5 March 2017
HARARE – The Daily News on Sunday’s Bridget Mananavire spoke to Zimbabwe
Hospital Doctors Association (ZHDA) president Edgar Munatsi about the
ongoing strike by doctors.
Q: As a starting point, what really triggered the strike?
A: To give you a background of the on-going strike, sometime towards the
end of last year, the government announced through the permanent secretary
of Health (Gerald Gwinji) that they were no longer able to absorb doctors
who finish internship into public institutions.
And then the ZHDA did engage the ministry trying to map a way forward, and
they insisted that they were not able to employ because they couldn’t
increase the establishment.
Then we also tried to tell the government that if that was the situation,
then government should be able to give doctors who finish internship open
practice certificates, which was the basis of our negotiations.
But the unfortunate thing is that they didn’t respond until very late in
December last year, when they called us for a meeting where nothing
tangible was reached as a way forward.
For us, what was making sense was either to employ the doctors or give us
open certificates and we even petitioned them. And we know there is a need
for doctors already at the country’s hospitals, our district hospitals and
provincial hospitals are not adequately manned in terms of
doctor-to-patient ratio. And then people said we can’t keep on writing
letters and from experience we know that the language they know best is if
people use their bargaining rights to say collectively as doctors, we are
now going to down tools.
Q: Where did the other issues of on-call allowances and duty-free vehicle
facility then come from?
A: In 2014, government said they were going to increase the on-call
allowance from a flat figure of $288 to a minimum of $720 for the least
They indicated that they were going to do it in two years, which they
didn’t.And people said we might as well remind them of our earlier
agreement of 2014.
In the same year, they had promised that they were going to provide for a
doctors’ vehicle procurement scheme, where the government was supposed to
chip-in in terms of payment of tax to the Zimbabwe Revenue Authority.
We decided it was high time they fulfilled promises and provide a clear
way as to what was going to happen when we finish our internship.
Q: How much do doctors earn?
A: The basic salary for a doctor is $329 and then on top of that, a doctor
gets $288 on-call allowance, $49 medical allowance and $70 for housing. If
you look at those figures, you can see that for example with medical
allowance, that figure is not commensurate with subscriptions in the
medical aid societies.
Q: How does this compare with other doctors in the region?
A: It’s quite bad. Taking for instance South Africa, doctors who are fresh
from school take home almost R36 000 after tax, which is way, way more
than what we are getting. And their working conditions are very different.
For instance, a doctor on-call, they have proper rooms where they take
naps, they are comfortable.
Here the conditions are very deplorable, the rooms are dilapidated, and
you are not provided with any meals for instance.
And this is the same person who is paid $1,20 for the night. And you know
sometimes we have to handle patients with bare hands without gloves,
sometimes the patients can’t afford to buy simple things like paracetamol,
simple things like getting a drip, and all these are the challenges the
doctors are facing.
Q: How is that affecting your duty to attend to patients?
A: There is no amount of money that can replace the feeling that you get
when a patient says, `thank you, I’m better today.’ And all that euphoria
that you get from the `thank you’ is being replaced by a lot of depression
and despair because you can’t help patients.
And these patients do not have anything and they get to a hospital and are
told they have to get everything. This stress is transferred to a doctor,
because there is also some level of attachment that you have with your
Q: How does the lack of resources and the poor conditions of service for
doctors affect service?
A: The service that patients get at the end of the day is compromised;
especially when doctors have to improvise so that you do something. So
generally, coupled with a doctor thinking about how am I going to get home
when I finish my call, what am I going to eat because these guys are
earning too little, so the services they provide are much compromised.
Q: How many hours do doctors work, roughly?
A: If a doctor is not on-call, which are the normal working hours, you
start around 7:30 in the morning and finish around 4:30 pm or 5pm. But
because of the dwindling number of junior doctors, what then happens is on
top of doing that duty, at 5pm then you start your on-call until 8am, then
you have to go freshen up, then you start again. So you can even go for 36
hours without proper sleep.
Q: What is your opinion on government’s commitment to health delivery?
A: For us it is an issue of priorities being misplaced because for one, we
can see in other sectors how well they are funded and how the public
health sector is being neglected. Patients are dying and suffering without
any assistance from the government, which is a very sad development. They
are failing to even fund the sector in accordance with the Abuja
Declaration which they ratified, and requires that health be allocated at
least 15 percent of the National budget.
Q: At what point do doctors open their own practice?
A: It is when you get an open practice. After you finish medical school, a
doctor does internship for two years and after that they are either
employed at a district hospital for a year or if you remain at a central
hospital you then get the open practice certificate after two more years
upon completion of internship.