Zimbabwe's walking sick

One of the most basic human needs is to be in good health. Poor health inevitably leads to death. Thus one of the primary functions of any government must be to secure the health of its citizens. This is why among our national objectives the constitution obligates the state to take all practical measures to ensure the provision of "basic accessible and adequate health services throughout Zimbabwe" and the Bill of Rights declares that every citizen has the "right to have access to basic health -care services, including reproductive health care services" and that none shall be "refused emergency medical treatment in any health -care institution".

The reality of our situation though is a far cry from the ideals and dictates of the constitution. This is as a result of the ideological bankruptcy of ZANU PF which has appropriated the liberation struggle and saunters about with a nauseating degree of entitlement, and yet delivers ill health and death to the citizenry of the country. There is no better symptom of this pervasive governance deficiency than a collapsed public health system. Actually, to even use the word 'system' is in itself a travesty of terminology. For many years,ZANU PF government, fronted by the self-anointed 'life president' President Robert Mugabe, has failed dismally to fulfill its mandate of offering sustainable public health delivery.

A few weeks ago, I commented on President Mugabe's obsession with public education. What I did not mention was that he has a deeper desire to fend off income anxieties of security forces, so much that there have been millions of dollars expended on uniformed forces more than any other public budget in the past thirty-five years. If we consider the monies poured in his proxy wars in Mozambique, Democratic Republic of Congo and of course, Gukurahundi, the figure could easily run into billions. And in all this political drama, health delivery has suffered severely, with Zimbabweans having been decimated by HIV/Aids, malaria, cholera, typhoid and cancer. According to the World Health Organisation, Zimbabwe has one of the highest HIV/Aids infection rates in the world (we account for 3 percent of new HIV infections worldwide), while our life expectancy is a paltry fifty-five years.

To add another line to Zimbabwe's health horror script, President Mugabe and his cronies despise local medical treatment to the extent that he commutes to the Far East every quarter for 'eye treatment'.  Since ZANU PF's eco-political ideology is largely a crude mixture of Maoist socialism and liberalism (socio-liberalism) government regulations and policy permit private investment in our health -care. Our  free market economy allows individually owned surgeries, hospitals and clinics to flourish. However, high poverty levels and low disposable incomes, coupled with a defunct national health system and predatory medical aid companies - means the average Zimbabwean can still not access basic health. Thus millions of Zimbabweans suffer silently with endemic illnesses which ordinarily would be cured - hence the 'walking sick' title of the piece.

Let me put this completely scandalous situation into perspective. In developed or should I say civilised countries like UK, USA and South Africa, governments have laws that create a national health system 'forcing' authorities to invest at least US$200 on each citizen per annum. Such governments ensure low infant and maternal mortality rates while 'guaranteeing' that each local community has access to at least five (affordable) doctors at any given time. Like in India, government supports private companies manufacturing primary health care drugs. In Zimbabwe, all figures related to above variables are in the negative. Press reports are that critical drugs among others (benzyl penicillin, ceftriaxone and rocephin; clorpheniramine , ARVs, amphotericin B, an anti-fungal; atropine, Nifedipine and atenolol, omeprazole , hydrocortisone cream, miconazole cream, clotrimazole, pessaries salbutamol inhalers) are either donor funded or in perpetual short supply for one reason or another due to corruption.

Despite vociferous claims that community share ownership schemes have 'delivered clinics', millions of Zimbabweans still struggle to access district and provincial hospitals due to poverty and bad roads. When patients eventually make it to Mpilo or Harare hospital, there are not enough doctors, drugs, food, water or electricity in those facilities. If in towns ambulances are a 'luxury', it means villagers ailing from critical conditions can hardly ever make it to hospital. It is no surprise that many babies are delivered in homes or, horror of horrors in public transport such as buses and passenger trains.

