Coronavirus Zimbabwe

Harare: Covid-19 epicentre

By Fazila Mahomed 6 August 2020
Caption
A woman walks past a clinic displaying a poster on Covid-19 in Harare, Zimbabwe. (EPA-EFE / Aaron Ufumeli)

More than two million citizens in Zimbabwe’s capital city Harare are faced with a serious health hazard after it became the new Covid-19 epicentre in the troubled southern African country. Of the 490 cases recorded countrywide on 1 August, 485 were from the capital.

Harare’s two biggest referrals, Harare Central and Parirenyatwa hospitals either have poor or no supply of running water or basic sundries and the infrastructure is dilapidated and obsolete. Health workers are poorly motivated and have been on a nationwide strike from early 2020.

Speaking to Daily Maverick, the Zimbabwe Association of Doctors for Human Rights (ZDHR) Secretary-General Dr Norman Matara noted with concern the increase in the number of Covid-19-positive cases in the capital, Harare.

“Covid-19 is now rampant and widespread in our communities. This means we’ve lost the battle for primary prevention. It’s very worrisome considering the state of our health institutions at the moment where nurses have been on strike for the past six weeks and now doctors have joined in.”

“This is of grave concern to us and we advise the government to quickly intervene on their stalemate with health workers in order to prevent unnecessary deaths,” Matara said. 

President Emmerson Mnangagwa this week appointed his vice president, retired general Constantine Chiwenga as Minister of Health and Child Care after sacking Dr Obadiah Moyo on allegations of “criminal abuse of office”.

Moyo was arrested in July by anti-corruption officials and taken to court, but was released on a ZWL50,000 bail at Harare Magistrate’s Court. Moyo was at the centre of the US$60-million Covid-19 procurement scandal exposed by journalists Hopewell Chin’ono and Mduduzi Mathuthu, that allegedly involved the first family.

Chiwenga is on record as dismissing doctors during their strike in March, referring to them as, “skilled technicians or labourers with knowledge fit for an occupation and not a profession”.

The former commander of Zimbabwe Defence Forces (ZDF) was appointed with yet another high-ranking former military official, Air Commodore Jasper Chimedza, who now is the permanent secretary in the health ministry.

The Covid-19 pandemic joins already existing deep-seated problems within Zimbabwe’s Health delivery system, broadly emanating from the inherent structural challenges in governance. Endemic corruption has destroyed livelihoods, while the socio-political discourse continues to deteriorate as human rights abuses and dissent are on a high.

The Covid-19 Government Taskforce Chairperson Dr Agnes Mahomva did not seem to panic over the sudden spike and asserted that they knew the numbers were going to increase. Mahomva said to Daily Maverick:

“Initially we were focusing on quarantine facilities and the reason why we are now getting large numbers is because we are testing more people.

“We are doing blitz testing at hot spots like Mbare Musika in Harare and also the city of Bulawayo in order to quickly know what’s happening and how we can strengthen our responses.”

“Numbers requiring admission are small, but as transmissions are going up in communities, we are educating them to take responsibility by stepping up the usual protective measures. Unfortunately, communities and individuals don’t seem to be taking this seriously at all”, said Mahomva.

According to the Ministry of Health and Child Care, on Tuesday 4 August, the total number of confirmed cases stood at 4,221 of which 3,128 are local transmissions while total deaths were at 81 after doubling from just 40 between 28 July and 3 August. From the total confirmed cases, Harare has the highest number at 1,625 while the southern provincial capital of Bulawayo is trailing with 1,065 cases.

The cumulative number of tests since the beginning of lockdown in March is at 124,194 (only 0.8% of Zimbabwe’s population of 16 million) of which 68,194 were Rapid Diagnostic Tests.

Zimbabwe Hospital Doctors Association (ZHDA) vice president Dr Dean Masimba told Daily Maverick:

“It’s unfortunate our healthcare system at the moment is on its knees, there’s really nothing to talk about. We urge the government to now seek prioritising the healthcare system especially now, in the midst of a Covid-19 crisis.

