Doctors in Zimbabwe have vowed to remain on strike until the unity government addresses their salary grievances. This is increasing concerns about the impact of the swine flu pandemic, in a country that already has an unacceptably high death rate in the hospitals.
Poverty, disease and overburdened health systems make Africa an easy target for the H1N1 influenza virus, commonly referred to as swine flu, which health experts say will be difficult to track as it spreads across the continent. Africa is the last continent to be hit by the virus that has killed over a thousand people around the world, since it was first detected in April in Mexico.
So far the continent's death toll remains small, with six killed in South Africa, three in Mauritius, and one in Egypt. Botswana, Gabon, Kenya, Madagascar, Namibia and Swaziland also have medically confirmed cases, but experts say the disease could be spreading undetected in more countries, due to a lack of medical facilities across the continent. Many African countries are already affected by immune-weakening illnesses like Aids, making them more susceptible to new viruses. In a country like Zimbabwe, where the health sector is slowly starting to recover after collapsing last year, even minor illnesses carry a potential death sentence.
The Zimbabwe Association of Doctors for Human Rights (ZADHR) has said the strike is also undermining efforts to recover the once effective health system in the country. The Association's Dr Douglas Gwatidzo on Tuesday said that a prolonged strike would ultimately result in "increased morbidity and preventable deaths."
"While it is the Government's duty to ensure that Zimbabweans have available, accessible and quality health care, doctors also have a responsibility to contribute towards this realisation of the right to health." Dr Gwatidzo said.
Efforts to end the strike failed last week, with striking doctors dismissing promises to amend their monthly allowances. Many doctors last week joined the two week long strike action by junior doctors, demanding higher salaries and the restoration of allowances, which had been withdrawn last month by the government. The Health Service Board has since said that allowances for items such as accommodation, uniforms and night duty had not been included in doctors' monthly salaries 'in error' and would be restored. But doctors have vowed to remain on strike, until the government heeds their call for an upward review of their salaries.
"We are still waiting for a solid decision from the government. If it refuses to honour our request we cannot return to work," said the head of the Hospital Doctors Association, Brighton Chizhande on Monday.
Experts meanwhile have also warned that Africa lacks the money to effectively combat the spread of swine flu. World Health Organisation (WHO) regional director Luis Gomes Sambo warned last week that the agency had already had US$31m shortfall in its African response plan.
"So far only $700 000 has been made available and it will be difficult to shift funds already earmarked for other public health programmes," Sambo said.
The WHO has set up a crisis management team in Brazzaville to help countries monitor the disease and ensure cases are detected early. This team will have support centres in Zimbabwe, Gabon and Burkina Faso. Dr Gwatidzo on Tuesday said Zimbabwe was 'fairly prepared' for the spread of swine flu in the country, explaining that consignments of flu-drugs used to fight the virus have arrived and are being prescribed in Zimbabwe. He said that so far, swine flu cases have only been diagnosed at private medical institutions, and acknowledged that the spread of the disease through public hospitals is a worry.
"Right now, with patient distribution being what it is, the institutions that can manage this disease are doing so," Dr Gwatidzo said. "What happens if this disease spreads into poorer areas is a different matter."