Health crisis moves from tragedy to farce

GOVERNMENT has failed to solve its impasse with medical doctors, who have withdrawn services from the country's major hospitals for 89 days today. While the country's health delivery system remains in intensive care unit, the situation worsened this week after senior doctors completely withdrew their services in solidarity with junior doctors. A total of 448 junior doctors have so far been fired by government for not reporting to work.

The senior doctors said government's vindictiveness and hostility have not helped in addressing the issues raised and capacitate the hospitals as well as improved the welfare of health workers. The incapacitation of the health professionals has crippled operations at the country's main hospitals particularly Parirenyatwa Group of Hospitals, Harare Central Hospital, Mpilo Hospital, United Bulawayo Hospitals and Chitungwiza Hospital.

Zimbabwe Independent senior reporter Bridget Mananavire (BM) sat down with Zimbabwe Hospital Doctors Association secretary-general Tawanda Zvakada (TZ) for a wide ranging interview including the fresh threats being issued by government as negotiations between the two parties continue.

BM: What is your assessment of the current situation in the country's hospitals and the health system?

TZ: The health system is on the verge of collapse. The situation is dire as there are no doctors to attend to patients and as a result the hopsitals are not functioning at optimum level. So the current state is very dire.

BM: There are over 400 doctors who have been fired so far, are you engaging government on their reinstatement? What is your next step?

TZ: Our next step is to continue negotiating with government. We have been calling for immediate reinstatement of the fired doctors, including myself so that we can continue negotiating in good faith because as it stands government has been negotiating in bad faith. They are still conducting the hearings so that number might increase.

Most are not attending the hearings.Some are attending for personal reasons, we cannot interfere with them. Now they are saying they will evict all doctors who are in accommodation. We have called on the government to stop this hostility towards the doctors and unfortunately the government is not willing to work on that.

It's a situation where doctors are even considering leaving the country in search of greener pastures. So in the long run we will have a shortage of doctors considering that health system is already constrained.

Firing the few doctors that the country has is not a solution. We hope government will come to its senses and re-instate the fired doctors
BM: I understand most of you have not completed your housemanship; can you get employment outside the country?

TZ: It is true that some of our members are still in training while some have however completed their training. For those who are still doing the housemaship, yes they can apply in other countries and finish their housemanship there. In some countries they are required to write an examination. What has been stopping many people is that these exams require a lot of more money, in stances around US$7 000.Once doctors raise that kind of money, they will definitely leave the country.

BM: Britain recently decided to relax requirements for health professionals incuding doctors and nurses. How do you view this?

TZ: It is an option that many doctors are actually considering given that the (UK) National Health Services relaxed requirements. And the doctors are even raising funds to make sure they write the exams I was talking about.

BM: Vice-President Constantino Chiwenga upon his return had harsh words for the doctors. What would be your reaction to that, given that he was receiving medical attention outside the country?

TZ: We were expecting much better from our Vice-President, seeing that he himself has seen the need for doctors for the past 136 days. Since he was in hospital, we were actually thinking he would be the one to come up with solutions for our healthcare system which is facing collapse. That's why we even tweeted on our handle that we welcome him and hope that he would upgrade our hospitals to the level of China.

BM: Do you think anything positive will come out of your negotiations since governmnet is adamant on their stance to fire doctors?

TZ: That is why they are called negotiations, we are hopeful something positive will come out of these negotiations. But I must also say that at the moment there has been little progress in these negotiations because government is not willing to move on their offer despite us making some compromises to our requests.

BM: Have you had talks with the health minister and officials from his ministry?

TZ: Yes, we are in continuous dialogue with them. We have met on three occasions so far since this whole thing started, for the past 85 days we have been incapacitated but nothing tangible has come out of that dialogue.

BM: have you considered the non-monetary incentives by government?

TZ: The non-monetary incentives that government is offering do not hold water. They said they will provide accommodation, by identifying flats in town, they said they will offer Zupco transport, food at work, but doctors have families to cater for. These are just extended to doctors, what about their families and how will you attend to work at odd hours using a Zupco?

BM: How are the doctors surviving now since they are out of work?

TZ: They are just finding means to survive just like any other in this economy. But this is not what doctors aspire, we want to do what we were trained to do.

BM: Has there been an improvement in equipment or medicines in the hospitals since you declared incapacitation?

TZ: The government said it had received some offers from the United Arab Emirates, but we have not been in hospitals to assess the situation. The government has been promising these things but on the ground it has been a different story. We said we need to progress on the tools of trade but our hospitals still leave a lot to be desired at the state that they are currently.

BM: How far are you willing to go with this?

TZ: It is not a matter of how far we are willing to go but a matter of how government responds to our needs. So we do not know how long it will last because it is a deadlock. The doctors do not have the means to report for work but the will is there. So it will last as long as the government wants it to last. We still want our allowances to be pegged at the interbank rate.

BM: We have seen now a number of people seeking medical attention at unconventional places including the tradional midwives who have been helping expecting mothers deliver babies in Mbare. What's your comment?

TZ: This is a reflection of a healthcare system that has failed. People are now stranded and have nowhere to go. Now they are seeking healthcare from unregistered and undignified places, which is a situation which cannot be perpetuated and promoted. It does not even meet the minimum requirements of the World halth Organisation. We urge the health authorities to work on it, because when emergencies arise they do not have the capacity to attend to them. They do not even have enough sundries.

BM: Do you still fear for your lives or have there been any threats on your lives?

TZ: We have not received any direct threats, to be honest, but we heard the comments made by the head of state referring to the doctor's leaders as people who are inciting others to take part in an industrial action. Coming from the head of state, it is very worrisome and sounds like an indirect threat to us.

BM: Would you like to meet the President?

TZ: We are open for dialogue with anyone. We would like to meet with him and clarify our position. Maybe he has been misinformed of the situation on the ground.