Shambolic health care system ought to be reformed now 

Source: Shambolic health care system ought to be reformed now – The Standard April 8, 2018

When political leaders shun the national airline in favour of well-kitted private jets, blowing a couple of a million dollars in the process, we must ask, if there is no money to pay junior doctors and nurses decent wages.Where is this money coming from in a country where some of us held bond notes or US dollars more than six months ago?


Whenever the top dogs in the leadership of our political establishment travel to far-away places to get the best medical care, persistently avoiding local establishments because of the shambolic state they find themselves in, then we must acknowledge where their priorities lie. Their prime concern nor most important consideration is certainly not the citizenry of Zimbabwe Incorporated. It is private and personal. When the politicians’ most pressing matters are about the welfare of themselves, their families and grovelling cronies, then Zimbabwe Incorporated is predestined for another long season of doom and gloom.

Health and prosperity have a symbiotic relationship

Zimbabwe Incorporated is in the process of being rebranded as an attractive destination for foreign direct investment (FDI). In all sincerity, there is only one race in the world, the human race. No one person’s humanity is neither better nor superior to another. The local investor keen to invest in Zimbabwe Incorporated uses the same currency that the FDI investor uses. If there is no enabling, business-friendly environment for the local investor, the FDI investor will adopt a wait-and-see approach.
There are many considerations and world-class healthcare provision is right up there at the top of the list with many other elements like availability of cash on demand, ability to repatriate profits, the general wellness of the workforce and so forth and so on. Health care reform has to be a key imperative for it has implications on fiscal stability.

We are a country of unhealthy people.

Generally speaking, we are a country of sick people, whose dimensions of illnesses vary from mild, moderate, serious to acute mental health illnesses. Many people among us cannot even afford health care nor medical aid. Many more who contributed for years to medical aid fell by the wayside when industry and commerce collapsed leading to massive retrenchments, which meant they could no longer afford to continue with monthly premiums for themselves and their families. If practicing doctors in the country were allowed to publish the simple to rare and complex to unfamiliar ailments that they deal with, the political powers-that-be may have mercy on the citizenry of Zimbabwe Incorporated. We cannot expect doctors to honour their Hippocratic oath within a health system that has very little to non-existent medical infrastructure. It is simply demoralising, heart-wrenching and traumatising for the medical fraternity to watch people die who could not be saved because they could not afford medical care at the better-kitted private hospitals.

The public health care system needs a complete overhaul and here are three reasons why:

1. Zimbabwe Incorporated is losing out on creating viable Public-Private Partnerships (PPP).

According to an April 2012 International Monetary Fund publication, “The Economics of Public Health Care Reform in Advanced and Emerging Economies”, editors Benedict Clements, David Coady and Sanjeev Gupta conducted various cross-country studies and empirical-based case studies . They highlighted that, “In advanced economies, the health sector has been one of the main drivers of government expenditure, accounting for about half of the rise in total spending over the past 40 years.”
Whereas in “emerging economies, health care reform, whilst also a key issue, has presented substantial lags in health indicators and limited fiscal resources. For these economies (and the developing ones), the challenge will be to expand public coverage without undermining fiscal sustainability”. That is where the private sector ought to step in and help fund health care under PPPs.
South Africa is well ahead in utilising this model mainly in provision of private health care. Thailand and India reformed their health care systems using different variations of PPPs. Some of the best medical care is found in these countries.
There is no reason why Zimbabwe Incorporated should not follow suit. The time is now when the country has been presented with a fresh opportunity to turn around.

2. Zimbabwe Incorporated is missing out on health tourism

According to Mordor Intelligence, medical tourism refers to “travelling to another country for obtaining medical treatment. It is a high-growth industry, driven by globalisation and rising healthcare costs in developed countries. A study shows that in the United States, about 750 000 residents travel abroad for care each year. Ranges of governments across the globe have taken up various initiatives to stimulate and improve medical tourism in their respective countries to improve patient quality care and boost the market.” Many countries like Brazil, India, Thailand and South Africa, for example, have recorded significant economic development potential in the emergent field of medical tourism. Mordor Intelligence revealed that procedures like “cosmetic surgery, dental care, elective surgery, fertility treatments, cardiovascular surgery, and genetic disorder treatments” are the most preferred forms in this sector.

The global medical tourism market was valued at $15.43 billion in 2017, Asia-Pacific has the highest share in the market and accounted for around 40% ($6,172 billion) of the global market in 2017. According to an African Business Insight online publication of April 18, 2017, “South Africa has been making medical advances, with statistics showing that in 2012, between 300 000 and 350 000 tourists from all around Africa travelled to South Africa for medical treatment. In addition to shorter travel times than India, South Africa advertises the added allure of safaris and spas.”

In addition, a significant number of “African travellers coming to South Africa for medical treatments do so less for cost savings and more because of South Africa’s advanced infrastructure and medical technology, as well as that its doctors have skills which are at par with international standards”.

Furthermore, the publication highlights the fact that, “For Europeans, Americans and Asians, South Africa offers an affordable alternative for many cosmetic procedures, thanks to the weak rand. For example, a breast augmentation procedure that costs US$8 000 in the United Kingdom would ordinarily cost about $3 600 in South Africa, according to Medical Tourism SA, a consultancy firm that offers total health care information for medical travellers. American patients who pay say $12 400 for in vitro fertilisation, a procedure that helps a woman become pregnant, can expect to pay a third of that in South Africa.”

This is low hanging fruit for Zimbabwe Incorporated which can be easily plucked if we commit to #1, above because we already have an abundance of medical manpower whose skills and acumen we are squandering as time lapses.

3. Poor health care is a barrier to Zimbabweans abroad wanting to invest, move or retire back home.

The shambolic health care system must not compel the local citizenry to suffer in silence. For those overseas and abroad, where they continue to spend health care income is where health care employment grows at the loss of Zimbabwe Incorporated’s medical fraternity. It is vital, therefore, that health care reform ought to be prioritised and now.

l Gloria Ndoro-Mkombachoto is an entrepreneur and a regional enterprise development consultant. Her experience spans a period of over 25 years. She can be contacted at