/ 19 July 2006

Doctors’ strike knocks out Zim health system

Themba Sibanda (27) is too ill to walk on his own and relatives have to carry him around each time he has to visit the hospital for treatment for the many opportunistic infections that frequently attack his weakened body.

Just four weeks ago Sibanda — who is HIV-positive — was brought to Mpilo government hospital almost lifeless after suffering from a severe bout of malaria. A doctor quickly prescribed a chloroquine course that had Sibanda on his feet after just two days.

But Sibanda’s luck ran out this week when he returned to Mpilo — this time suffering from acute diarrhoea. He was turned away because there were no doctors at the hospital, the largest state hospital in Zimbabwe’s second-largest city of Bulawayo.

”The nurses said because of his HIV status, only a doctor could prescribe what drugs he should take for the diarrhoea and we should come back when the doctors’ strike is over,” Sibanda’s sister, Nokuthula, told independent news provider ZimOnline.

”He has not been able to sleep for the past two days because of the diarrhoea … only if we had the money to take him to private clinics,” added Nokuthula, despair unmistakable on her youthful face.

Intern doctors, referred to as junior doctors in Zimbabwe, are on strike for better pay and working conditions. It is the umpteenth time the interns — who effectively run public hospitals — have downed tools to press for better remuneration since the country’s economic crisis began seven years ago.

The doctors have defied a government directive earlier this week to return to work while their grievances are being examined, insisting they would only call off the strike after firm commitment from the government to pay them Z$500-million per month, up from a present salary of Z$57-million, which is way below the poverty datum line of Z$68-million.

The doctors also want the government to improve supplies of essential medicines and equipment in public hospitals, saying they are tired of watching patients die of otherwise treatable diseases simply because there are no medicines.

But the strike has dealt a knock-out punch to the public health system that was already on its knees after years of mismanagement and under-funding.

For example, at Mpilo and the United Bulawayo hospitals — the two biggest referral hospitals in the city and the surrounding Matabeleland and Midlands province — only a handful of senior doctors could be seen attending to only the worst of emergency cases.

The outpatients departments at the hospitals were shut down.

It was the same situation at Harare Central hospital and at Parirenyatwa, the two biggest hospitals in the capital city and where ZimOnline reporters witnessed dozens of patients — some on wheelchairs — being turned away because there were no doctors.

”It is the poor like us who have to suffer for this [impasse between the government and doctors],” said Lazarus Ndlovu, who added he had travelled about 100km from the border town of Plumtree, south of Bulawayo, but was told by nurses at Mpilo to go back and return when the doctors’ strike is over.

Deputy Health Minister Edwin Muguti this week tried to use the law to cajole doctors to return to the hospitals, telling them that they provided an essential service and were not permitted by law to engage in industrial action.

The government’s Labour Relations Amendment Act prohibits providers of essential services such as doctors and nurses from striking.

But Hospital Doctors’ Association president Kudakwashe Nyamutukwa said doctors would take no heed of Muguti or the law, vowing that the strike would only escalate until the government accepted the doctors’ demands.

”The strike has spread and now everyone has joined in. We will not go back to work until the government has met all our demands,” said Nyamutukwa.

With no quick end to the doctors’ strike in sight, Nokuthula said there was little option left for her family except to take her brother to traditional healers for treatment.

”We are devout Christians and it’s something we would never have done … but the only other option is to just fold our arms and watch my brother die,” she said, no doubt echoing the dilemma facing many patients and their families across Zimbabwe. — ZimOnline