Harare — Striking Zimbabwean medical professional are returning to the wards after non-governmental organizations started paying monetary incentives, but many have yet to resume their duties.

In 2008 government doctors and nurses embarked on strike action in protest at poor salaries and working conditions, forcing hospitals and clinics virtually to shut down. In their absence, student nurses provided health care for patients.

Zimbabwe's hyperinflation eroded the salaries of health care professionals to such an extent that their monthly income was barely enough to cover a day's transport costs.

Amid a cholera outbreak that has killed nearly 4,000 people and infected more than 80,000, international donors have sought to lure health workers back to their posts with the promise of wages paid in foreign currency.

"We decided to step in and help in rescuing the desperate situation in the health sector by disbursing top-up incentive allowances to striking health staff at public hospitals," Tsitsi Singizi, spokesperson for the United Nations Children's Fund (UNICEF) told IRIN.

"This is a life-saving stopgap intervention, meant to complement government efforts to get the staff back at work; paying the workers their salaries remains the responsibility of the government."

Singizi said US$5 million had been disbursed since January 2009 - a third of the salary budget for the year - with other non-governmental organizations committed to making their own contributions. The allowances are being paid to health employees via an independent international firm.

On a visit to Parirenyatwa hospital, the largest referral clinic in the capital, Harare, an IRIN correspondent observed a sharp increase in the number of qualified doctors and nurses present.

'More like a sit-in'

However, most were not assisting, but basking in the sun or chatting in groups while trainee staff attended to patients. "It is almost like a sit-in, because what we are receiving at the moment falls far too short of what we have been striking for," said Tendai Gezi, 35, who asked that her real name not be used.

The allowances from private donors are welcome but, unfortunately, they are not doing enough to address our plight. The donors have set the pace and it is up to the government to play its part

"The allowances from private donors are welcome but, unfortunately, they are not doing enough to address our plight," the nurse told IRIN. "The donors have set the pace and it is up to the government to play its part so that we can start working in earnest once again."

Gezi said she had received US$100 as an allowance from humanitarian agencies, which had covered her monthly transport costs to the hospital but left little for daily living expenses.

She has three school-going children and has to pay US$850 in fees for the term, as well as US$250 monthly rent. She is also supporting her parents, who live in a rural area.

The government has introduced a US$100 voucher system for civil servants, which can be converted into cash or used to buy basic commodities, but the combined wages of US$200 does not cover Gezi's monthly expenditure.

A junior doctor, who declined to be named, told IRIN if the government had not withheld his medical certificate he would already have left Zimbabwe to offer his skills in another country. In accordance with new regulations, medical staff have to complete up to four years of service before they can seek employment elsewhere.

Equipment shortages

At Chitungwiza hospital, in a dormitory town about 35km south of Harare, IRIN saw more nurses at work than at Parirenyatwa. "The situation has slightly changed and more qualified nurses are helping attend to the sick, thereby taking some pressure off the skeleton staff that remained when nurses and doctors went on strike last year," said a senior doctor at the hospital, who declined to be named.

We still have a long way to go because there are hardly any drugs, protective clothing or equipment to use. While about half of our nurses returned, the sorry working conditions are demoralising

"However, we still have a long way to go because there are hardly any drugs, protective clothing or equipment to use. While about half the number of our nurses returned, the sorry working conditions are demoralising and it might not be long before we see them refusing to work once again," the doctor told IRIN.

Takesure Matsika, 35, who lives in Chitungwiza town, said his wife was not receiving adequate postnatal care at the hospital. "It has been hell for me since my wife went into labour this month [February]," he told IRIN.

"I was told that she had to be induced to deliver the baby, but at that time they said they did not have the equipment to do so, right from gloves to the sophisticated gadgets," he said.

"Luckily, she ended up giving birth normally, but my woes have continued because she is now back in hospital due to bleeding. It is the same old story because there are no drugs or equipment."

The only relief for Matsika is that the daily hospital fee has been reduced from US$70 to US$5, while the adult admission fee has been cut from US$50 to US$8.

"I am smuggling food in because the diet at the hospital is so poor," he said. "Since my wife is using her own room, I am also bringing in new linen, because the blankets and sheets provided by the hospital are not being washed properly."

[ This report does not necessarily reflect the views of the United Nations ]