adminThe institutions have been forced to operate on a shoestring budget.
Investigations by our Harare Bureau into the state of affairs at central hospitals have proved that all is not well at the highest level of healthcare in the public sector.
This has negatively impacted on efficiency and in other cases, quality of services offered.
Most hospitals have since consumed their budgetary allocations.
Some have inadequate staff complements, especially specialists while basic equipment is obsolete and keeps breaking down.
The existing infrastructure built as way back as the 1950s needs to be expanded to match with the growing burden of care.
Sadly, disease burden continues to grow with HIV/Aids, and cancers topping the list of ailments seen at the institutions.
A typical example of the state of affairs at public institutions is Harare Central Hospital where a measly $958 000 has been received from Treasury since the beginning of the year.
The institution however requires about $25 million a year to function efficiently and effectively.
“Our services have severely been crippled by nonavailability of funds. Most of the times we have had to scrounge for survival,” Harare Hospital chief executive Ms Peggy Zvavamwe said.
She said patients who come to her institution were of very poor backgrounds and could not afford services leaving the institution to offer those services free of charge.
“There is a mentality within our population that public health services are for free because even those who can afford still do not want to pay.
“Surprisingly you hear them preferring to have their sick relatives transferred to a private institution,” Ms Zvavamwe said.
She said close to 80 percent of the sick population in Zimbabwe was assisted at her institution saying other central hospitals also referred to Harare Hospital.
Unfortunately, only 970 nurses and 387 doctors are left to save thousands of patients who pass through the institution on a daily basis.
Two nurses save a ward of 30 patients against the ideal situation of one nurse for five patients.
Ms Zvavamwe said wards mostly affected were the medical, burns and maternity units that accommodate patients needing assistance all the time.
These patients need to be bathed, fed, given medicine and a range of other services.
“Because of this pressure, doctors are sometimes forced to do nurses work and in the maternity department, some women deliver halfway on their own because the person supposed to assist them will also be assisting other patients,” she said.
She said because of increased pressure, the institution is sometimes forced to make floor beds.
Aging equipment has also become an eyesore at most of the institutions with patients requiring services such as scans among others being referred to private institutions.
Radiotherapy machines at Parirenyatwa and Mpilo hospitals broke down leaving cancer patients stranded.
Although the institutions are in the process of installing new machines, the process is expected to take up to four months before they can provide services to the public again.
At Harare hospital, the rehabilitation department is as good as nonexistent.
“Unfortunately, most of our equipment is old and breaks down every now and then. This has affected our service greatly as we fail to assist patients referring them elsewhere for certain procedures or tests to be done.”
Chitungwiza Central Hospital has received a paltry $450 000 out of the required $15 million.
The hospital’s chief executive officer Dr Obadiah Moyo said although his institution was privileged to have state of the art equipment in most departments, the financial crisis in the country had not spared it.
“Chitungwiza was upgraded into a central hospital but establishments and infrastructure were not upgraded to match with demand.
“Previously, this used to be a pass through hospital but now it is now a referral institution,” Dr Moyo said.
According to the Ministry of Health and Child Welfare Harare and Bulawayo need at least six district hospitals each to effectively save their communities.
Deputy director policy, development and planning Mr Stephen Banda is on record saying a lot of minor cases were being treated at central hospitals at the expense of serious cases.
A clinic should ideally refer a patient to a district or provincial hospital.
These should then refer cases a central hospital unlike the current scenario where patients are coming from as far as Mutare straight to central hospitals without even passing through local clinics.
Because the referral system is no longer intact, service at central hospitals is now deplorable with outpatients departments characterised by long queues while floor beds are the order of the day.
Patients sometimes spend hours before being attended to as the few available nurses and doctors do their duties on first come first served basis.
At Parirenyatwa Hospital’s outpatients department, patients interviewed complained of slow and poor service
“We have been here since 9 o’clock but have not been served up to now.
“We have already paid for the card but have not seen the doctor as yet,” said Mrs Pauline Makanza.
Consultation fees at central hospitals remain at $10 compared to $50 in private institutions.
Sidumisile Mabena
Online Reporter