Zimbabwe Health and Medical Care
State and private health care has been drastically affected by the years of economic crisis. Because of institutional mismanagement, treatment options have deteriorated in rural areas; There was also a lack of medication in cities. Because of extreme workloads and low or no wages, many well-trained doctors, nurses and carers migrated to South Africa or Europe after 2000.
In spite of the national health strategy, which has a comprehensive and integrating claim, the supply differs in individual provinces – as in many other sectors, the west of the country is particularly disadvantaged. Desperate sick people or their families seek help in some places from traditional healers or Pentecostal churches, but they expect financial compensation. The situation of disabled people is particularly problematic.
The mentally ill and people with mental health problems, the reasons of which include HIV and economic poverty, are largely dependent on help from civil society. Some non-governmental organizations advocate the right to health and concrete situation improvements.
International development organizations and donors, including the European Union, finance the majority of the public health system, for example through the Health Transition Fund with 436 million US dollars from 2010-2012. Since 2003, Zimbabwe has also received US $ 707 million from the Global Fund against AIDS, Malaria and Tuberculosis(In 2020 it was not enough. According to philosophynearby, the international funds were not enough. Nevertheless, the government continued to cut the state health budget, most recently to 22 US dollars per citizen, only a tenth or even less compared to neighboring countries. The state clinics received According to media reports, only $ 25 million for surgeries, although they were already in debt of $ 33 million to suppliers of medicine and hospital equipment, and in 2016 the clinics were paid $ 53 million, according to media reports allocated from the national budget to carry out operations. They applied for $ 303 million. International development organizations paid 147 million US dollars. In 2017, a large part of the funds for the health care system came from international donors. The nevertheless small health budget has not met the requirements of the African Union for years. In the national budget 2018, the share of GDP for the health budget was estimated at 2.1% (there are some different figures), the share for the military and the state security apparatus over 6%. Also in the 2019 budget, this unequal distribution continued: The health sector was granted a total of only 694.5 million US dollars, despite rising inflation, according to media reports. According to medical experts, at least 1.3 and 1.5 billion US dollars would have been necessary. The structural deficiency affects the entire health sector and drug access. The extensive financial aid from international and bilateral donors and companies during the 2020 corona pandemic did not remedy the structural deficiencies and crisis in the healthcare system.
After a massive corruption scandal, there was a change at the top of the Ministry of Health. The previous health minister, Obadiah Moyo, was dismissed at the beginning of July 2020, and Vice-President Constantio Chiwenga took over the office at the beginning of August 2020, which has been criticized by civil society organizations for legal, political and labor law reasons. In 2018 Chiwenga fired around 16,000 striking nurses because of their very poor pay. protested the lack of equipment in the hospitals and the resulting structural obstacles to work. Nurses were arrested in early July 2020 who protested over the lack of protective clothing and their very poor pay (less than $ 50 a month).
Because of the desolate water and sewage supply, cholera broke out in 2008/2009, killing around 4,000 people. According to the World Health Organization, around 31,000 people contracted cholera in 2008, compared with 66,000 in 2009. In September, October and November 2018 there were cholera outbreaks in different parts of the country with several sick people and over 50 dead. Typhoid fatalities are also repeated locally, 4900 in the period 2011–2012. The Ministry of Health put the number of typhoid fatalities between January and November 2013 at 1,472 and cholera deaths at 423. Human Rights Watch and health care workers assumed the numbers were much higher, with 3,000 cases of typhoid alone recorded in Harare in 2013. Malnutrition, measles, malaria and tuberculosis are also common diseases. In 2018, over 50 people died of cholera in Harare and more than 10,000 fell ill. In the first half of 2019, the number of typhoid cases in Harare was put at over 850, the cause was the inadequate supply of clean drinking water. In June 2020, 13 people died of typhus in Bulawayo, 1500 sufferers; contaminated drinking water was the cause of these deaths and illnesses. Since sewer pipes broke open at the beginning of August and the sewage ran openly through densely populated city districts, these infection and disease problems persisted.
Depending on the statistical source, there are 0.07 doctors and 1.35 nurses per 1000 people. In 2015 some statistics assumed 1.6 doctors and 7 nurses or midwives for 10,000 people. They then have to take on complicated tasks, especially in rural areas. Nationwide, the number of specialists and surgeons is limited to individuals. Again and again, overworked nurses in poorly equipped clinics stop their work in protest against the unbearable working conditions and structural deficiencies in basic medical care. Nurses and doctors protested in November and early December 2018 again because of the difficult working conditions, mass layoffs were the government’s response. In September, October and November 2019, doctors at state hospitals struck again, partly because of their low salaries, which are barely enough to make a living due to the rapid inflation. They also turned to the World Health Organization for help. Here, too, the government reacted with numerous layoffs. In mid-September 2019, a representative of the doctors’ interests was kidnapped by state security forces and only released days later after many protests. His subsequent treatment in South Africa was delayed by the police and had to be legally enforced.
The supply problems in the health sector mainly affect the impoverished female population due to their own illnesses and gender-specific role assignments to women as carers or those responsible for the health of children and the elderly. According to the World Bank, the fertility rate was 3.8 children per woman in 2015; statistics currently estimate it to be 3.63 children per woman. The maternal mortality rate was 242 in 2017 (depending on the statistics even 525) for 100,000 live births and 651 per 100,000 in 2019 – sometimes there are also different numbers. Many poor pregnant women and young mothers find it difficult or impossible to pay the fees demanded by hospitals.Malnutrition and malnutrition are a burden not only to adults, but especially to children. As a result, 29.4% of children under the age of 5 already have growth and health problems. According to UNICEF, the mortality rate of children under five was 54.6 per 1,000 live births in 2019, according to the World Health Organization (WHO) it was 32.14% for newborns and 67.86% for toddlers under 5 years of age. The situation of handicapped children is also problematic, especially when they become ill.