9 June 2003

Zimbabwe: Shortage of Nurses Cripples Health Services

Harare — A group of women with children strapped on their backs with fallen faces exuding profound weariness and abject demoralisation sit under a tree outside Majada Clinic in Gutu South.

They have walked long distances of up to 10 kilometres to the clinic but the will power to return home has evaporated after being told the vaccination of babies has been postponed to another date to be announced.

Elsewhere, at Mashenjere clinic in Murinye communal lands, Masvingo District, a woman who has failed to give birth has been writhing in agony for several hours as there is no ambulance to ferry her to Masvingo for an operation.

Neither does the salvation lie in the benevolence of a local businessman who after a spate of non-committal gestures, concurs to sacrifice his business to save life by taking the woman to Masvingo.

Health delivery in the country's most populous province has been severely affected by the acute shortage of nurses coupled with the crippling shortage of ambulances and delivery vehicles.

Most clinics in the province are now being manned by inexperienced nurse-aides who cannot administer certain drugs to patients.

The fuel crisis currently plaguing the country has fuelled the transport woes as most ambulances and service vehicles are grounded.

Some are constantly on and off the road resulting in crippling inconsistencies.

The service vehicles, crucial in the transportation of drugs and food to various hospitals and clinics dotted around the province, are hardly available. It is believed most of them are grounded and require mechanical attention.

"There are hardly any service vehicles to transport drugs and food to all parts of the province as most of them are down at the moment," said Masvingo provincial medical director Dr Tapiwa Magure.

Caught in a web of acute shortage of delivery vehicles by the Ministry of Health and Child Welfare, the immunisation of babies, an important project on the health calendar every year, has been postponed on numerous occasions.

In Gutu district, nervous mothers narrated ordeals where they have been walking repeatedly to the clinics to have their children immunised, only to be told to return on another date.

"I have been taking my two little children to Majada clinic for vaccination only to be told to go back home and wait for another date to be announced," said a demoralised Mrs Leona Dzingirai, from Chiwara communal lands, seemingly pondering on the fate of her two little children.

Dr Magure, however, defused the growing anxiety among worried mothers saying his office had already deployed a vehicle to Gutu to assist in the immunisation outreach programme.

"The provincial medical director's office had to deploy bone of its vehicles to Gutu last week to assist in such critical areas like the immunisation outreach programme," he said.

Shortage of proficient health personnel, long the Achilles' heel of the country's health sector, has not helped matters in the province where most health centres are now run by nurse-aides whose main bane is inability to administer certain drugs.

Skilled health professionals have been leaving the country en masse to neighbouring countries where their excellent skills are in high demand and are well remunerated.

Others have ventured into private practice where they have the unlimited potential to accumulate wealth faster.

However, a vibrant private health system is not a panacea to a dilapidated public health system of the country because it excludes the majority of the people who are living in rural areas or do not have the financial muscle to afford it.

Masvingo needs at least 276 qualified nurses to fill the vacant posts in the province which requires about 1 104 nurses to operate normally.

This, according to health officials, translates into a 25 percent vacancy ratio in the province leaving some health institutions especially those in rural areas being the worst affected.

The situation is said to be more desperate in those rural health centres that are run by rural district councils and those that do not have incentives like electricity and proximity to busy roads.

"We are working with a skeletal staff of nurses resulting in some health centres being run by nurse-aides.

"The situation is better in health centres run by Government as compared to those run by rural district councils because the latter does not have fixed pay days thereby alienating itself from qualified personnel," Dr Magure said.

He said the province has embarked on a primary care nurse course almost similar to the state certified nurse at Silveira Mission for a start, to expedite the training of nurses in the province.

Most qualified personnel shun rural areas that do not have electricity and access to clean water. Dr Magure, however, said the ongoing rural electrification programme was going to prioritise health centres so that they can attract qualified workers.

He added the ongoing rural electrification programme was going to improve storage of drugs that had been hampered by the erratic supply of gas for use on refrigerators.

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