Zimbabwe’s political and business elite are forced to confront the realities of the country’s failing national health system as most of them can longer fly off to private hospitals abroad.
The second wave of the coronavirus pandemic has killed several senior figures in the regime, including foreign minister Sibusiso Moyo, and the hospitals are full to capacity with Covid-19 cases.
But there is confusion about whether and how much Zimbabweans will have to pay for the vaccine. On 3 February Finance Minister Mthuli Ncube, who is desperately trying to cut state spending, said that most Zimbabweans would have to pay but the government would subsidise vaccines for the “most vulnerable groups”.
The following day, President Emmerson Mnangagwa welcomed China’s announcement that it was donating 200,000 doses of the SinoPharm vaccine. The vaccine would be “state-funded and free” said Mnangagwa. Health workers and others most at risk would get the vaccine first, he added.
After that Ncube, tried to backtrack, saying his remarks on the cost of the vaccines were taken out of context. But the level of donations will have to be ramped up fast by China and others to cover Zimbabwe’s 16 million people.
Shot of reality
Meanwhile, conditions on the ground – in clinics, hospitals and schools across the country – are deteriorating with shortages of protective equipment, let alone supplies of therapeutics and oxygen and ventilators.
Last Sunday, we visited 30 year-old *Johnny Zimondi in his two-room apartment in Budiriro, a densely populated high density suburb in Harare. He is a nurse and was off from work at Parirenyatwa Hospital, the largest referral hospital in Zimbabwe.
Despite being a frontline worker he takes home a 18,000 Zimbabwean dollars (Z$) (US$200) salary each month
He fears exposing his family to Covid-19 from his work.
“We work with inadequate personal protective equipment (PPEs) in the Covid-19 isolation wards. This is exposing me to Covid-19 thus putting my family at risk,” he tells The Africa Report. “I am suffering mentally from these working conditions. There is a need to increase my salary so that I can be motivated to work.”
Worst economic crisis
The total consumption poverty line for one person stood at Z$4,426 in November 2020, according to the Zimbabwe National Statistics Agency.
Zimondi says his salary is not enough to meet his family’s needs let alone to buy food items to keep himself healthy in the midst of this global pandemic.
Zimbabwe is going through its worst economic crisis in decades with a three figure hyperinflation resulting in the rising cost of living.
Zimbabweans are grappling with currency instability, poor salaries as well as shortages of basic commodities and public services such as electricity and water.
Surging cases amid a weakening health system
The health sector has been hit particularly hard, with shortages of modern equipment, medicines and PPE.
In late 2020, the number of Covid cases surged as Zimbabwean residents returned from neighbouring South Africa for the festive season.
As of 30 January 2021, Covid had claimed the lives of over 1000 people in the country while infecting more than 33,000 people, according to the Health Ministry.
Covid patients dying outside health facilities
Last year the government secured resources to improve Provincial Hospitals throughout the country to cater for Covid-19 patients.
But Zimbabwe Nurses Association president Enoch Dongo says these provincial centres were overwhelmed with Covid patients.
“These Red Zones [provincial centres] can not cope because of this second wave. There is a large number of Covid-19 positive people who need to be hospitalised,” he says.
“There is an overwhelming situation in terms of staff and resources. They do not have proper oxygen and ventilators to cater for Covid-19 patients.”
Because of the soaring number of cases in public medical facilities, Dongo says more people are dying of Covid-19 outside hospitals.
“We have more community deaths because some of the patients, when they visit hospitals, find it difficult to be admitted,” says Dongo, adding that both public and private hospitals are struggling to handle Covid-19 patients.
Zimbabwe Professional Nurses Union secretary-general Douglas Chikobvu says the health situation in Zimbabwe is dire.
“Both government and private hospitals barely have enough of the required ventilators and PPEs to efficiently thwart Covid-19,” he says.
Health is not a priority
Doctors and nurses in the country have been striking – on and off – over inadequate salaries and poor working conditions for more than two years now.
As it presides over a shrinking economy, President Emmerson Mnangagwa’s government has tried to boost health spending in relation to other areas but it still falls short of what is required.
In the 2021 budget, Ncube allocated 12.74% ($668m) of the national budget to the health sector, the highest allocation for decades as a percentage of total spending. That figure is below the 15% required by the Abuja Declaration which requires all African Union countries to set aside at least 15% of their budget towards improving the health sector.
Harare’s public hospitals have only 30 intensive care unit beds, according to Norman Matara, secretary of the Zimbabwe Association of Doctors for Human Rights.
Itai Rusike, Community Working Group on Health executive director tells The Africa Report that the Covid-19 pandemic is highlighting a deeper problem in the financing of public health delivery services.
“The health services in Zimbabwe are underfunded and have been so for the past two decades. For Covid-19 the demand is at the frontline, but also at the hospitals providing intensive care where there is a serious shortage of PPE, diagnostics and generally poor remuneration for the health workers.”
Since March 2020 when Zimbabwe recorded its first Covid death, about 1500 health workers across the country have contracted the respiratory disease while eight have succumbed to it, says the Zimbabwe Medical Association.
Corruption and mismanagement
There are allegations of diversion of funds earmarked to improve the health sector by top government officials in Zimbabwe.
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In July 2020, Mnangagwa fired health minister Obadiah Moyo after he was charged for illegally awarding a multimillion dollar tender to Drax International LLC based in the United Arab Emirates to supply drugs to Zimbabwe.
Dongo says the government should prioritise the buying of PPEs, modernisation of hospitals and the remuneration of health workers.
Zimbabwean elite coming to terms with reality
The pandemic has offered a slice of reality to Zimbabwe’s top government workers. With travel restricted, they can no longer fly off to foreign health centres in China or South Africa for treatment. That means they are forced to see the true state of local health facilities.
Already, Covid has claimed the lives of four of Mnangagwa’s cabinet ministers:
- Agriculture minister Perrance Shiri
- Minister of provincial affairs for Manicaland Province Ellen Gwaradzimba
- Transport minister Joel Biggie Matiza
- Foreign Affairs minister Sibusiso Moyo
Pallbearers stand next to coffins of three top government officials at their burial at the National Heroes acre in Harare, Wednesday, Jan, 27, 2021. ( AP Photo/Tsvangirayi Mukwazhi)
“The Covid-19 crisis is a wake up call for our political elite to prioritise investments in our health delivery system,” says Rusike.
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“With travel restrictions, our politicians can no longer fly outside the country to seek health care services. It was going to also benefit them if they had invested in our own hospitals. They are now being treated just like anybody else in the dilapidated and poorly funded hospitals,” adds Rusike.