What is most shocking is that President Mugabe is chaperoned by a public media drunken with poisonous patronage that 'flood lights' his medical trips to Singapore while praising his 'state-of-the-art' Gushungo diaries. Meanwhile, Ekusileni medical centre in Bulawayo remains mothballed while central government fails to service medical society bills. Millions of dollars have been pumped into 'agricultural mechanisation' as thousands of Zimbabweans (those who can afford) seek cancer treatment in India or incrediblly TB Joshua's shrine in Nigeria. The tragedy is that President Mugabe's late wife, Sally Heyfron, was 'allowed to die' at Parirenyatwa while Grace Mugabe flies to Singapore, China or Dubai at the shortest possible opportunity and at the slightest ailment. Former ZANU PF top dog Cephas Msipa once commented that his colleagues do not even bother to experience the professionalism of local medical treatment.

The tragedy is that with a mere three hundred million dollars allocated for health, the Zimbabwe government has no hope in hell of fulfilling its constitutional obligation of ensuring every citizen has access to basic health- care services.

Our talkative government, foul mouthing international organisations on one hand while on the other, hoping that the WHO will supplement its health budget requirements, is increasingly looking unable to 'heal the nation'.  Imagine where our HIV/Aids programs would be without the international donors - the same 'bad people' barred from helping us in elections, land reform and debt management. Doctors keep leaving the country as nurses strike for more pay. ZANU  PF pays thousands of 'patronage salaries' to ZBC bosses and parastatal heads than they do to public health practitioners. Millions of dollars are spent on large government delegations overseas to sign invisible 'mega deals' as women deliver still born children on floors in dark, cold rural clinics. It is a tragedy of mammoth proportions.

Many Zimbabweans have turned to traditional healers and 'Pentecostal prophets' for health relief, some women and teenage girls exposed to rape by bearded false prophets dressed in white and carrying some fake sticks.  Sadly, most Zimbabweans choose to be silent in sickness, walking sick and waiting to die. Just stand in any street corner in any of the urban areas and watch citizens walk by pulpably unwell, stoically going about their business with the scars of their illness painfully etched on their drained and dazed faces. Truly the walking sick hoping against hope that death is not awaiting them around the next corner.

My party, the MDC believes that a devolved service delivery framework will guarantee health care sustainability and respond effectively to the conditions of virtual collapse and widespread dysfunction in health care infrastructure. Our National Health Care Strategy will be founded on new, innovative ways and approaches to sustainable long-term funding and resource mobilisation for the health sector. The MDC will fulfill, protect and promote the constitutional right of all Zimbabwean citizens to have access to affordable basic health care services as we are of the firm belief that the right to access health care must be realized across society so that those who need care are able to access it regardless of who or where they are or their ability to pay.

We  will promote the increased role and contributions of indigenous knowledge systems (IKS), traditional medical interventions and the value of herbal medicines to increase choice and health care diversity. MDC exalts green lifestyles and/or a society wide value system that gives priority to holistic health living standards, effective family hygiene and green diets and community-driven solution initiatives will be encouraged. In addition, community input in healthcare awareness, promotion and monitoring will be encouraged, including community testing centres on pandemics and epidemics.

We believe that mitigation measures, including but not confined to the following should be incorporated in order to create a sustainable health system in the country:

    - Create easy access for anti-retroviral drugs, underwritten by government funding.
    - Fulfillment, promotion and protection of the right of all citizens to health and mechanism for sustained focus on women, children, the elderly, disabled and vulnerable sections of society.
    - Investing in child immunization programs and centres for disease awareness and control.
    - Introduction of mobile food programs in all primary schools nationwide to promote comfort and interest in education during drought periods.
    - Encouraging nationwide entrenched culture of preference for natural, traditional food sources, health nutritional and physical practice and hygiene-conscious community.

It must however be understood that for all this to be possible we must get the economy working again for it to generate taxes for government for government to be sufficiently resourced to fund health-care. The situation where where government which generates no wealth is the biggest employer in the country is wholly inconsistent with the obligations of the state to take all necessary measures to ensure citizens' access to basic health -care.