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COVID-19 Pandemic: The Ultimate Equaliser

At a church-run mission hospital, funded by both the Church and the government, in Chiredzi Town, in southeast Zimbabwe, one nurse, who aske...

At a church-run mission hospital, funded by both the Church and the government, in Chiredzi Town, in southeast Zimbabwe, one nurse, who asked not to give her name, shared her experience.

“I started caring for coronavirus patients from January 2021 with 25 positive patients in the isolation ward. At first I was scared and lacked in confidence. Though I had undergone training on COVID-19, still I felt I could not manage the task,” she explained.

In her line of work, she says, there is no such thing as a “normal day”. “At one moment the patient is stable and the next, I need to ventilate the patient. Out of 25 positive patients, only one died and 19 have recovered. I am happy for the recoveries and a bit disappointed by the death.”

Though they have enough personal protective equipment (PPE), she says she is frightened by the lack of medical equipment. “We have only two ventilators which are small and not enough for the patients. The scariest thing is going into the ward and administering medication to the sick patients.”

In public hospitals, employees are very demoralised, says a nurse at Chitungwiza Hospital, who refused to be identified. “There is a shortage of medication for disease like diabetes and BP (hypertension) and most elderly patients are skipping their medication, running the risk of losing their lives because they cannot afford to buy medication from private pharmacies.”

Medical staff are seen assisting a patient at a hospital in Harare, Zimbabwe (Image: Philimon Bulawayo/Reuters)

“Our hospital equipment is sometimes broken and overwhelmed by patients and we have to refer patients to other bigger hospitals in Harare or private hospitals with better equipment,” the nurse added.

An empty manifesto

Mugabe’s cabinet engaged in medical travel as enthusiastically as their leader did. At the peak of the ZANU-PF’s factional fights in August 2017, Emmerson Mnangagwa, the then Vice President (now President) was revived at a South African hospital, following claims of poisoning by opponents seeking to eliminate him from the path to succeed Mugabe.

The ZANU-PF 2018 election campaign manifesto under Mnangagwa pledged to “ensure that treasury allocates at least 15 percent of the national budget to healthcare sector”. It further proposed to review medical professionals’ remuneration, and to rehabilitate and invest in new healthcare facilities. Most of these promises remain on paper, however.

The 2021 national budget committed $683 million towards health – 12.9 percent of the country’s overall budget. Development partner support (funding for healthcare which comes from donor organisations and countries) was projected to rise to $495.9 million from $351.7 million in 2020, according to the budget statement.

The state denies that there is a health crisis in the country or that the nation’s hospitals are overwhelmed. “Let me reassure citizens that Zimbabwe’s public and private health institutions still have adequate capacity to offer health services to all patients,” Vice President and Health Minister Constantino Chiwenga was quoted as saying in the media
The aloe plant is used to make home remedies against COVID by people in Zimbabwe, but doctors say there is no evidence it is beneficial (Image: Derick Matsengarwodzi)
However, the Finance Minister painted a gloomier picture for public healthcare during the national budget presentation in November. “The COVID-19 pandemic has put a spotlight on the challenges in the healthcare system and infrastructure, from shortages of testing and medical supplies to access to health services for underserved populations,” Finance Minister Professor Mthuli Ncube said.

“The health crisis provides useful lessons for longer term reforms required to build greater resilience in our health systems against any future shocks,” he added. The country’s six central hospitals were allocated $32 million, a rise of just over 10 percent from the previous year.

The Ministry of Health did not respond to questions about the state of the healthcare system and about how the nation is coping with the global pandemic. 

Despite President Mnangagwa’s assurances that he would revamp the healthcare system when he came to power in 2018, the government clamped down on nurses who went on strike to demand a living wage and better working conditions that same year. Vice President Chiwenga, sacked all 16,000 nurses who went on strike in a counter reaction echoing Mugabe’s administration’s strong-arm tactics. Many of these dismissals were later reversed.

The former general’s fondness for travel to China as a medical tourist also showed. In 2019, Chiwenga departed for China in a frail state, returning after four months of treatment for an undisclosed ailment. He has subsequently returned to China for further check-ups. Chiwenga took over the health portfolio as Health Minister as well as being Vice President in 2020.

 His predecessor, Obadiah Moyo, had been fired after displaying what the government termed as “conduct inappropriate for a government minister”. He has since been charged with criminal abuse of office for awarding a $60 million contract to a company which allegedly supplied COVID testing equipment to the government at inflated prices.

Chickens come home to roost for Zimbabwe’s wealthy

But other wealthy members of Zimbabwean society are starting to feel the full force of the travel ban now in place because of the global pandemic.
Children pick guava leaves to make home remedies for COVID. They can be used to make tea and for steam bathing. Many Zimbabweans rely on such home remedies rather than use the country’s over-stretched healthcare system (Image: Derick Matsengarwodzi)
Four ministers have died after succumbing to COVID-19-related complications and being forced to seek treatment in Zimbabwe’s hospitals. One was Agriculture Minister Perrance Shiri who passed away in July last year.

The state is generally secretive about officials’ health status. However, it is known that government departments were functioning at 25 percent capacity to minimise infections during the last lockdown. A large number of state officials retreated to their countryside getaways, away from their spacious offices, despite the fact that the government has declared the entire country a “hot spot” and current lockdown rules outlawed unnecessary travel within the country.

