Kadzire, a mother of two, is accompanied by her sister and
aunt lest she encounters danger on her way to Chiwenga Clinic, which is several
kilometres from their village in Mudzimu.
She intends to barter trade her millet for healthcare
services.
Resorting to the age-old barter trade is helping hundreds
of villagers who cannot afford paying cash or are uninsured at local clinics in
most parts of Muzarabani district.
While it is government policy to provide free maternal
health services, most public health facilities across the country are charging
a “nominal fee” to keep them going.
Given the country’s general poor economic performance
coupled by the ailing agro-industry, healthcare facilities in Muzarabani have
turned to barter trade as a stop-gap measure for the down-trodden villagers.
Although historically barter trade was common among
villagers, it was unusual for government services to be paid with grain,
chickens or goats, among others.
“Some of us don’t have the money that the clinic might
require, so they ask us to bring grain in order to get medical assistance,”
Kadzire said.
“I think that way, it makes medical services affordable for
most of us because in these communities, the currencies in circulation are the
United States dollars and the Mozambican metical.”
Chiwenga ward is on the fringes of Zimbabwe’s border with
Mozambique and the clinic also serves a number of patients from across Tete
province in the neighbouring country.
According to a poster on the walls of the clinic, one can
get medical assistance after parting away with a gallon of sorghum/millet or
two gallons of maize.
The clinic’s sister-in-charge Vimbai Muguti confirmed to
NewsDay that they were bartering because most villagers were struggling to get
cash.
“We realised most of our patients have grain and do not
have cash, so we ask them to bring grain,” she said.
“We collect the grain and resell it in bulk. The money is
used for the day-to-day running of the clinic.”
Chiwenga health centre committee chairperson Israel Mutombo
said the idea of bartering was meant to cushion both sides — the patient and
the health centre.
“It was the idea of the committee after realising that
things were not looking good and we wanted to keep our institution going,”
Mutombo said.
“Our clinic faces a number of challenges ranging from
furniture to resource constraints due to the big catchment area that it serves.
Some people would die at home or they sold their livestock for a song to raise
that nominal fee charged by the clinic and we decided to barter to cushion
them.”
Many villagers are now seeking help at the clinic ever
since the introduction of bartering.
However, the health centre, which caters for close to 7 795
people in Muzarabani’s wards 23 and 24, as well as parts of Tete province in
Mozambique, faces a number of challenges.
“Our catchment area is too big for such a small health
centre and this strains the resources we have. We also need an ambulance to
ferry patients to the referral hospital at St Albert’s, a hundred kilometres
away. We have received a lot of support on malaria programmes, but as a
community, we should also act in curbing such diseases by properly using
mosquito nets and also filling up gullies where mosquitoes breed,” Mutombo
explained.
Muzarabani North legislator Zhemu Soda (Zanu PF) said
efforts were being made to decongest the health centres by setting up health
posts across all wards.
“Our clinics are few and people have to walk long
distances, so as government, we are building what we call health posts in the
wards. For instance in Kairezi ward, we have a health post that is almost
complete,” Soda said.
“The idea to decentralise health service is meant to ease
pressure on the few clinics that we have in the constituency. The other problem
is that Muzarabani does not have a district hospital and very sick patients are
referred to St Albert’s, which is owned by missionaries. We are contemplating
building a district hospital at Muzarabani centre to cater for referred
patients from this part of the district,” he added.
Community Working Group on Health executive director Itai
Rusike said the policy of free public sector healthcare at rural clinics was
still in force.
“Pregnant women, children under five years and adults over
65 years are also fee-exempt up to district level,” Rusike said.
“Poor people have, thus, faced a variety of de facto cost
barriers such as transport costs, private purchases of medicines due to drug
stock-outs and non-functioning exemption schemes. Barter trade for health care
using grain will create serious logistical challenges to the health facilities
and the communities in terms of costing, storage and accountability.
“The advent of the new Constitution means that the
government of Zimbabwe, as the guarantor, must commit to health as a human
right and mobilise domestic resources to fund a health benefit that is
accessible to all.”
Rusike also pointed out that there has been a shift in the
region towards abolition of user fees, with evidence that this was proving more
successful when accompanied by increased investment in primary and district
level services.
Defence and War Veterans Affairs minister Oppah
Muchinguri-Kashiri bemoaned the obsolete equipment and furniture at Chiwenga
Clinic.
“Please Honourable MP [Soda], you need to mobilise
resources, especially furniture and equipment for this clinic because what I
saw in the maternity ward is not pleasing at all,” she said. Newsday
0 comments:
Post a Comment