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A staggering number of Zimbabweans dying outside hospitals

by Nokuthaba Dlamini
23 Jan 2021 at 22:48hrs | Views
A huge number of Covid-19 victims in Zimbabwe are dying outside health institutions with half of the casualties in Matabeleland South succumbing to the respiratory disease before accessing treatment, an analysis of official statistics has revealed.

Zimbabwe's health delivery system is in danger of being overwhelmed by the resurgent Covid-19 outbreak, which some experts believe is being fuelled by the new South African variant of the virus that was first identified in China in 2019.

Some Zimbabweans that have fallen seriously ill after contracting the virus have failed to access life-saving treatment because hospitals had either run out of beds or don't have enough oxygen.

In some parts of the country such as Bulawayo – the epicentre of the pandemic before the shift to Harare during the second wave there are limited facilities to handle Covid-19 cases as the government is still struggling to upgrade designated hospitals.

Authorities at the United Bulawayo Hospitals, the only operational public health facility for Covid-19 patients in the country's second largest city, last week warned that oxygen stocks had become dangerously low.

An analysis of Covid-19 statistics tracked by The Standard working in collaboration with the Information for Development Trust a non-profit organisation supporting local investigative journalism revealed that a staggering number of people were dying in the communities.

According to statistics from the Health and Child Care ministry, Harare accounted for 49.1% of the Covid-19 deaths that occurred outside hospitals countrywide between March 20, 2020 and January 16, 2021 against a national average of 31.7%.

At least 45.4% of Covid-19 deaths in the capital during the same period happened outside hospitals.

Matabeleland South, at 50% community deaths, however, had the highest provincial proportion of people dying at home.

It was followed by Mashonaland West at 48.1%, Matabeleland North (42.9%) and Mashonaland East (42.1%).

Health experts say the reasons for the high number of people dying outside health facilities varied from the general lack of access to health facilities in Zimbabwe to diminished confidence in the health delivery system.

Zimbabwe's once robust health delivery system has over the years been weakened by gross underfunding and a brain drain that has left major hospitals without equipment and drugs.

The Covid-19 outbreak that began in March last year also coincided with prolonged strikes by health workers, who were protesting against lack of personal protective equipment and poor working conditions.

Zimbabwe Association of Doctors for Human Rights (ZADHR) executive director Calvin Fambirai said the high incidence of community deaths pointed to a serious crisis in the health delivery system.

"Firstly, this could be indicative of an overburdened health system that is now failing to cope with the disease burden," Fambirai told The Standard.

"It can also point towards a weak surveillance system where cases are not identified early.

"It may also show poor confidence in the health care system as some individuals choose to be treated outside the formal care system."

Zimbabwe's Covid-19 testing capacity remains very low with only 3 829 having taken PCR tests countrywide on Friday.

Chitungwiza, a sprawling town with a population of 350 000, conducted a meagre 28 PCR tests on the day.

Itai Rusike, executive director of the Community Working Group on Health (CWGH), said the second wave of the Covid-19 outbreak that started with the reopening of borders in December and the influx of returning residents during the festive season had put a severe strain on the health delivery system.

"What has been happening since the country was opened up and the borders, together with the relaxation of the lockdown up to the festive season, our cases have escalated and as a result we have overburdened our hospitals," Rusike said.

"What we are now seeing is the reality as a result of the complacency that has been happening within the generality of our population in terms of the adherence to the Word Health Organisation (WHO) Covid-19 prevention guidelines.

"It's not surprising that some people are now beginning to die at home because as the cases are increasing, our hospitals throughout the country are overwhelmed and most of them are at full capacity.

"So it is very common now that some people call the hospitals seeking admission and they are told that the hospitals have no extra beds to offer."

Some desperate Zimbabweans have been taking to social media appealing for help to secure hospital beds or oxygen for their dying relatives.

Those with resources even offer to pay any amounts of money to secure hospital beds at Covid-19 treatment centres.

Rusike said a significant number of Covid-19 patients have also died while on their way to hospitals because they would have first tried less expensive home remedies to treat the disease.

"What is commonly happening is that some relatives try to drive to the hospitals late and some patients die on the way, some in hospital car parks while others upon admission and this brings a lot of challenges not just to the health sector, but to the communities in terms of the transmission levels," he said.

"Most of the family members may not be well equipped in terms of protecting themselves from getting Covid-19, so as a result we are seeing a spike in local transmissions because of the poor management that is happening starting at family level."

Zimbabwe Nurses Association president Enock Dongo said it did not come as a surprise that more people were dying of Covid-19 at their homes as the country's health delivery system was in shambles.

Dongo said most people suffering from Covid-19 opted to use home remedies such as lemons, zumbani/umsuzwane leaves and ginger, among other concoctions to strengthen their immunity.

"People are dying from their homes and it's not out of their liking," Dongo said.

"Whenever they go to institutions, they do not get the help that they are supposed to be getting so that's why you find that a lot of people are now advising each other that you are better off being sick at home because you will be getting home remedies on top of the painkillers that they will be given at the pharmacy than going to hospital where they will not be treated properly.

"We do believe in modern medicine, but most of the times the required treatment such as tablets and injections will not be available at public hospitals.

"This is the reason why the business of selling oxygen is at the highest peak because people are buying it and nebulisers to keep in their homes.

"So in a way people have become their own nurses and doctors. They are desperate and helpless."

Rusike and Dongo concurred that Zimbabwe's response to Covid-19 remained poor nearly a year after the first case was recorded in the country.

"If you look at the number of hospital beds, they are very low and unfortunately our health workers are also being overwhelmed and are not fully protected and as a result some have lost their lives," Rusike said.

The CWGH boss, whose organisation is a network of various groups lobbying for universal access to health, also believes that a large number of Covid-19 deaths are going unreported especially in the remote parts of Zimbabwe.

"Even on the issue of mortality, there a lot of community deaths that are happening in remote communities and some people have been buried without the families knowing that it was a Covid19-related death,"Rusike said.

"So this is why even in our health education and awareness campaigns, we are saying at this moment, Zimbabweans should treat almost everyone as a Covid-19 suspect because the second wave is very much upon us and this new strain is now killing a lot more people. "

Dongo said to prevent further loss of lives, Treasury should allocate more money to the Health ministry.

"This is a critical and dire situation and the government should not allow people to die in their homes when we have the hospitals, meaning there is something that went wrong which needs to be addressed," he said.

Fambirai from ZADHR said the government must restore confidence in the health delivery system and improve capacity for disease surveillance for Zimbabwe to tame Covid-19.

"The government must increase confidence in the health care sector and improve its preparedness to deal with the pandemic and institute a robust surveillance system where confirmed cases are isolated and treated optimally in the health care system," he said.

Health and Child Care deputy ministry spokesperson Donald Mujiri said one of the reasons people were dying in their homes was because some people did not cooperate with health workers during contact tracing.

"Provinces are getting a high number of Covid-19 cases," Mujiri said. "Over the festive season the country had a surge in the number of people arriving from neighbouring countries.

"In that regard we need to be more cautious."

Source - the standard