Councils should collaborate in health service delivery 

Source: Councils should collaborate in health service delivery | The Standard

By Dr Johannes Marisa

Health and development are symbiotic hybrids of each other, so it is prudent to enhance public health if national development is to be realised particularly for developing countries where the health care system is underdeveloped, fragile and vulnerable.

Zimbabwe has suffered from massive brain drain since the days of the Economic Structural Adjustment Programme, a neo-liberal policy introduced in 1991 that was aimed ostensibly at reducing state interference in the economy. Thousands of our well-trained professionals left Zimbabwe for greener pastures, which I think should not continue anymore.

Medical professionals have faced attacks from many corners despite the dedication they have shown to the nation. Many have shown great patriotism and it does not mean that they cannot leave this nation to work overseas.

It was obvious during serious  Covid-19 attacks that Zimbabwe has resolute and candid medical practitioners that stood tall to defend the nation. A lot of lives were saved despite the limited resources that were in place. For sure health professionals deserve plaudits for the work they did. In Italy, there were statues erected in honour of the health workforce.

It is a pity that many health professionals are grumbling at their work places. There are many tribulations and transgressions that impede the smooth functioning of health professionals in both private and public sectors.

Impediments are coming from a lot of regulations which I believe are not necessary especially during this time of Covid-19 where extraordinary measures are needed to counter such an extraordinary virus. The Health Professions Authority (HPA) is the regulator of all medical professionals and this organisation acts professionally, does its inspections professionally, creating cordial relations with its members in a bid to understand problems bedevilling the health personnel.

The HPA is credited for quality health care that Zimbabwe is enjoying today. The same credit goes to the mother regulator of doctors, the Medical and Dental Practitioners’ Council. I remember when I was starting private medical practice when I got strong support from the council. Life was made easy and things have been flowing quite easily because of the way the council executes its duties.

However, problems arise when the medical practitioners meet other regulators, some of whom  deliberately throw spanners on the way. What we desire to see is a robust health service delivery system which will benefit the entire country. Harare City Council has not cooperated with practitioners on a number of issues and I wonder why the council seems to want acrimony between itself and medical practitioners. They show  paternalistic leadership, there is a high degree of vindictiveness as if the so-called implementers come from Mars. We have noted with concern the following:

Harare City Council makes use of Harare Municipal Medical Aid Society (HMMAS), a medical aid that many practitioners are not accepting because of failure to honour claim forms. Council employees face misery when accessing medical care in private practice as there is no trust anymore between service providers and this particular society. Who is in charge of this medical aid society? If we are to deliver the basic right of life, why not correct the ills of this medical aid society?

The City Health department has made life difficult for private practitioners and until now, the Food Handlers certification issue is still raging on. My colleague, Dr Cletos Masiya, has been at loggerheads with the City Health department that has sent its so-called inspectors to clients that he signed for. All this tension continues despite numerous attempts to engage City Health. We should never be treated as kindergarten kids for things that we are legally mandated to do or perform as medical practitioners.

The city’s Fire Brigade department is busy with enforcing its so-called regulations. What is mesmerising is the way the inspections are carried out. The HPA, our mother regulator, respects private property and book for inspections, but city council employees budge into practices even when the owner is not around or in the midst of consultations of sick patients. If law enforcement agents need to acquire a search warrant from a criminal’s premises, why is it not supposed to be the norm in private premises? What is surprising is the arrogance on issuing out penalties for slight mistakes which could have been avoided by simple explanation or teaching. A number of businesspeople have been penalised for thousands of dollars for possessing old fire extinguishers. Many people are not fire experts, therefore simple education is required.

Council should use the resources it is spending on some of these so-called inspections to put oxygen cylinders at Wilkins Hospital, buy medicines and sundries at its clinics and hospitals. India is in trouble today and we are facing threats of the third wave of Covid-19 yet there is poor preparedness by the local authorities.

If council is doing all it is doing in the name of promoting health, then I can see the reason why there is a lot of nauseating garbage at Mbare Musika. The embarrassing debris at that public place is a recipe for disaster as there are high chances of cholera, typhoid and  dysentery outbreaks. The way the city council is running shows that the there is poor strategic planning, a phenomenon which may show lack of skills and qualified staff. Poor service delivery will remain forever then!

We want collaboration and not conflict!

  • Dr Johannes Marisa is a medical practitioner and public health practitioner who writes in his personal capacity. He can be contacted on: