Zim hospitals rely on charity to survive

Conditions in Zimbabwe's public hospitals continue to deteriorate as facilities face medicine shortages and cannot afford to properly maintain their operations and infrastructure. (AP)

Conditions in Zimbabwe's public hospitals continue to deteriorate as facilities face medicine shortages and cannot afford to properly maintain their operations and infrastructure. (AP)

Referral hospitals are struggling to sustain their operations, with rural and provincial hospitals also hard hit.

The Mail & Guardian understands that Mpilo Central Hospital in Bulawayo and Harare Central Hospital – two of the country's largest referral health centres – are faced with critical shortages of health consumables such as drugs, detergents and food for patients.

Mpilo Central Hospital recently held a fundraising drive, during which the hospital invited private-sector companies to donate money and health consumables to ease shortages in the wards and to repair dilapidated infrastructure and equipment at the facility. 

In the country's 2012 budget, Mpilo hospital was allocated $4.1-million, but health officials at the institution recently reported that only $1.1-million of that amount had been made available to the hospital.

Hospital officials said the abolition of user fees has reduced the hospital's cash flow from about $200 000 to $60 000 a month.

In terms of the health transition fund, which is being implemented by the United Nations Children's Fund and Zimbabwe's ministry of health and child welfare, pregnant women and children are treated for free.

The idea behind the project is to reduce maternal mortality by encouraging women to give birth in public health institutions. According to the 2010/2011 Demographic Health Survey, more than 30% of women deliver outside of health facilities. Following the collapse of the economy in 2008, many women could not afford the fees charged by private and public hospitals, resulting in an increase in deaths from complications related to home births.

Low budget disbursements have also impacted negatively on the operations of Chegutu District Hospital, about 200km outside Harare. The hospital, which serves the mainly farming community of Chegutu, recently held a fundraising dinner at which musician Selmor Mtukudzi was a drawcard.

Lack of funds cripples operations
Insiders at Harare Central Hospital said that the treasury had disbursed $958 000 from the 2012 budget to the facility, whereas its operations require over $25-million per year.

The chairperson of the Harare Central Hospital board and the Zimbabwe Medical Association's secretary general, Dr Douglas Gwatidzo, said the situation at Harare hospital and most public health institutions is dire because of a lack of funds.

"Most of these public health hospitals have budgets of about $30-million to $40-million a year of recurrent expenditure," said Gwatidzo.

"The treasury is supposed to fund about 10% of that budget, but it sometimes does not even come through with that percentage and this cripples the operations of most of these hospitals."

Gwatidzo added that, as public institutions, most affected hospitals are not permitted to charge market rates for their services to enable them to fund their operations.

'Find alternative financing': Govt
The health minister, Dr Henry Madzorera, said Zimbabwe's underperforming economy and low tax revenues have led to the health sector as well as other ministries not receiving adequate funding from the treasury.

Although the 2013 budget allocation for the health sector is higher than last year's, the money set aside for operational expenses has been reduced. As a result, health institutions are likely to be in a far worse situation this year than they already find themselves.

Madzorera encouraged health institutions to seek private funding, citing the example of the Kwekwe and Gweru hospitals, which recently held fundraisers.
Gweru Provincial Hospital, about 400km outside Harare, raised about $260 000 in one day from the initiative.

He said health institutions must look for "alternatives ways of financing their operations and fundraise within their communities and from the corporate sector, businesspeople and municipalities, because the treasury has no money". – M&G health correspondent