The government’s continued failure to fund the health sector adequately has forced Mpilo Central Hospital in Bulawayo, one of the country’s largest referral hospitals, to extend a begging bowl to international and local donors for a $15-million bailout package to fund infrastructural development and operations.
Built in 1957 in the heyday of the Central African Federation, which brought together the then British territories of Southern Rhodesia (Zimbabwe), Northern Rhodesia (Zambia) and Nyasaland (Malawi), Mpilo is the largest hospital in southern Zimbabwe and has referral patients who come from Bulawayo Metropolitan, the Midlands, Matabeleland North, Masvingo and Matabeleland South provinces. This year, Finance Minister Patrick Chinamasa unveiled a paltry $4.2-billion national budget in which the health and childcare ministry got $337-million, which is 8.2% of the total budget allocation and is slightly less than the 9.87% allocated in 2013.
Soon after the January budget presentation, Itai Rusike, the executive director of local health think-tank the Community Working Group on Health, expressed concern that Zimbabwe was failing to meet the stipulations of the 2001 Abuja Declaration on Health that at least 15% of national budgets should go towards health. He also said that since 2009 the bulk of the health ministry’s expenditure went towards paying wages, contrary to international best practice of a ratio of 30:70 for wage and nonwage expenditures.
Consequently Mpilo, as is the case with other health institutions, has suffered from acute funding inadequacies that have not only seen a decline in the infrastructure, including leaking roofs and faulty elevators, but also, more importantly, in equipment, contributing to a serious deterioration in the quality of health care.
It is in this context that the hospital recently sought and obtained government’s permission to host a donors’ conference to arrest the continuing decline in healthcare provision.
The Mail & Guardian is in possession of a letter dated May 6 from Health Minister David Parirenyatwa, authorising the hospital to host a donors’ conference on August 21. Its aim is to raise $15.64-million to purchase medical equipment and fund infrastructural projects, including doctors’ and nurses’ accommodation, as well repair the old institution.
“The ministry of health and child care supports your initiative, whose objective is to harness resources from the donor community and corporate world. In this regard I grant you permission to hold the donors’ conference,” Parirenyatwa wrote to the hospital’s chief executive, Los Mantiziba.
Mantiziba confirmed the impending donors’ conference in an interview on Tuesday, telling the M&G that the hospital is targeting “diplomatic missions, development partners, nongovernmental organisations, big corporates and individuals as it seeks to raise $15 640 000 to fulfil Mpilo’s strategic development plan of offering high-quality healthcare.
“We are also looking to SADC [the Southern African Development Community], Comesa [the Common Market for Eastern and Southern Africa], churches as well as individuals to assist, because there are so many projects that need to be implemented or completed,” he said.
The hospital has produced a document detailing the gaps to be filled. These include hospital infrastructure and plant and equipment rehabilitation.
Dilapidated infrastructure, staff shortages
“It is noted that the infrastructure and plant built in 1957 faces several challenges due to lack of preventive maintenance, resulting in infrastructure being broken down and dilapidated. The hospital roofs are leaking, causing damage. Incomplete infrastructure includes the chapel, mortuary and doctors’ residence,” reads the document.
Mantiziba also said there were staff shortages, particularly of radiographers and consultants; there are only 11 consultants out of the required 41.
“The hospital theatres face challenges of equipment and infrastructure, as out of 12 hospital theatres only four are fairly functional; out of the 10 hospital elevators only three are functional, while three out of eight hospital autoclaves are functional, with the laundry department having no reliable equipment, forcing [us] to utilise private laundries.”
Mantiziba told the M&G that the fundraising initiative was meant to complement the efforts of the government in view of the prevailing economic hardships, but sources at the institution said hospital management was forced to take action because of the economic decline. They said the hospital has been underfunded for several years, resulting in service delivery standards worsening.
“The support from government has been very good and we know they are going through a difficult period hence this initiative to complement their efforts. Government has already completed a $200 000 pharmacy store at the hospital and a $6-million radiotherapy centre is 75% complete. They are also paying the salaries of our staff,” said Mantiziba.
He said it was not all gloom at the hospital, insisting the institution had covered a lot of ground in sourcing some equipment, in construction as well as the recruitment of key personnel.
“There are eight renal dialysis machines and consumables sourced from the Zimbabwe-Chinese equipment project and these have been commissioned and are now fully functional. The hospital has also filled critical posts in management, including the chief executive, clinical director, director of operations and director of finance. The hospital has also completed its computerisation project at the cost of $86 500 and the website is now fully functional.”
Meanwhile, Zimbabwe’s other health institutions are facing serious difficulties. The intensive care unit at Parirenyatwa Hospital, the country’s largest referral hospital, was temporarily shut down because of the breakdown of the ventilation system and critical equipment. The hospital, like many others, is also facing serious water shortages. Other, smaller hospitals are also grappling with myriad problems.