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FEATURE: Young musician’s death exposes Zimbabwe’s collapsing health care system
Garikai Mapanzure, popularly known by his stage name Garry, has become the latest high-profile victim of Zimbabwe’s deteriorating health facilities.
A rising Afropop musician,Garry, who was 25, died in mid-October after sustaining grave injuries in a horrific accident near his home in Masvingo, 295 kilometres from Zimbabwe’s capital, Harare.
His family blames poor medical equipment after spending hours battling for his life at a government-run Masvingo Provincial Hospital in the same city.
Garry has joined many Zimbabweans who have been losing their lives as a result of a lack of medicine, a shortage of ambulances, and a lack of oxygen supplies.
He left behind his wife and a year-old son.
His family also lost Garry’s friend, a student at Great Zimbabwe University, and a niece, who all died on the spot.
Collapsing Health System
Speaking at the funeral of the Afropop sensation in Masvingo, Garry’s sister, Kudzai Mapanzure-Chikwanha, said the health system in Zimbabwe failed Garry.
“He held on for 12 hours, but there was nothing in Masvingo,” she said.
Garry suffered from the injuries for 12 hours, while the family was told that there was no computed tomography (CT) scan used to detect injuries inside one’s body.
They also could not fly him to Harare as there were no ambulances with oxygen support on board and no air ambulances.
Mapanzure-Chikwanha pleaded with the government to improve the country’s health system.
“Just one scan could have saved Garry,” she said.
The southern African nation’s health sector has been collapsing for several years now with shortages of health workers, a lack of critical equipment like intensive care unit beds, and shortages of basic drugs, including paracetamol.
Johannes Marisa, president of the Medical and Dental Private Health Practitioners Association of Zimbabwe, tells IPS that Zimbabwe does not meet the World Health Organization’s six building blocks of 2007, which are combined to make a robust health delivery system.
“These include the health workforce, medicines and drugs, health financing, governance, service delivery, and information systems. If a country lacks any one of these building blocks, their health delivery system becomes weak,” he says.
“It is like a house that is held on five pillars instead of the required six. If you look at our Zimbabwean situation, you find the health workforce is in shambles because of brain and health financing, which is poor.”
Zimbabwe’s budget for health care in 2023 fell short of the Abuja Declaration of April 2001, which calls for at least 15 percent of the total budget to be allocated to the health sector.
“We fall short of the Abuja Declaration. This means health financing has never been adequate in Zimbabwe for a time immemorial,” he says.
Marisa says nepotism and cronyism have destroyed the health sector.
“You look at leadership again, or governance. You will find that people who are not competent are running offices. Some people without management qualifications are running big hospitals because of patronage and nepotism,” he says.
Marisa says most hospitals are operating without medicines, drugs, ambulances, and oxygen.
“If you look at the medicines and drugs again, they are not even there. Yet medicines and drugs are part of the six building blocks. We will continue to lose as many people as possible,” he says.
Just a few weeks after Garry’s death, a bus that plies a route from Harare to South Africa was involved in an accident in Masvingo Province.
Those who were injured were taken to Chivi District and Masvingo Provincial Hospital, where they spent several hours without assistance due to a lack of equipment and basic drugs for pain relief, according to eyewitnesses.
Brain Drain
More than 4000 nurses have left Zimbabwe since 2021, according to the country’s Health Services Board.
Most healthcare workers are leaving for the United Kingdom and the United States.
The number of Zimbabweans granted worker visas increased sharply to 8,363 in September 2022 from 499 in 2019, according to the UK Office of National Statistics.
Zimbabwe’s weak healthcare facilities as well as poor salaries and remunerations are some of the reasons behind the brain drain.
Zimbabwe has only 3,500 doctors for a population of almost 15 million people, according to the Zimbabwe Medical Association.
Itai Rusike, an executive director at the Community Working Group on Health, says the current situation is that the health facilities are not capable of providing basic health care.
“The capacity of public health facilities to screen, diagnose, and manage communicable and non-communicable diseases and conditions has declined to all-time low levels and remains weak in this challenged health delivery system,” he tells IPS.
“These include diabetes, hypertension, cardiovascular conditions, injuries, cancer, and mental health through the training of health care workers, procurement of diagnostic equipment and consumables, as well as advocacy towards healthy lifestyles.”
Rusike said the health crisis is compounded by conditions that increase the risk of traumatic injury.
“For example, the state of our roads in Zimbabwe’s road network raises concern, especially when they are further damaged by heavy rains and other climate disasters,” he says.
“Poor roads not only raise the risk of accidents but also mean that ambulances cannot easily access patients in need. During the rainy season, rural roads become even more impassable, making access to emergency services even more difficult.”
Marisa says the poor healthcare system is even affecting the elites with the best medical aid in the country.
“The medical aid societies are giving headaches to medical practitioners. There are so many service providers who are rejecting the best medical aid card holders,” he says.
“This is because no one has confidence in several medical societies operating today. They find excuses for not paying.”
Medical aid societies charge exorbitant prices, which are beyond the reach of many people in the country who are unemployed, while those employed earn paltry salaries.
Private healthcare facilities are expensive and are mainly found in big cities like Harare and Bulawayo.
Rusike says when public emergency care services are not adequately funded, staffed, or provided, it leads to a growth of commercial and privatised services.
“While this is a private sector response to demand and can help to minimise morbidity and mortality, it is not appropriate to rely on the private sector for this service. It leads to inequities in access to health care,” he says.
“The driving force of private provision is maximising profits and not the needs of the most disadvantaged members of society.”