/ 28 October 2014

Zim doctors lay down stethoscopes as state refuses to talk

Health was allocated R145.7-billion
Junior doctors lives stand still as they wait to be paid after the human resource staff failed to capture their details to the payroll system on time.

Zimbabwe’s ailing health sector has been plunged into further chaos after doctors in public hospitals went on strike on Monday to press for salary increments and an improvement of service conditions.

The doctors, who on Tuesday continued their industrial action, are demanding $1 200 (about R13 200) as a basic salary up from the current $282 (about R3 100) as well as transport, accommodation and risk allowances.

Farai Makoni, the secretary general of the Zimbabwe Hospital Doctors Association (ZHDA), which represents doctors in the public sector, told the Mail & Guardian that most senior housing officers, senior resident medical officers and junior medical resident officers had joined the strike, leaving consultants to take charge of government hospitals with the assistance of student doctors.

The strike has affected all the country’s major referral hospitals including Parirenyatwa and Chitungwiza General in Harare, United Bulawayo Hospitals, Ingutsheni Hospital and Mpilo Central Hospital in Bulawayo.

Provincial hospitals have also been affected and Makoni said doctors at district hospitals would also join the strike.

Nurses carry out doctors’ duties
A nurse at Parirenyatwa – the country’s biggest referral institution, with 1 800 beds, – said some nurses were also doing the work that ordinarily would be done by doctors.

She said several patients were turned away without being attended to while measures were being made to discharge some patients, even those who had not fully recovered. “Patients who have been referred here are spending hours without being attended, the situation is serious. We are only attending to very serious cases and the outpatients department has been closed.”

A visit to the hospital by the M&G on Tuesday morning revealed that there was only one doctor attending to patients. A long queue of patients waiting for attention, with some on stretcher beds, was observed.

At Mpilo Central Hospital, the largest referral institution in the southern parts of Zimbabwe, notices have been put in public areas informing the public of the strike.

“Please note that doctors are on strike. Only dire emergencies will be attended to. All outpatients clinics are hereby suspended till further notice,” reads part of the notice.

The strike has affected mostly the poor who are not on medical aid and cannot afford private healthcare.

Public hospitals usually charge $5 for a new file for a patient and no consultation fees. On average, private general practitioners charge $35 in consultation fees on weekdays, $60 at the weekend and $70 at night.

‘Unfortunate for our patients’
Makoni said the doctors would be on strike until the state addresses their grievances.

“The strike is going on, which is very unfortunate for our patients whom we value so much. We have no choice but to take such action because the government has shown that they are not concerned about our plight,” he said.

“We are not asking for anything out of this world but the government has refused to formally hear our grievances, which shows that they are not serious.”

Doctors wrote to the state this month, pushing for a review in their salaries and improvement of their conditions of service.

In addition to the salary increment, doctors want their on-call allowances to be increased to $10 (about R110) an hour from the current $79 a month.

“We also want to import goods duty-free. Given what we earn, it is obvious that we drive cheap ex-Japanese vehicles. We want to be able to import without hassles,” said Makoni. “We also want risk allowance because we deal with patients with communicable diseases every day and are therefore at risk. We also want out-of-residency allowance of between $450 and $500 a month from the current $250. We believe our demands are not out of this world.”

Makoni said that they had tried raising their grievances, but the government had refused to formally meet the doctors. He said his association had held informal meetings with officials from the ministries of health and finance, and the Health Services Board, who wanted to hear their grievances, but the state officials insisted the meetings were informal.

State ignored 14-day ultimatum
The deputy minister of health, Paul Chimedza, refused to comment on what the government was doing to ensure doctors returned to work, although he hinted that negotiations were in progress.

He said the ministry would issue a statement later in the week. “It is premature for us to comment because there is a process going on and it is something delicate which I wouldn’t want to compromise.”

Dr Emmerson Pazara, the chairperson of the ZHDA in Bulawayo, said the government had ignored their 14-day ultimatum, hence the decision to strike.

Pazara said although doctors were aware that the country was facing serious economic challenges, their demands were “modest”.

“Our regional counterparts are earning around $3 000 but we are only asking for $1 200 as patriotic doctors. Surprisingly the chiefs and the magistrates have all been awarded increments by a government that shows no intention of meeting our realistic demands.”

However some doctors who spoke to the M&G on condition of anonymity said they will be using the strike period to explore employment opportunities in Swaziland, where they have received lucrative offers.

“The Zimbabwean government is giving us peanuts and we are surviving on being illegal locums [stand-in doctors] in private surgeries, which we only do when the owners are away and when we are free.”