Health workers are on strike and not reporting for duty. It’s a true reflection of how the healthcare system is not functional and it’s time to up our game and save more lives,” Masimba said.

Hospitals rejecting patients

On Monday 3 August, the government warned hospitals against refusing patients with no Covid-19 test results saying:

“All hospitals both public and private should admit all patients without the pre-requirement of a Covid-19 test and proceed to do a PCR test on admission.”

Zimbabwe Nurses Association (ZINA) president Enock Dongo expressed deep concern over the sudden increases.

“Nurses are the frontliners, as far as Covid-19 is concerned. We are worried with the increasing number of positive cases, especially considering that among those that are positive are a lot of nurses. We are begging the government to seriously look into the whole process of Covid-19 in hospitals.”

“Our nurses are not protected. They work in public hospitals without adequate PPE and it’s now dangerous to the citizens because nurses are now becoming the source of infection. They get infected in hospitals, travel using public transport, go to supermarkets… their families and subsequently spread the virus.

“If we fail to protect the health workers, we are likely to see a total collapse of the health delivery system. Government should consider total lockdown especially, as we did in March”, Dongo said.

Problems faced by the health sector and budget allocation in Zimbabwe

On Monday, Zimbabwe’s Treasury released special allocations in Zimbabwe dollars (ZWL) to the most affected cities. Harare received ZWL$10-million (about R1.5-million), Bulawayo ZWL$6-million (R971,000) and Chitungwiza ZWL$2.5-million (R400,000) for the Covid-19 teams. Authorities said the money was intended to “sufficiently capacitate” Covid-19 rapid response teams.

In its 2020 national budget, Zimbabwe’s Treasury allocated ZWL6.5-billion (US$62-million) to the Ministry of Health and Child Care to cater for “infrastructure, personnel welfare, medicines, drugs and sundries”.

The executive director of Community Working Group on Health (CWGH) Dr Itai Rusike, argues that Zimbabwe’s health sector is grossly underfunded compared with neighbouring countries in the region.

“Per capita health allocation in Zimbabwe stands at about US$41. In South Africa, it’s at US$650, Zambia US$90 and Angola US$200. There is an over-reliance on donors due to inadequate public financing of health services in Zimbabwe and this is highly unsustainable.”

“This is being worsened by the fact that Zimbabwe’s nurses’ establishment was last reviewed in 1983, yet the population has since increased significantly”, said Rusike.

The Covid-19 pandemic joins already existing deep-seated problems within Zimbabwe’s Health delivery system, broadly emanating from the inherent structural challenges in governance. Endemic corruption has destroyed livelihoods, while the socio-political discourse continues to deteriorate as human rights abuses and dissent are on a high.

In 2018, cholera and typhoid were declared a national disaster and the outbreak claimed more than 4,000 lives. Many pregnant women have resorted to traditional midwives as the stalemate between government and health workers continues with no end in sight. Last week the BBC reported that 7 babies were stillborn in one night in a Harare hospital when “urgent treatment was delayed because of staffing issues.”

Vice president of the MDC Alliance Lynette Kore told Daily Maverick:

“It’s heartbreaking to lose a child considering the pains and trauma of carrying a child for nine months to no avail. It’s sad that with the current situation, the government has failed to be accountable. Remuneration of health personnel must be of top consideration.”

A complex scenario presents itself as many households are faced with a tough decision whether to stay at home or go out to do business while ignoring exposure to Covid-19.

According to police, since the beginning of lockdown in March, more than 105,000 people have been arrested for violating health measures, but some have accused the government of using the pandemic as cover to crack down on planned protests over corruption.

Zimbabwe’s economy is predominantly informal with official unemployment at above 90%. Some have ignored lockdown measures and continue to conduct business as they survive from hand to mouth. DM

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