by Clayton Masekesa
For Mavis Mukubva from Bikita in Masvingo province, the year 2008 will forever be marked in her mind as one of the most disastrous years of her life.
She lost her daughter-in-law Margaret, who died soon after giving birth. As if that calamity was not enough, the newly born baby died too.
Margaret gave birth at the side of the road on her way to Bikita rural district hospital. Barely able to walk, with the newborn in her arms, she slowly continued, unaware that her uterus had prolapsed during delivery.
When she reached the hospital, there was no doctor and no senior staff to attend to her. Her health deteriorated and she died.
The hospital had lost many of its nurses to greener pastures and, in an interview with The Zimbabwean, the Bikita district nursing officer, Thomas Nyamayaro, remembered the worst of it.
“There was lack of equipment in many of the clinics in the district. Drug supply had dried up. Some clinics had to close. Most health workers left the country for better opportunities in other countries,” he recounted.
Nyamayaro said mothers and babies suffered most under the crumbling health system. Maternal and child mortality rates shot up.
Eventually, in 2011 the international donor community stepped in.
Through a fund led by the Ministry of Health and managed by UNICEF, a group of donors pledged $435m to create the Health Transition Fund (HTF).
Donors include the UK Department for International Development, the European Union, the Canadian International Development Agency and Irish Aid. Other partners are the Norwegian government, the Swiss Technical Corporation and the Swedish government.
The money goes towards maternity and child health and nutrition, essential medicines, vaccine, basic equipment and human resources, as well as health policy and financial planning.
Nyamayaro confirmed that essential medicines were now available in many rural clinics.
Eunice Matimba, the sister-in-charge at Bikita, said: “We received $5,000 from the HTF and we bought benches for our patients since most of them used to sit on the floor. We also bought foodstuffs for admitted patients. We now have a balanced diet for the patients.”
She added: “We also have enough drugs and medicines as a result of the HTF. We have all the major types of vaccines, medicines and drugs.”
Matimba said the hospital could now re-invent itself thanks to the fund. Services had improved and there were now free maternity services, HIV/AIDS programmes and facilities for young people.
Ngorima rural clinic in Bikita district is also feeling the benefits of the HTF.
Said Chipo Dzvore, sister-in-charge: “There has been a great improvement in quality assurance services. The HTF has enabled us to achieve the best possible quality care for our community.”
Dzvore added: “We used to refer our patients to faraway hospitals like Silveira Hospital, which is 40km away, to get treatment, but now our community can get treatment at the clinics, since we now have more medicines and drugs.”
Susan Chitemera from the Ngorima community said: “We are happy and delighted that we are now accessing health services at our nearest clinic. Previously, it was very difficult for us.”
A young mother, Fadzai Vambe, said: “I am now happy that user fees have been eliminated for pregnant and breastfeeding women. It had become difficult for us, as we were not able to raise the money to pay. This resulted in high maternity and child mortality cases. This is a step in the right direction as far as maternal health is concerned.”
In an interview, the European Union health adviser D. Paolo Barduagni said one of the most urgent measures of theh HTF was to retain the few skilled health workers left in the country.
He said: “HTF comes in by raising low wages, in collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria. Progress has been steady but hampered by administrative hurdles, and many posts remain vacant, especially in rural areas.
“Currently HTF is also supporting doctors at rural clinics with salary top-ups. This has resulted in an increase in the number of doctors at district level across the country, thus improving healthcare delivery at district level and the country as a whole,” said Barduagni.
He added that midwives were also supported by the HTF through allowances.
Said Barduagni: “All midwives working in the maternity departments from district up to central hospitals are considered. HTF is also funding midwifery nurse tutors with allowances and this has seen a great improvement in the health sector.”