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
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