Caiphas Chimhete
12 October 2003
SINCE her admission to Parirenyatwa Hospital, one of the country's largest referral hospitals some two weeks ago, Joyce (9), has not been attended to by a medical doctor.
Joyce was referred to the country's premier medical institution from Mutare after she was diagnosed to be suffering from a brain tumor, a disease that requires urgent attention.
"She was referred here two weeks ago so that she can be operated on but up to now she has not been attended to. The nurses are saying the doctors are busy elsewhere," said Joyce's mother, who requested anonymity.
Doctors said if left untreated for a long time, brain tumor "grows and it gives a lot of headaches" to both the patient and the doctors.
Joyce's case is not only a true reflection of the situation at Parirenyatwa Hospital but also a microcosm of the health crisis that has gripped Zimbabwe partly as a result of the massive brain drain of medical personnel.
It is ironic that Zimbabwe, a country that once boasted of an impressive health sector soon after independence in 1980, is currently facing a critical shortage of medical doctors, pharmacists and nurses, equipment and essential drugs.
The crisis has turned Zimbabwe's health care gains into a major disaster. It is estimated that over 65 percent of Zimbabwe's 12,5 million people can not afford to pay for their medication.
More people are likely to fall into that bracket as the economic meltdown worsens.
The majority of Zimbabwe's highly trained medical personnel are leaving for Botswana, Namibia, South Africa, the United Kingdom, the United States and Australia, where salaries and working conditions are better.
The exodus of medical personnel is largely because of the lure of stronger currencies as the Zimbabwean dollar, and the economy in general, continue on the downslide.
The president of the Zimbabwe Medical Association (Zima), Billy Rigava, confirmed that the country is facing a critical shortage of doctors due to a brain drain.
He said although there were 2 000 registered doctors in Zimbabwe, only 1000 were working in the country.
"Half of the doctors have left the country. It is a survival issue, you can not expect doctors to stay here when they cannot pay for their children's school fees or have a decent house or car," said Rigava.
His sentiments were echoed by renowned medical practitioner Chris Mushonga, who also attributed the exodus of doctors to the current harsh economic environment that has gripped Zimbabwe.
He noted that the number of doctors leaving Zimbabwe surpassed those that were being trained at the University of Zimbabwe annually.
"It has reached a desperate situation. It is serious. There is more doctors leaving the country every year than those being trained locally," said Mushonga, who runs a number of private surgeries in Harare.
The University of Zimbabwe churns out an average of 80 doctors a year, a number too small to satisfy local demand. This situation is exacerbated by the fact that specialist and experienced doctors are also leaving the country. Statistics indicate that the doctor to patient ratio stands at about 1:12 000.
"That ratio is certainly out of what is expected by the World Health Organisation. We definitely need more doctors that is why the government is getting more doctors from countries like Cuba and the DRC," said Rigava, who was quick to add, "but the university cannot train more doctors because the lecturers, who are also doctors, are leaving".
The Minister of Health and Child Welfare, David Parirenyatwa, who admitted the critical shortage of personnel, said the ministry had no statistics on the doctor to patient ratio.
"We don't know because some doctors are registered with us but are no longer in the country while others are in the private sector," said Parirenyatwa.
A WHO official said the doctor to patient ratio depends on the level of development of each individual country.
"It actually depends on the accessibility of other health services in each country. People in developed countries have more access to doctors while the reverse is true in developing countries," said the official.
Also leaving the country in large numbers are pharmacists and this has impacted negatively on public health institutions.
Rigava said there are only four senior pharmacists in the public sector, two of whom are carrying out administration duties. This leaves only two to serve in government hospitals.
The critical shortage of doctors in most of the country's hospital departments has resulted in some nurses having to perform doctor's duties in a bid to arrest the situation. But that has not improved the situation either as scores of senior nurses are also leaving the country in droves.
An official with the Zimbabwe Nurses Association (Zina) said there were 18 000 registered nurses in the country, of which nearly half have left the country in search of better living and working conditions. This translates to a nurse serving about 1 333 patients.
Zina president Abigail Kuranga could not be reached for comment as she was said to be out of the country on business.
Besides the brain drain, the shortage of mortuary space, equipment, drugs and food have also plagued the health sector.
Many clinics and large hospitals such as Parirenyatwa, Harare Central Hospital, Mutare General Hospital, Gweru General Hospital and Mpilo Hospital in Bulawayo, are failing to cope with the food requirements of patients.
Only recently, it was reported that about 10 women stumbled over each other as they tried to get an extra plate of food in Ward 3A at Parirenyatwa Hospital.
"If you do not have your own money to buy food you will die of hunger here. The hospital gives us very little food. I stayed here a few years ago but it was much better then," said one woman, who was staying at Parirenyatwa Hospital nursing her child.
Health officials said the situation was worse in small institutions, particularly those in rural areas. Some hospitals have resorted to food rationing while other health centres request relatives to bring in additional food.
Zimbabwe's mortuaries are also crowded, a condition that has been attributed to the Aids scourge, which is claiming at least 3 800 lives every week. At times several bodies are put on the same tray while others are heaped on the floor.
Commentators said as the Zimbabwe economy continues to degenerate so will be the health sector and other facets of the economy.
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