They can’t flout international travel bans, however. “The international travel restrictions have made sure that everyone, powerful and weak, are going to [have to] use the available, poorly resourced health services. I hope this will serve as a lesson to the elites to improve and develop the health sector for the benefit of everyone,” says Dr Bhebhe.

The ultimate equaliser

Before the South Africa-Zimbabwe border was shut (from January 11 until February 15, because of the pandemic, and may close again if it worsens still) – except for permit holders and essential cargo – patients journeyed to the country to access South Africa’s better equipped public hospitals on a regular basis. 

The trips were live-saving pilgrimages for some pregnant women and business people like Tendai Muchenje, 55, a well-off car dealer who lives in an exclusive suburb of Harare.

“I was scheduled to travel to South Africa for my regular, general medical check-up before the lockdown was announced in December,” says Muchenje. However, South Africa is now only allowing entry for emergency medical attention for life-threatening conditions.
An assortment of guava, avocado, Fever Tree and mango leaves which many Zimbabweans use to make home remedies against COVID, rather than rely on the over-run healthcare system (Image: Derick Matsengarwodzi)
“For now, I have to rely on local health facilities but most of their services and drugs are overpriced and cannot be compared with South Africa,” he says. “My family and friends have also been affected and we hope we don’t have a health complication in the family for now.”

Nesta Chitembwe, 35, a businesswoman from Harare who conducts trade overseas, is also decrying the closing of the border. “I use to travel regularly to South Africa to visit my husband who works in Johannesburg, at the same time I would consult a specialist for my cancer treatment.” With the ban, she remains stuck in the country.

“I was privileged to travel to South Africa but after the border closed I now rely on private hospitals for my cancer treatment but they are very expensive. Rich and famous citizens, most Zimbabweans are failing to access treatment at hospitals and suffer in silence and die at home. Something must be done to revamp our healthcare system which is a time bomb,” says Nesta.

‘Steam or die’

In order to avoid attending crowded, understaffed and under-equipped hospitals, many poorer citizens are turning to home remedies for their ailments instead.

 People visiting each other’s homes against lockdown regulations or going to funerals drink Zumbani tea, made from the Fever Tree, to ward off potential infections.

Home remedies have long been used by ordinary Zimbabweans, even before the pandemic, but more and more are doing so now. Indeed, an estimated 80 percent of the nation’s population uses traditional herbal medicine for its immediate health needs, the WHO has observed.

Innovative concoctions of lemon, ginger, eucalyptus leaves, guava leaves, fever tea tree and aloe plants are regular “treatments” for coronavirus. They are harvested in woodlands or grown in home gardens, administered by herbalists and family members.

As well as drinking tea, steam bathing is performed regularly in many homes in a bid to improve people’s respiratory systems, much to the frustration of doctors. “Zumbani tea, steaming, among other things lack scientific evidence to support their use in the treatment of COVID-19. People must know that they are doing all these practices at their own risk,” says Dr Bhebhe.
Steam bathing is common in most Zimbabwean hospitals, and is used to improve the respiratory system in a bid to avoid succumbing to COVID-19, much to the despair of doctors who say there is no scientific evidence that it has any health benefits (Image: Derick Matsengarwodzi)
‘We are just asking for basic healthcare, not expensive holidays abroad’

Medical tourism has long been a flourishing global business, worth $87.5 billion annually before the COVID-19 outbreak. Mugabe’s most trusted health tourism destination, Singapore, is ranked sixth in the world for its advanced medical facilities. The UN World Tourism Organisation projected that the industry would shrink by 60 percent to 80 percent by the end of 2020, however, as a result of the pandemic.

As the pandemic rages, countries in Asia and the Pacific – where treatment can be up to 90 percent cheaper than in the US, for example – have been starved of an estimated 33 million tourists.

In Africa, health and medical tourism are regarded as a necessity and a status symbol. But, as coronavirus casualties pile up, the killer virus has closed the gap between the rich and poor in many countries on the continent, including Zimbabwe.

Before the novel Covid-19, cholera wiped 4,200, mainly poor city dwellers between 2008 and 2009 due to lack of clean water among other basic needs. With the pandemic, everyone is a potential victim – it does not discriminate and the rich are panicking.

Giving birth to a fourth son was a blessing for Anna Bangare, 28, from Nyatsime, just outside Chitungwiza Town. She delivered her 3.5kg baby at the public Beatrice Hospital with her husband, a self-employed technician, at her side.

But, two weeks later, with the baby failing to breastfeed, the celebration turned to mourning. “My child was crying non-stop for days and we took him to Chitungwiza Hospital [one of the six central government hospitals]. On arrival, we were attended by a doctor who diagnosed that it was pneumonia.”

After waiting for six hours for treatment which never came, other patients and a nurse told her to buy milk for her child who was crying non-stop. “The doctors were avoiding direct contact with patients to minimise being infected by coronavirus. So, I went home with the baby, but he did not recover. We did not have money for the private hospital, so we continued to try to breastfeed,” says Anna.

On the third day, moments after feeding her baby, he died in her arms. “The death of my child has caused a lot of pain in my family,” she says.

Like the majority of Zimbabweans, Anna feels betrayed by a healthcare system that was supposed to protect her family, but could not. “All we are asking for is a right to live and access to humane health facilities, nothing special such as expensive holidays abroad,” she said.

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