Zimbabwe: Health system in crisis

HARARE, 25 November 2008 (PLUSNEWS)

• Stanley Takaona, deputy president of the Zimbabwe HIV/AIDS Activist Union, has spent the past month volunteering at two state hospitals in the capital, Harare, after health workers began a work stoppage that has virtually closed both facilities, leaving hundreds of people without medical assistance.

Takaona, who is HIV positive and a counsellor, told IRIN/PlusNews that thousands of HIV-positive Zimbabweans regularly sought treatment and collected their antiretroviral (ARV) drugs at the government-run clinics in the Parirenyatwa and Harare hospitals, and he could not watch other HIV-positive people suffering.

The health workers maintain they cannot report for duty because the hospitals have become "death traps" for patients: there are no drugs or medicines, and essential and often life-saving equipment is badly in need of repair, or beyond repair or outdated. The HIV clinics have no drugs to treat opportunistic infections, no HIV test kits, and no blood sample kits.

They are also protesting against poor remuneration and demanding that their salaries be paid in foreign currency because of the unofficial dollarisation of the economy.

Takaona told IRIN/PlusNews: "As a person living with HIV myself, I know how important it is to have these ... clinics open - that's why I have had to volunteer my services and come out of retirement. I was particularly worried that if those on ARVs couldn't access them, then we would have a much bigger problem of drug resistance in the country."

Workers who have not joined the strike have been so overwhelmed that they have been unable to run the HIV treatment clinics, so Takaona and other members of the HIV/AIDS Activist Union who are healthcare workers have stepped in.

The volunteers are restricted to dispensing ARV drugs because of the shortages of other drugs to treat opportunistic infections. "HIV-positive people on ARVs, and those not on any therapy, need to be constantly monitored ... If someone develops a rash or any side effects to the ARVs we cannot treat them because there are no drugs," Takaona said.

"All we do is refer them to the private sector, but not many people can afford the medical care there because it is now very expensive - you are looking at nothing less than US$300 for each consultation, blood tests, and then buying whatever drugs are prescribed."

Kumbirai Mafunda, communication officer at Zimbabwe Lawyers for Human Rights, said the government was in denial. "Government needs to come clean about its failures and declare an emergency in the health sector, so that the donor community can come in and assist," he suggested.

"But as long as they continue to lie and tell people that these hospitals are open when in actual fact we all know they closed, that aid will not come and people will continue to die."

Last week hundreds of nurses, doctors and support staff attempted a protest march against poor salaries and deteriorating conditions in the health sector, but were shocked to find riot police had cordoned off the whole hospital, preventing them from going out to march.

Dr Douglas Gwatidzo, Chairman of the Zimbabwe Association of Doctors for Human Rights, said using the police would not solve the problem facing the health sector.

"Zimbabwe's public health system is in a state of collapse and in need of urgent action to rescue it. Measures should be taken to provide adequate medical supplies, drugs and equipment to Zimbabwe's hospitals and clinics," he urged.

"The government must also guarantee quality for health professionals, and ensure that conditions in which these skills can be retained are put in place, including adequate remuneration and safe working conditions."

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