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The death throes of Harare's hospitals

Empty beds at Harare Central Hospital

By Brian Hungwe
Harare

Hospital wards in one of Zimbabwe's main hospitals bear a resemblance to deserted, poor rural classrooms and the country's empty supermarkets.

Desks and chairs are piled up in a corner, while educational health posters hang precariously on the wall with paint peeling off.

The paediatric beds, with no linen or mattresses, look like lonely, abandoned supermarket trolleys.

There are no more patients inside the wards, just empty beds
Dr Malvern Nyamutora
Junior Doctors' Association

The pitiable sight of Harare Central Hospital, a once-busy referral medical centre, sums up the dim state of the economy.

The sick lose all hope of finding treatment the moment they step into the lifeless hospital reception.

Years back, the hospital car park would be jam-packed.

Inside the wards, attentive nurses and doctors would pace the long, meandering corridors, while well-fed patients would loiter outside for some exercise or sunshine.

But now, the entrance into the hospital is deserted, with hardly a doctor or nurse in sight.

The floors may be well-polished, but the majority of wards are empty - mattresses piled up one on top of another.

The sound of birds outside dominates the occasional cries of sick babies facing injections.

These children are the only patients getting treatment - for their cleft lips - thanks to a team of doctors from the US-based group Operations for Hope.

'Go home'

"Harare Central officially closed down on Friday last week, and at the Parirenyatwa Hospital, most wards have not been functioning, save for one or two," says Dr Kudzanai Chimedza.

Outpatients reception at Harare Central Hopsital
The usually busy reception at Harare Central is deserted

He is president of the Junior Doctors' Association - the 200-strong group considered the backbone of the public health delivery system.

"It's a decision undertaken by senior doctors, citing poor working conditions," he says.

Hospital authorities asked relatives to come and pick up their sick loved ones.

They could no longer cope, weighed down by lack of resources.

Rarely does a referral hospital shut services, except in a time of war.

But Zimbabwe gives all the indicators of being at war - it has the world's highest rate of inflation, which officially stands at 231,000,000%.

'Genocide'

The cost of treatment has shot through the roof, leaving the poor sick very vulnerable.

"The neglect of the health sector by government is genocide," says Malvern Nyamutora, vice-chairman of the Junior Doctors' Association.

The patients might be unwell, but government officials are sick in the head
Nurse at Harare Central Hospital

"To me nothing can explain this better, it's genocide, simple.

"Patients are dying needlessly; drugs are not there; prescription papers are hard to get, tubes for blood collection are difficult to come by; food for patients isn't available; surgical operations for patients have been stopped and doctors are only attending to emergencies.

“There are no more patients inside the wards, just empty beds.”

At the country's major referral hospital, Parirenyatwa, there are no more surgical operations.

"The two theatres have been closed, even the one for caesarean operations," he says.

"Everyone is being referred to private clinics, and if you don't have money, you die."

A cholera outbreak has hit the capital's townships, so far claiming more than 20 lives, according to the non-governmental organisation Doctors for Human Rights.

"The stark reality is that they will be coming to hospital to die, because there is nobody to care for anyone," Dr Nyamutora says.

The cholera crisis has been compounded by sewer pipes which have burst and severe water shortages.

"Cholera is treatable, just fluids and tetracycline [an anti-biotic] is enough, but if you get people dying of this diarrhoea - that explains the state of the health crisis," Dr Nyamutora says.

Deputy Health Minister Edwin Muguti has acknowledged the crisis in the health sector, but has put the blame on international sanctions.

These are hurting the economy, putting pressure on the health delivery system, he says.

'Peanuts'

At Harare Central, student nurses have nothing much to do, even if 70% of the qualified staff have left to neighbouring countries.

Family in Epworth
This family live in Epworth which has been hit by a cholera outbreak

A nurse showed me her September payslip, her salary of Z$12,542 - about 12 US cents - is not even enough to buy a soft drink.

"This is the misery we are going through," said Beaular, a nurse who asked for her real name not to be used.

"With these peanuts, the government expects us to come to work, board our commuter omnibus, and feed our families.

"The patients might be unwell, but government officials are sick in the head," she said.

Her anger is echoed by other colleagues.

"There is zero dedication to duty, because there is zero concern to our plight by government," another middle-aged nurse said.

At Parirenyatwa Hospital, the sight of the grave faces of relatives carrying patients being turned away is heart-wrenching.

Tragedy

Even if someone opts for treatment at expensive private hospitals, people cannot get access to their cash because of limits on bank withdrawals.

Public hospital are also able to accept money, but have to turn patients away simply because there are no drugs, nurses, doctors or medicine.

A report by six Zimbabwean doctors compiled just before the controversial March elections painted a sorry state of affairs.

"Elective surgery has been abandoned in the central hospitals and even emergency surgery is often dependent on the ability of patients' relatives to purchase suture materials," it said.

"Pharmacies stand empty and ambulances immobilised for want of spare parts... this is an unmitigated tragedy, scarcely conceivable just a year ago."

Seven months on, and hospitals seem to be in their death throes.

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