Zimbabwean doctors have ended a 40-day strike for better pay and conditions that crippled public hospitals without a deal on salary increases, their union said, but warned that members may not report for work daily due to acute fuel shortages. The Times reports that the announcement by the Zimbabwe Hospital Doctors Association (ZHDA) came just hours before public sector unions were to meet the government, which is expected to table an offer to expand cost-of-living payments in an attempt to avert unrest.
Junior doctors downed tools on 1 December complaining about lack of drugs in hospitals and to press for US dollar salaries. Teachers are also on strike, and other civil servants have threatened additional action.
ZHDA said President Emmerson Mnangagwa's government had started delivering medicines and other sundries in state hospitals and made a written undertaking to hire more doctors and review salaries and allowances. There was no timeline given. "Our members have begrudgingly resumed work with effect from today as dialogue continues," ZHDA said. "Poor remuneration and the current fuel shortage remain a threat that may spontaneously hinder our members from reporting to work daily."
The report says cash shortages have plunged Zimbabwe's financial system into disarray, threatening unrest and undermining Mnangagwa's efforts to win back foreign investors side-lined under his predecessor Robert Mugabe. With not enough hard currency to back up funds showing in bank accounts, the value of electronic money has plummeted, prompting businesses and civil servants to demand payment in US dollars they can withdraw.
The strike has crippled a health system that was already in intensive care from neglect, reports News24. It mirrors the state of affairs in a country that was full of promise a year ago with the departure of long-time leader Robert Mugabe but now faces economic collapse.
According to the report, doctors describe grim conditions: bare-handed surgeries; plastic bread bags used to collect patients' urine; and broken-down machines – Zimbabwe's health sector, once considered one of the best in Africa, is on its knees.
"It's so sad. The hospitals are empty, the patients are being turned away to die somewhere else," said Prince Butau, treasurer of the Zimbabwe Hospital Doctors Association, which represents about 1 000 doctors who anchor government hospitals.
"Affordable quality health care guaranteed," read campaign billboards for President Emmerson Mnangagwa, a former Mugabe protege, ahead of the July 2018 election. But, the report says, six months after he narrowly won the disputed vote, Zimbabwe's health sector has widespread shortages of basic medicines such as painkillers and contraceptives.
Mnangagwa and others in the country's political and economic elite receive medical care mainly in neighbouring South Africa, while Mugabe frequently visits Singapore for treatment. But, the report says, at home, everyday Zimbabweans seeking health care have had to bring their own drugs, syringes, bandages and, at times, water.
Government hospitals were paralysed by the five-week doctors' strike that "begrudgingly" sputtered to an end with no resolution for their demands. The end brings no improvement in conditions.
The situation, coupled with low salaries, forced doctors to strike, Butau said. Without adequate gloves, doctors sometimes use their bare hands while masks and goggles are non-existent, he said. "We are exposed to fluids, blood spillage, HIV and hepatitis B."
He has seen rope used in place of bandages. "We cannot keep on doing that," he said.
One of the striking doctors, Wallace Hlambelo, described using everyday plastic bags with catheters for some elderly patients. "What we were doing was not to treat patients. Patients feel you have done something but you would have done nothing. That's not medicine," he said.
The report says early this month, Mnangagwa cut short his annual leave to help resolve the doctors' strike. The problem may widen after the Apex Council, which represents all government workers, gave notice to strike if Zimbabwe's government fails to pay salaries in US dollars. The government has said it cannot afford to pay in dollars, which is Zimbabwe's de facto currency. Many government workers are paid in quickly devaluing electronic money instead, forcing them to tap the black market at risk of arrest.
Poor funding is a major cause of the health system's collapse, said Itai Rusike, director of Community Working Group on Health, a non-governmental organisation. Zimbabwe's finance minister has allocated $694m for the health sector in 2019 against an annual need of $1.3bn. To return the sector to its former glory days, the health ministry said it needs about $8bn, which is the entire government budget for 2019.
"The hospital has nothing but we are running out of money because the pharmacies are demanding US dollars," said Nobert Nzonzo, who accompanied his 77-year-old father for dialysis at Parirenyatwa Hospital. At times, they have spent an entire day without being helped due to machine breakdowns while the doctors' strike means his father could not be checked for catheter-associated infections, Nzonzo said.
Health Minister Obadiah Moyo said the government was working on resuscitating the health sector. "The challenges are huge but not insurmountable," he is quoted in the report as saying. "Already we have begun buying medicines, protective clothing and other essentials. It will come right." The government has pledged to improve the supply of medicines and other items.
But for some, the government is hardly doing the bare minimum. "I am being betrayed by the government," Hlambelo said. "It is useless for me to continue working in this environment. It is not helping me, it is not helping my mother and it is not even helping my patients. It is a difficult time for everyone in this country."
[link url="https://www.timeslive.co.za/news/africa/2019-01-10-zimbabwe-doctors-end-strike-without-deal-as-unions-meet-government/"]The Times report[/link]
[link url="https://www.news24.com/Africa/Zimbabwe/bare-handed-surgeries-as-zimbabwes-health-system-collapses-20190112"]News24 report[/link]