Poor bear brunt of doctors’ strike

via Poor bear brunt of doctors’ strike – The Zimbabwe Independent 3 November 2014 by Wongai Zhangazha

Abject despair and hopelessness are painted on the faces of patients, their friends and relatives at Parirenyatwa Central Hospital’s casualty area as they wait patiently to be served by a single doctor available at the country’s biggest medical centre, signalling the devastating impact of the ongoing junior doctors’ strike.

There is the piercing sound of a siren as a Harare municipality ambulance arrives at the hospital carrying an elderly man in visible pain, wrapped in blankets, yet no one is available to attend to him immediately despite the urgency of his situation.

His relatives put him on a stretcher where he joins a long queue of other patients who have gone for hours without being attended.
The single female doctor attending to patients is clearly overwhelmed.

A short while later, a visibly shaken woman arrives holding a baby in her arms. Identifying herself as Beverly Chirimo from Warren Park, she is desperately looking for help as her four-month old baby has a boil on her head. The baby is in excruciating pain and wails uncontrollably.

Sadly, as with other patients, there is no help for Beverly’s child as the situation continues to deteriorate. Getting ever more desperate she seeks the attention of hospital guards, but they brusquely tell her to join the long winding queue as they cannot help her.

Beverly has no choice but to wait patiently for her turn as her husband runs around sorting out the paperwork.

“I don’t know what to do as my baby has a big boil on her head,” said Chirimo. “The head is a very sensitive area. When I left home I thought the service would be prompt, but it seems I could be here forever while my baby writhes in pain.”

Meanwhile, the doctor is pacing up and down, giving preference to those on stretchers. Scores of patients look to her with pleas of help written all over their faces.

Nearby at Parirenyatwa Annex Hospital, which deals with the mentally ill, patients waiting in the queue are peremptorily told by the sister-in-charge doctors are on strike, adding that they did not know when the single doctor who had promised to report for duty would be coming in.

Patients who had arrived as early as 7am were still to be attended by 10am.

After sparring with government in the media over the last few weeks, junior doctors finally began an indefinite strike over poor pay and working conditions.

They have warned they will only return to work if their demands are met, leaving thousands of patients countrywide stranded at a time some facilities of the country’s healthcare system are in the intensive care unit.

In a statement this week, the Zimbabwe Hospital Doctors Association (ZHDA) said: “We would like to confirm that the nationwide strike has attracted overwhelming response from all government hospitals with over 300 doctors withdrawing their services until the employer meets their demands.

The current impasse has been a result of the lack of a timely response by the government to address the issues as laid down to them in our 14-day ultimatum. The ZHDA will also take this opportunity to urge its members to avail their services only if their executive has given them a formal communication that their concerns have been fully addressed.”

The doctors are demanding an upward review of their basic salary from US$282 per month to a minimum of US$1 200 per month, exclusive of allowances. They also want government to urgently set up a comprehensive health insurance scheme that protects them and other health workers from communicable diseases.

Other demands include that government stops charging doctors “exorbitant rates” for residing in government accommodation, reducing them to US$37 for bachelors’ flats and US$45 for one-bedroomed ones; and an out-of-residency allowance of between US$450 and US$500 a month from the current US$250.

They want US$10 per hour on-call allowances and a reinstatement of the duty free facility to enable them to import cars and other goods.

The strike has affected all the country’s major referral hospitals namely Parirenyatwa, Harare, Mpilo and United Bulawayo Hospitals, while provincial hospitals have also been seriously affected. Most major hospitals are only attending to absolute emergencies only, while patients are being discharged before sufficient recovery.

Vulnerable people who have no medical aid have been left without healthcare as they cannot afford fees charged by private doctors. On average, private general practitioners charge US$35 in consultation fees on weekdays, US$60 at the weekend and US$70 at night — way beyond the reach of most Zimbabweans.

While the impasse between the doctors and government continues, ordinary Zimbabweans suffer the consequences as witnessed by the Zimbabwe Independent during a visit to Parirenyatwa’s casualty section.

A junior doctor at Mpilo hospital in Bulawayo who spoke to this paper on condition of anonymity said he earns as little as US$329.

“With such a salary they make you pay for hospital accommodation; in Bulawayo hospitals don’t have accommodation so we resort to alternatives. Those staying at the hospital are given a room each ideally made for general workers,” he said. “When you are on call, you work 24 hours plus your normal day duty the following day. On average you have five to six on-call days and the on-call allowance is a mere US$80.”

He complained junior doctors were overworked, especially at casualty departments.

“The consultants only come for duty for a few hours on selected days, then they spend most of their time making extra money in private surgeries, leaving juniors to do all the work,” said the doctor.

The doctor said government hospitals have inadequate resources, including essentials such as gloves, which compromises health workers when dealing with infectious diseases.

Social commentator Stanley Tinarwo attacked government for an “it-will-fix-itself” approach when it comes to health services provision.
He said government has tended to rely on donor funding to finance the health sector instead of it funding public health, hence the deteriorating conditions of service for doctors and the poor state of public hospitals.

“This has meant strenuous conditions for medical personnel in state hospitals and in the long-run compromised health service delivery for low-income patients. One may get admitted, but there is no guarantee of proper treatment unless you or your family has money to pay for drugs or specialist services,” Tinarwo said.

On Tuesday a meeting between the Health Services Board, Ministry of Finance and ZHDA ended in deadlock, with Health minister David Parirenyatwa urging all parties to continue negotiations to resolve the impasse.

But as negotiations continue, one should spare a thought for the thousands of patients who cannot afford alternative treatment who will continue to suffer at government medical institutions where sometimes people go to die.