe’s parliament has acknowledged the impact of staff shortages on all the country’s health centres. Minister of Health Dr David Parirenyatwa could only say the government was looking into the situation at Harare Central, “A team has since been sent to come up with a report on who best we can turn around the hospital.” – IWPR

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