Sunday, 4 July 2021

MASS STAFF EXODUS HITS COUNCIL CLINICS

A perfect storm is brewing in council-run clinics, which are currently plagued by a debilitating mass staff exodus.

Poor remuneration and working conditions, coupled with the huge demand for health personnel in the region and beyond as countries expand their healthcare systems to deal with the coronavirus pandemic, is believed to be fuelling the brain drain.

Harare City Council, which runs 15 health facilities, recently lost more than 300 nurses and midwives. “We are working with a skeleton staff and under such situations, a lot happens. At least 300 nurses have resigned in the recent past,” said City of Harare spokesperson Michael Chideme.

“In some cases, service is compromised while others have to wait for too long to be attended to, if they are attended to at all. The Government is taking over the payment of salaries while we will also chip in where we can.

“We have also resorted to locums (a person who stands in for someone else) with increased allowances and proposed that we have our own training centre to allow for continuity and our nurses to bond. These measures could help improve the situation.”

Healthcare workers are seeking greener pastures abroad while others are joining local private organisations that offer better packages. Most of the health institutions are poorly manned and they offer services to a selected few.

A general nurse or midwife is paid between $15 000 and $20 000 by Harare City Council, while those in the private sector are earning about US$800 or the equivalent ($65 000) at the official exchange rate.

The appetite for trained health personnel has been high abroad, particularly in Europe and America. However, these countries are currently recruiting more workers to cope with the global health crisis of Covid-19.

The continued haemorrhage of critical staff is said to be linked to the deteriorating standards of healthcare at council clinics, including malfeasance. There have been cases of pregnant women being forced to pay bribes to get preferential treatment and assistance.

Also, some patients are having to spend hours queuing to be served. Private health facilities in most high-density areas are considered to be prohibitively expensive as they charge about US$20 or equivalent as consultation fees, compared to US$5 at municipal health centres.

Mai Tafi from Norton knows how unacceptably inconveniencing it can be to unsuccessfully seek emergency treatment at a municipal clinic. She recently sought assistance after her toddler sustained serious burns.

“My child suffered while they (nurses) watched without taking any action. She sustained some burns after a pot . . . fell on her . . . I had to travel to my home area in Norton and eventually she was admitted at Norton Hospital.”

In some cases, the health personnel at the clinics are outrightly rude.

The Sunday Mail Society witnessed a verbal spat between a patient who had tested positive for Covid-19 and nurses at Kuwadzana Polyclinic, who turned him away without advising him how he could manage his condition.

Health workers are ordinarily guided by World Health Organisation (WHO) and Ministry of Health and Child Welfare protocols on how to handle Covid-19 cases. This is meant to prevent further transmissions and adverse health outcomes for patients.

Brian (surname withheld), who worked at St Mary’s Clinic for six years before resigning a few months ago after securing employment in Cyprus, said the working conditions were bad.

“Sometimes we would go for four or so months without salaries. The situation was bad. The patients have no choice, but to pay the little bribes, which will still be far less than what is charged by private surgeries,” he said.

Some desperate patients even end up bribing pharmacies to purchase medication without prescriptions or simply buying drugs on the black market, which might be unhelpful for their medical conditions.

“We have been surviving on meagre allowances for a long time, which makes it difficult for us to travel to and from work or even look after our families. I am owed three months’ salary. Most of our friends are leaving for other countries because the conditions here are really frustrating. If I get an opportunity to leave, I will not hesitate,” said a 34-year-old midwife at a council-run clinic in the capital.

Zimbabwe Nurses Association president Enock Dongo, said there was need for urgent intervention to stem the growing tide.

“Better remuneration is the only option. Most of the nurses are leaving for European countries where health workers are appreciated, be it financially or otherwise,” said Dongo.

“ . . . Let us as a nation learn to appreciate the little good things nurses are doing for us. It has been long since we have tried to engage council. They owe these nurses unpaid salaries from way back. As it stands, we cannot blame the nurses for leaving.”

Some of the few functional polyclinics in Harare such as Highfield, Hatfield, Mabvuku and Mbare have been getting assistance from donors.

Harare Residents Trust (HRT) director Precious Shumba said the lack of access to public health services by most residents was disturbing.

“The pace at which they attend to patients, if they decide to, leaves a lot to be desired. Reports we have indicate the situation is the same and even worse in other clinics.

“There is low staff morale within Harare City Council. The nurses used to have good salaries, but that is no longer the case. They are now trailing their Government counterparts who are earning better money and have better working conditions. We pray the Ministry of Health and Child Care quickly intervenes.”

The Government is in the process of taking over health facilities owned by local authorities as part of a grand plan to ensure standardised service delivery as envisaged by the National Development Strategy 1. Sunday Mail

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