Online Reporter
WHEN upgrading a hospital, it is necessary to think about a bit more than just the wards, operating theatres and equipment, important as that must be.
A major referral hospital running fairly flat out 24 hours a day and 365 days a year needs to make sure that the staff needed by the multiple shifts can be present at some very odd times, such as 1am on a major public holiday, and in suitable shape to do the work.
This usually means that major referral hospitals need to have a lot of staff accommodation of adequate standards, either within their complex or very close, especially if besides being the referral hospital they are also the teaching hospital for both nurses and doctors, and so have a lot of very useful staff who are not exceptionally well paid.
The oldest staff housing at Parirenyatwa Group of Hospitals in Harare is the Adlam House nurses residence, built some years before the large central complex of wards and when the old hospital was carrying the burden.
It definitely needed what amounted to a rebuild, with just the core masonry coming through from the past, but with new plumbing, and other finishes. Plus, in these times, it also needed an independent water supply based on boreholes and storage tanks. The municipal supply that worked more than 70 years ago now being a lot less reliable.
Radical refurbishment is a lot cheaper than bulldozing the old building and starting afresh since even when there is a lot of removal and replacement of so many of the services, at least the building itself is there with its walls and its roof. The Government put the project out to tender and chose a competent contractor offering value for the large number of taxpayer dollars being paid.
As a result the nurses home should reopen in the middle of next month. It should be noticed that while the Ministry of Health and Childcare will be running the residence, the Ministry of Finance, Economic Development and Investment Promotion is the one dealing with the contractor, and making that we get quality work that is definitely value for money.
With the refurbished home housing 353 nurses, rather than the 40 sleeping amid the near ruins a little while ago, Parirenyatwa administrators will be able to have a good chunk of the more junior staff on each shift on call. There are flats for the more senior sisters and the junior doctors that were built later, although we hope that the maintenance schedules have been kept up to date.
All this means that when patients arrive there should be staff to cope, promptly. Other parts of the upgrades, and President Mnangagwa stressed this during surprise visits last year, obviously include having the essential equipment, consumables and medicines available in adequate quantities. Just having wards is not all that useful.
The second of the present major renovations at Parirenyatwa involves the Mbuya Nehanda Maternity Ward, a multi-storey block that also predates the large central ward complex although not by many years. But after more than 70 years with, sometimes, indifferent maintenance there was need to pull out floors, plumbing and most of services and replace them.
Even with very good maintenance, this sort of radical refitting is usually required every few decades. Hospitals are a special case when it comes to hygiene and other requirements, needing to guard against the risk of infection as well as making sure everything works. And a maternity wing is in a very special place for these requirements. Infections among women giving birth used to be appalling until quality engineering and germ killing chemical washing of maternity wards combined to sort that out.
NSD2 lays down a long programme of bringing Zimbabwe’s public health sector up to the sort of levels that an upper middle-income country can be proud of, something a bit more than the minimum even for that sort of country. We need to continue with the programmes and make sure we get special quality and value for money.
People talk about much of the Parirenyatwa complex being 70 years old, with some parts even older. This is not a big deal so long as everything is working properly and maintenance assumes the importance it demands.
Considering that some of the work being done now may well still be there in 70 years’ time, the importance of getting it right during the upgrade is obviously critical, and we hope that the plans will also make it easier for regular upgrades to ever higher standards along with the general running of the hospital and the routine maintenance of facilities.
We are not going to be stuck in a time warp of upper middle-income status for decade after decade and so we need to be able to move up the ladder at will.
Peter Tanyanyiwa