The Zimbabwean Government is digging in its heels, refusing to grant clearance letters to health workers now stranded in Ireland and other countries under new proposals to criminalise the hiring of its nurses.
Vice-President and Health Minister Constantino Chiwenga said the measures to prevent citizens from working abroad were necessary as “people are dying in hospitals because there are no nurses and doctors”.
“If one deliberately recruits and makes the country suffer, that’s a crime against humanity,” he said.
In December 2021, he had said there were plans to approach the UN to seek reparations for the brain drain in the health sector: it costs around R6.3m to train a doctor in Zimbabwe.
Stranded in Ireland
Stanley Ncube (not his real name) told News24 he would be jobless in Britain next month if the Zimbabwe Nurses Council does not clear him.
“I arrived in 2021 with my initial clearance … but now I am supposed to get a secondary clearance, and for some reason, they are not processing the letters. Now I am stuck.”
To work in the UK, permission to be employed is only granted after clearance from one’s home country.
“When I got here, I wrote an exam and passed. Thereafter, the Zimbabwe Nurses Council must issue the verification letter for me to register and get a critical skills visa,” he said.
Without the permit, many nurses, like him, could be deported.
Zimbabwe had emerged as the biggest African contributor to the UK health sector, according to figures from the British Home Office.
Government statistics have revealed that since February 2021, some 4 000 nurses have left Zimbabwe. Last year alone, 1 800 fled to greener pastures.
The Zimbabwe Medical Association said there were only 3 500 registered doctors in Zimbabwe at present, for a population of more than 15m.
Exacerbating the crisis, there are only 2.6 nurses per 1 000 people, according to the World Bank.
Chiwenga playing a hard game
From calling doctors “skilled labourers”, to firing more than 15 000 nurses and later enacting a law banning health workers from undertaking industrial action, Chiwenga is an unpopular man in the sector.
Since January this year, health workers are no longer allowed to strike for more than three days because they are a critical labour force.
Defiant union leaders can be jailed for up to six months under the law.
The government has refused to increase their salaries and the working conditions are shocking, with massive shortages of basic and critical equipment such as drugs and machinery.
In 2018, Chiwenga fired about 15 000 nurses who were protesting for better pay. While many were rehired, some, who made plans to leave the country, did not return to work.
Retired nurses were called back but still, they did not cover the void left by those who had moved on.
Meanwhile, the government has been silently training soldiers and the police as health workers. This will guarantee a smooth flow because neither sector has provision for industrial action.
Through its health centres, the army is also training nurse aides who are then deployed countrywide.
Ailing health sector
Nurses earn less than R4 000, including benefits, while doctors earn barely double that. In the 2023 budget of Z$4.5 trillion (R250bn), 11% was allocated to the health sector.
The Community Working Group on Health said the money channelled to the health sector was insufficient.
The Abuja Declaration, of which Zimbabwe is a signatory, stipulates 15% of a country’s annual budget should go towards health.
As Covid-19 struck, years of underfunding of Zimbabwe’s health system were exposed, with severe shortages of vital and lifesaving supplies, including ventilators and intensive care beds.
To plug the gap left by the government, most of the funding for the countrys health sector comes from external sources.
In hard-to-reach areas, village health workers funded by NGOs provide health services.
One health worker, Wisma Mugano, covers a variety of health needs and is available 24 hours per day. “In a way, as a village health worker, I work 24 hours because I have people coming to my home for emergencies, like women who are in labour, and I assist where I can or refer them to the clinic,” said the 67-year-old.
However, the proposed Private Voluntary Organisations Amendment Bill could alter funding for health services offered by NGOs.
See more from MedicalBrief archives:
Clinics in crisis as nurses exit Zimbabwe over R1,000 per month salaries
Zimbabwe wants compensation for brain drain of nurses and doctors
Massive UK nursing shortage sucks in Kenyan, South African and Zimbabwean nurses
Zimbabwe Health Bill amendment will limit doctors’ and nurses’ pay strikes
Zimbabwe doctors may need state approval to work abroad