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Joseph Madzimure-Senior Reporter
SANCTIONS imposed on Zimbabwe by Western nations have negatively impacted the provision of primary healthcare in the country as hospitals and clinics make do without requisite medicines and sundries, frontline workers have said.
Prior to sanctions, municipal councils, clinics, public hospitals and rural health centres, which focus on maternal, neo-natal and child health were adequately supplied with medicines, ambulances and qualified personnel.
In the 1990s, it was estimated that 85 percent of the population had access to health care.
Ahead of the Sadc Anti-Sanctions Day that is marked on October 25, Medical and Dental Private Practitioners Zimbabwe Association president Dr Johannes Marisa said sanctions have been devastating to the local population.
“Because of chronic underfunding, health workers have exited the country for greener pastures. Many health institutions are understaffed and a lot of experienced workers are leaving the country,” said Dr Marisa.
Sanctions, he said, forced some private organisations and Governments that were doing projects in Zimbabwe to abandon their programmes.
For example DANIDA halted vertical health programmes worth US$29,7 million in 2000, while the Swedish government withdrew its HIV/AIDS programme in 2001.
“How many people then died of HIV and AIDS as a result of such measures. HIV patients need to go for routine tests which include CD4, Viral load, Full Blood Count, Liver tests, Kidney tests etcetera. Without donor support, many people cannot afford to have the tests done in private,” said Dr Marisa.
Hospital equipment, he said, has been in use for some time and spare parts that used to come from suppliers mostly in Britain, US, Canada and many other European countries are no longer available.
Sanctions also derailed repairs to a lot of equipment as direct purchasing is prohibited from many European countries.
“Banks that were placed under sanctions such as ZB bank could not transact on their own and in 2017, Commercial Bank of Zimbabwe (CBZ) was slapped with a US$385 million fine by America’s Office of Foreign Assets Control for transacting on behalf of ZB Bank,” said Dr Marisa.
Zimbabwe, he said, has witnessed sluggish investment in the health sector.
“The country could be having medical tourism by now considering the favourable climate that exists in the country. This means the health sector remains poorly developed and the pharmaceutical sector is limping as well.
“Research has been slowed down in the midst of calamitous diseases like the Covid-19 pandemic. Financial injection is required to keep pace with the research dynamism of medicine,” Dr Marisa said.
However, he said, the effects on the health sector are insurmountable with surgical procedures being cancelled, mortality being higher in High Care Units, and drugs losing potency because of loss of cold chain. Dr Marisa said the collapse of water and sanitation infrastructure is largely attributed to underfunding which can be traced to the sanctions that closed the easier lines of credit.
“In 2008, Zimbabwe experienced a cholera outbreak which claimed more than 50 lives. There has been an increased demand for safe water in order to avert water-borne diseases like typhoid, dysentery, and cholera. Nevertheless, the ageing water treatment plants in the country cannot cope with the demand. Many people therefore unnecessarily lose their lives due to treatable diseases.”
Consultant Obstetrician/Gynaecologist at the University of Zimbabwe College of Health Sciences, Dr Velda Mushangwe, said sanctions are impacting heavily on the quality and access to health services in Zimbabwe.
The health service delivery system, he said, is reeling under the same sanctions which have saddled Zimbabwe for close to 22 years now.
“Zimbabwe trains some of the best medical practitioners in the world, a development which puts the entire country on the world map. The country, however, does not have a robust health service delivery system and it is incontrovertibly true that sanctions are implicated in the so-called crummy health service delivery. Many people fail to appreciate both the direct and indirect effects of sanctions on the health sector,” said Dr Mushangwe.
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On his part, Harare dental surgeon, Dr Hamadziripi Dube, said the structural economic and social challenges inherited from the late 1990s were aggravated by unilateral sanctions and the isolation of the country, especially during the first decade under sanctions, exacerbated by the consequences of over compliance. As a result, the public health system collapsed.
He said the total health expenditure fell from 10,8 percent of GDP in 1996 to an average of 7 percent to 8 percent in the period from 2005 through 2013.
“Vacancy rates in the health sector were consistently high throughout the period under sanctions, reaching 69 percent for doctors; 61 percent for environmental health technicians; over 80 percent for midwives; 62 percent for nursing tutors; over 63 percent for medical school teachers; and over 50 percent for other health personnel, including pharmacy, radiology and laboratory services. Recent data on vacancy rates indicate figures as high as 89 percent for midwives, 64 percent for government medical officers and 49 percent for nursing tutors,” said Dr Dube.
Most provinces, he said, have less than 10 health professionals per 10,000 people.
Official data evidenced a steady decline in the country’s main health indicators combined with periods of stagnation.
Demographic health surveys showed trends in child morbidity and mortality rates generally declining since 1995, especially with regards to infants and children under 5 years of age.
The Zimbabwe National Health Strategy 2009-2013 identified a high prevalence of mortality among infants and children under 5 years of age.
“It is high time that sanctions be lifted if our health delivery service is to improve. Sanctions are there for real and their effects will continue to pound us for a long time. We will continue to have higher mortality rates, higher incidence rates, higher prevalence rates and morbidity will sky-rocket,” said Dr Dube.
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