Zimbabwe’s rural health delivery system, once regarded as one of the best in Africa, is now in a state of distress.
“Diseases are now part of life for most people in rural areas. Families have resorted to traditional herbalists, known as ‘vana tsika mutanda‘,” researcher Bright Mombeshora said after a tour of Kasiyo in northern Zimbabwe.
Mombeshora, who is also a social commentator, said: “The nurses we found in one clinic didn’t seem to be working at all. If all the health centres in the country’s rural areas are like that, then we have a time bomb on our hands.
“We found the nurses enjoying the sunshine. We asked them, without meaning any offence, if they were still on strike. They said they had no work to do. And it looked like they meant it,” he said.
Mombeshora said the biggest job he saw the nurses doing was distribution of condoms to mostly young clients.
Poor drug supplies, staff shortages and transport problems have rendered the clinic a sham, he said. The workers said most rural clinics were in the same state.
Mombeshora said he spoke to “a lot of people who claimed they no longer go to clinics, but have resorted to the services of traditional healers. At one time, I saw a family paying a traditional healer two goats and another giving away five cattle.”
Lower Guruve district, in which Kasiyo is situated, is infested with malaria and malnutrition, two of the most deadly diseases that are claiming millions of young lives in Africa.
Mombeshora said aid agencies are now feeding children under the age of five in a scheme aimed to fight malnutrition. They also cater for adults who have not been spared by hunger.
The United Nations World Food Programme says more Zimbabweans now require food aid than the 5,5-million people — 50% of the population — initially forecast by a UN study last year. Aid agencies have appealed for $197-million.
Mombeshora said heavy rains have created an atmosphere conducive for mosquito breeding. He said the aid agencies, apart from the feeding schemes they were carrying out, also distributed drugs to prevent and treat malaria.
Health officials say malaria, which is transmitted by the female mosquito known as the anopheles, is an added strain on the health delivery systems in rural Zimbabwe, where HIV/Aids is also on the increase.
About 2 500 people die of Aids-related diseases in Zimbabwe every week, according to official statistics.
In Shurugwi district, central Zimbabwe, the health delivery problem seems to be confined to the urban area.
Christopher Mapfuti, a municipal police officer in Shurugwi, home to former prime minister Ian Smith, said: “All the places and houses that used to be the best in the town have been turned into gold mining sites. You won’t like it if you had been to Shurugwi before.”
Mapfuti said mounds of ore are found at most of the homes in the town. The water, used to extract the yellow metal, comes from the town supply. Then the waste from the final work is pumped into the main drainage and sewer systems, which are now continuously blocked, he said.
Mapfuti said the town council and the ruling Zanu-PF officials spend most of their time quarrelling among themselves. While the town council would want to get rid of illegal gold panning, party stalwarts want to maintain support and would not like to hear of a stoppage to the panning activities.
“The two sides are working against each other, although the council is made up of Zanu-PF councillors, who should be working together with the party,” Mapfuti explained.
He warns that an outbreak of disease looms in the town. The sewerage water, he said, flows freely in front of houses where children play and through the streets, which themselves are on the verge of collapsing due to neglect.
Peter Mataruse, a former mayor of Chinhoyi, a town close to the Zambia border, said the economic problems, caused mainly by Zimbabwe’s controversial land-reform programme and sanctions, have paralysed the country’s health delivery system.
“The structures that were built during the good times are collapsing. Medicine supplies were better before Zimbabwe fell out with the Western powers and the donor community,” he said.
The United States and the European Union slammed sanctions on Zimbabwe for allegedly refusing to uphold the rule of law. Zimbabwe began descending into chaos in 2000 after the government of President Robert Mugabe ordered the seizure of lands from 4 500 white commercial farmers for resettling landless black peasants. Critics say the land-reform programme has destroyed Zimbabwe agriculture, which was the backbone of the economy.
Mataruse, who now runs a private clinic, said the World Health Organisation and other NGOS were helping in malaria control and feeding schemes in his area.
He said it would not be possible for Zimbabwe to stand on its own if the international community was to pull out from supporting the country’s health system.
The biggest problem facing the rural health system is the shortage of doctors and nurses, who mostly prefer to work in towns where facilities are better.
Chivhu General hospital in Mashonaland East Province, for example, has no doctor. Cuban doctors, who had been deployed to the town, went home on leave. And the lone Zimbabwean doctor in charge of the health facility joined the private sector as most of them are now doing. Some have gone to Britain, South Africa, Australia, Canada and New Zealand.
The staff at Chivhu hospital referred all questions to the provincial medical director, who was also not available, for comment.
Residents interviewed said the hospital mortuary, which caters for 36 clinics and hospitals, was built to hold eight bodies at one time. It now holds as many as 32 corpses. Aids, cholera and malaria are reported to be the main cause of death.
Immediately after independence from Britain in 1980 Zimbabwe launched a programme to build clinics and hospitals throughout the country. These structures are now either falling apart due to lack of maintenance or are without beds and equipment as a result of poor and erratic funding.
Recently doctors went on strike demanding an 8 000% pay rise. They said the increment was necessary in a country that is reeling under a galloping inflation, now estimated at 600%. — IPS