Doctors’ strike worsens patients’ plight

Paidamoyo Chipunza Senior Health Reporter
When two elephants fight, it is the grass that suffers.

Indeed, the continued impasse between junior doctors and Government has left many patients with critical conditions stranded as they fail to access health care.

A majority of the stranded patients are those with serious conditions as they would have been referred from a lower level of care without capacity to deal with complicated conditions.

Sadly their hope for therapy is threatened by the two giants’ stalemate, which has seen the other party downing tools since Tuesday February 14, 2017.

Their seniors, who are specialising in obstetrics and gynaecology, also stopped seeing patients last Monday. They argued that the burden of care was becoming unbearable in the absence of their juniors, who are normally the first port of call for patients after being seen by a nurse.

The Herald caught up with a cervical cancer patient at Parirenyatwa Group of Hospitals who came all the way from Silobela, Midlands province but failed to get service from the central hospital because of the strike.

“We arrived last night after we were referred from a local clinic to this hospital. Since last night, my aunt who has cervical cancer has not received any meaningful service,” said a relative who spoke on condition of anonymity.

“Last night she was made to take blood tests, which were taken at some place in the Avenues area but when we returned with the results we were told that there was no doctor to assist us further and we were told to wait until this morning.

“This morning the gynaecologist who came only attended to one person and left saying he was overwhelmed and we were all asked to seek services elsewhere,” further added the relative.

She said they were now considering going to Karanda Mission Hospital in Mt Darwin.

“You can see her condition. We cannot go back home with her. She is really sick, she must get medical attention.”

Hospitals are discharging even the seriously ill patients.

Relatives of a patient, Rosemary Phiri, who was discharged from Harare Central Hospital two weeks ago owing to the strike, expressed concern at the continued impasse.

Sadly, Rosemary died on Sunday night at her brother’s house in Belvedere West and her relatives believe she could have recovered if she had stayed in hospital.

The relatives said Rosemary was admitted on February 8, 2017, after she started complaining that she was not feeling well.

“Doctors said she had a kidney problem.

“At the clinic, it was noted that she had too much fluid in her body and she was then referred to Harare Hospital where she was admitted.

“Surprisingly, she was discharged on February 16 while she was still undergoing various tests and before she even received treatment. She was bedridden, could not eat, sit and talk.

“She died yesterday (Sunday, February 26) at 9pm at her brother’s house. It’s painful that we had to keep her at home watching her die. We could not afford to take her to private institutions. We believe she would still be alive if doctors had kept an eye on her,” added her daughter Florence.

Last week Sunday, a 17-year-old accident victim was sexually raped at Parirenyatwa’s ward A1 by a male nurse – a situation that has since been attributed to the doctors’ strike.

“The ward was almost empty because many patients had been discharged due to the strike and no new admissions were being made, so it was easy for the nurse to rape the patient,” said nurses from the hospital.

The whole of last week, central hospitals circulated memos alerting their staff that due to the strike, they were only attending to emergency cases.

“Due to the ongoing strike by the junior doctors, we are finding it difficult to cope with the work load, therefore we have resolved to attend to dire and emergencies only.

“We will only resume our duties once the outstanding issues have been solved. We hope the impasse is solved urgently for the benefit of our patients,” wrote United Bulawayo Hospitals on February 20, 2017.

Another memo from Parirenyatwa Hospital indicated that it was combining the paediatrics and adults casualty departments as a contingency plan to the strike crisis.

“Please note that with immediate effect (February 17, 2017), A2 paediatrics casualty will be closed in line with the contingency plans. All paediatric patients will be seen and managed in main casualty.”

The junior doctors downed tools a fortnight ago demanding release of their open practice certificates, upward review of on-call allowances to about $730 and other non-monetary incentives.

Government announced earlier in the year that all establishments for Government Medical Officers and Hospital Medical Officers were now filled and it was unable to employ all doctors coming from the medical school, starting this year.

The current policy requires the junior doctors to work for a year at a district hospital after completing their two-year internship. Thereafter their open practising certificates are issued enabling them to look for employment anywhere.

Although Government could not guarantee that it would employ the junior doctors, it still refused to release the junior doctors’ certificates resulting in the stalemate.

Secretary for Health and Child Care Dr Gerald Gwinji said indeed when one or two people withdraw their services, there was bound to be interruption of service delivery.

“When some people are not coming to work there is bound to be an impact on service delivery and because these cadres on strike are at the first level of care, the impact is even greater.

“Clinical directors are however trying to re-arrange their departments to see how they can continue providing a service although it’s a bit more work on those available,” said Dr Gwinji.

Dr Gwinji said Government had done all it could to address the immediate needs for the doctors and all they could do now was to continue encouraging them to return to work while working on their other grievances.

He said following Treasury’s concurrency to review doctor’s establishment by 250 posts, they had since come up with a distribution list of the posts from which the doctors were now expected to contact provinces of their choice for employment.

According to the distribution list, Masvingo Province will get 27 additional posts while Manicaland and Mashonaland East will get 26 posts each.

Mashonaland Central will get 22 additional posts while Mashonaland East and Midlands will get 21 posts each. Matabeleland North and Matabeleland South will get 20 and 14 additional posts respectively.

The distribution list has since been sent to provincial medical directors.

But the Zimbabwe Hospital Doctors Association insists that they want assurance from Government that their seniors will also be included in the distribution list.

“The Ministry of Health and Child Care has made some effort in establishing GMO posts but we still await the distribution list of the posts and we also want assurance that registrars working for free in hospitals will be included in those posts,” said the doctors in a statement.

They also said some of their concerns of upward review of on-call allowance and non-monetary incentives had also not been honoured.

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