As healthcare soars, the inequality gap widens

By Charles Kautare

 “Pregnant woman dies of negligence at Parirenyatwa.” This was one of the most disturbing headlines carried by The Herald on 5 September 2019 as it was reported that a pregnant woman died together with the child at Parirenyatwa Hospital allegedly due to negligence by medical staff manning the maternity ward. It is frightening that the unfortunate incident happened at one of the biggest public hospitals in Zimbabwe.  What then do we make of public health service delivery in a country aiming at becoming an Upper-Middle Income Economy 10 years from now? The story was not only heart-breaking but signaled the extent of inequality in the country’s health sector as no case of any member of the elite cluster was reported to have died at a local hospital due to negligence. The inequalities can be highlighted by the circumstances surrounding the death of the former president, Robert Mugabe who took his last breath in a world-class Gleneagles hospital in Singapore yet the poor die at local “death traps.” Currently, some government officials are criticised for seeking medical attention in foreign lands instead of them resolving the ills associated with the sector at home. 

As the 1% of the world population is gathered in Davos for the World Economic Forum, Zimbabweans must reflect on the inequalities in the country’s health sector. The current healthcare delivery system in Zimbabwe leaves a lot to be desired. The Southern African country’s health sector is in limbo, characterised by a shortage of drugs and basic medical necessities like gloves as well as incapacitation of the medical personnel that has witnessed an unresolved impasse between the government and public hospitals medical doctors. There exists a widening gap between the rich and the poor in terms of access to quality healthcare such that the former, because of their financial and mostly political muscle can access world-class healthcare even for a simple procedure such as a blood pressure check outside the country whilst an ordinary poor citizen is left to die at public hospitals. 

It is regrettable how the poor and the marginalised are succumbing to treatable and Stone Age diseases like cholera and typhoid due to the dilapidated state of the public health delivery system. Maladministration coupled with corruption has not spared the sector and this can be exemplified by the recently exposed rot at the country’s drug procurement and supply entity, National Pharmaceutical Company (Natpharm) where for instance drugs meant for public consumption were diverted for private gains at the expense of the poor.

PPPs not ideal for the health sector

Despite the commonness of Public-Private Partnerships in the health sector across the globe, their effectiveness is yet to be realised in as far as Zimbabwe is concerned. The most worrying issue is that the initiative is perpetuating inequalities in the health sector to the extent that the poor are finding it difficult to access basic essential services that would have been put under private care. A case in point is the privatisation of medical services at Chitungwiza Central Hospital, where almost all the essential services at the hospital were privatised, for instance, mortuary services are now run by Doves, pharmacy and radiology services are run by Baines Hospital. To what extent does Chitungwiza Hospital remain a public hospital when the critical services are left in the hands of private players to the detriment of the poor who are wallowing in abject poverty and cannot afford these services? The argument that PPPs enrich the capacity, quality and reach of public health services, therefore, remains a fallacy. 

The fight against inequality must never be a once-off endeavor but a never-ending process in our lifetime and for generations to come until responsible authorities and everyone else appreciates the fact that equality is a virtue for human existence. A healthy nation is a productive one. It is therefore critical for the Government of Zimbabwe to put in place policies and measures to resuscitate the ailing health sector to ensure that quality healthcare is guaranteed to all and sundry in line with Chapter 4, Section 76 of the Constitution. If the inequalities in the health sector are not addressed at national levels across the globe, Sustainable Development Goal 3 of ensuring healthy lives and promoting wellbeing for all at all ages will remain a pipe dream.

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