On July 27, 2020, seven babies were stillborn in Harare Hospital on the same day. An anonymous doctor, in a letter to the nation, confirmed that the babies were of a healthy weight and could have been saved, but it was Zimbabwe’s crumbling health system that killed them.
This incident is just one of the many unreported and completely avoidable deaths. Many patients are forced to be turned away from hospitals either due to lack of staff or lack of equipment. There have been reports of pregnant women giving birth in unconventional and unsafe places leading to increased mortality rates. Doctors and nurses have consistently been underpaid and overworked.
Although this situation is common to many countries as a result of the COVID-19 pandemic, the situation in Zimbabwe has been dire for a long time. In September 2019, medical personnel across the country went on a 4-month long strike to protest their devastatingly low wages and poor working conditions. It was not that they did not want to work, it was that they could not afford to work. In the face of triple-digit inflation, doctors and nurses could barely meet their food and transport costs. In fact, the doctors did not call it a strike - rather an “incapacitation”.
The government’s response was disheartening, stating that it was not just medical personnel, but all workers who were suffering under inflation, including civil servants. However, looking at the standard of life of government officials, this did not seem plausible. Suspiciously enough, not long after the strike began, their union leader, Dr Peter Magombeyi, was abducted for five days under mysterious circumstances.
The staff only returned to work in January 2020 when the telecoms tycoon Strive Masiyiwa offered to supplement the government wages with a monthly subsistence allowance through his charitable foundation.
Then in March 2020, COVID-19 reached Zimbabwe. President Emmerson Mnangagwa fell short in governance. Not just the healthcare system but the entire economy is facing an insurmountable challenge. The unemployment level is close to 90%, with most people falling deeper into poverty and being unable to afford a proper meal a day.
In April, the High Court ordered the government to ensure all healthcare workers were supplied with Personal Protective Equipment (PPE). However, according to doctors, there is still hardly any PPE available. N-95 masks are occasionally provided but mostly a surgical mask and plastic aprons are given to last an entire day. An increasing number of medical personnel are being affected and there is no insurance for them. Adding to this risk of practicing, the pay has been dismally low.
The situation is even more terrible for nurses. Many of them receive just $30 per month and cannot even afford proper food and housing. On these grounds, nurses in Zimbabwe went on a strike in June 2020. Instead of providing PPE kits and improving pay and working conditions, the government brought in student nurses and those who had been out of work for a long time. Thus, many wards were staffed with nurses who were either inexperienced or who had not received recent training. Shortly after, doctors followed them, demanding PPE, better conditions and equipment in hospitals, decent pay, and for salaries to be paid in US dollars rather than the RTGS dollar (or “Zimdollar”) which is subject to hyperinflation.
Reinaldo Ortuno, head of mission at Médecins Sans Frontières Zimbabwe said, “Hospitals and clinics are now manned by student nurses, junior doctors, and other staff who have no choice as they are still under training. This has compromised quality of care and has inadvertently contributed to high morbidity and mortality rates”.
The government seems to have little incentive to bring a change. The people in power do not exert pressure for a better healthcare system as they do not get treated in government hospitals. When they fall sick, they go abroad. Ex-President Robert Mugabe received treatment in Singapore before he passed away in 2019, at the age of 95. Vice-President Constantino Chiwenga, the former military man who played a major role in overthrowing Mugabe, has received four months of medical treatment in China.
The government even saw the pandemic as a money-making opportunity. This clearly revealed the multi-million-dollar equipment procurement scandal that led to the recent arrest of the Health Minister as well as the vindictive detention of Hopewell Chin’ono, the journalist who uncovered it. The government then appointed Constantine Chiwenga as the new Health Minister, even though he had made insulting and abusive comments against doctors in the past.
The pandemic has led to strikes by medical personnel all across the world. This presents a dilemma of whose needs should be put above the others. Should doctors and nurses suffer through their long hours and low wages as a part of their duty to society? The reality is that in Zimbabwe, they have been making this sacrifice for a long time. However, now the nature of COVID-19 means that this sacrifice could cost them their lives. Norman Matara, head of Zimbabwe Hospital Doctors Association said that about 15% of the nationally recorded virus infections had been detected among health workers. The lack of attention from the government has broken their spirit.
Many have called this crisis in Zimbabwe a “silent genocide”. The government must increase public spending in the healthcare sector on an emergency basis, and should also look towards securing foreign assistance for equipment and personnel, like Cuba has been providing, to support them through the pandemic. Refusing the demands of the workers and degrading their protest by accusing them of not fulfilling their duty is not beneficial to any side. President Emmerson Mnangagwa needs to act in order to rebuild the trust of doctors and nurses in the government. They are at the frontline of the fight against the pandemic, and their wellbeing, both physical and mental, is quite literally a matter of life and death.
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