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Services at State referral health institutions have deteriorated amid claims that patients sometimes pay bribes to doctors and nurses to get assistance. There is also a serious shortage of resources, staff and space and alleged ill-treatment of patients. Investigations by The Herald over the past two weeks revealed that some referral hospitals were owed up to US$50 million by defaulting patients, some of whom gave fake addresses on admission, putting a huge dent on service delivery.

Many institutions survive on crisis budgets, have inadequate staff complements, use obsolete basic equipment and operate on infrastructure built in the 1950s for a much smaller population.

Nurses sometimes have to perform doctor’s duties, while in maternity sections, the few midwives battle to meet service demands.

Health and Child Care Minister Dr David Parirenyatwa acknowledged the public health challenges and said Government was doing its best under the circumstances.

On staffing, Dr Parirenyatwa said: “Yes, we are short-staffed but particularly because there is a freeze on recruitment of staff and yet our establishments are not filled and if anybody resigns or retires we are not able to fill that post because of the freeze.

“So there are more shortages of this critical staff as the disease burden gets more and more.”

The minister said the solution to congestion of public health institutions was decentralisation of services.

“The solution is that we want to decentralise our services. For example, if we look at Kuwadzana Clinic (in Harare), services that they are offering now – we want them to offer more. We want X-rays to be done at Mabvuku Polyclinic so that a person is not referred to Harare (Central Hospital). We also want to have a doctor there so that we don’t congest our referral hospitals,” he said.

A senior Health Ministry official speaking on condition of anonymity said the situation was deplorable.

“What you witnessed is the correct state of affairs in most institutions in the country,” he said.

The official said some institutions were improvising to get by, and this sometimes meant using substitute medications that were not as effective as drugs recommended for particular conditions.

Harare Central Hospital is placing mattresses on floors to deal with patients overflow, while at Parirenyatwa Group of Hospital makeshift wards have been created.

Ageing equipment means patients are often referred to private institutions. Doctors also said in many instances they were sending people to private pharmacies as theirs had inadequate drug stocks.

Patients interviewed claimed that in some cases bribes had to be paid to get affordable drugs and to get treatment quicker.

“What surprises us is that some patients are told to buy drugs while others are given the same drugs. We suspect those given the drugs may have paid a bribe to get the medication,” said a patient who spoke on condition of anonymity.

A relative of a patient at Parirenyatwa added simply: “I have paid for my sister to be assisted.”

The managing director of Natpharm – Government’s drug supplier – Mrs Flora Sifeku said they had been unable to boost medicine stocks since dollarisation and were surviving on donations.

“Natpharm requires funding so that it can float tenders. Without an allocation, we do not procure,” she said.

Source : The Herald

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