Tafadzwa Mwanengureni
Chenai Gatsi (36) is still traumatised by watching her 3-year old daughter die at Chinhoyi Provincial Hospital after she was diagnosed with diabetes in May last year.
Her daughter unexpectedly became weak and that prompted Gatsi to rush her to hospital.
Three days after her daughter was admitted, Gatsi was told that she had diabetes and she was in a comma.
“My daughter’s condition continued deteriorating and in the evening the doctor declared her condition an emergency. She had to be rushed to Parirenyatwa Hospital in Harare to see a specialist of children with diabetes,” she said.
“The next morning we were supposed to leave early for Harare, so we were moved from the ward to the waiting area. My daughter was on oxygen.
Chinhoyi is 116 kilometres northwest of Harare.
“We waited until after lunch. I then I enquired, only to be told that all 11 ambulances had gone for rehearsals in preparation for upcoming presidential rally. I had no money to hire a private ambulance.
“I was left with no option than watching my daughter battling for her life and in an hour she was gone in front of my eyes. I felt helpless and heartbroken and still I am but there is no one to tell.”
What pains her most is the believe that she could have saved her child if she rushed her to Harare with her own car. She was however told it was not possible because it had no oxygen inside.
Gatsi was stranded because she had no money to hire a private ambulance.
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Accessibility of public ambulances as part of emergency medical services in Zimbabwe has proved to be one of the greatest challenges for patients at public health institutions.
According to the Ministry of Health and Child Care’s 2022-2025 National Surgical Obstetric and Anaesthesia Strategy (NSOAS); “The same ambulances are sometimes used as service vehicles since the hospitals do not have alternative vehicles. This therefore results in delays in transfer of patients, compromised infection control protocols and also reducing the lifespan of the vehicle as it is always on the road. (Include the issue of the terrain)”.
Itai Rusike the Executive Director for Community Working Group on Health (CWGH) told She Corresponds Africa that the emergency services that are provided by the public health institutions in Zimbabwe are weak and poorly resourced, thereby violating the citizens’ right to health.
“Emergency departments are under resourced, without adequate equipment and staff to cope with with the critically ill patients coming to them, including patients who have delayed seeking care until they have an acute emergency,” Rusike said.
“Good quality emergency medical services provide an immediate response to a variety of illnesses and injuries and the treatment and transportation of people in health situations that may be life threatening.”
Gatsi’s story is not an isolated example as many ordinary citizens in Zimbabwe have faced face the same challenge.
Even in Harare, patients have been let down at public health facilities.
In July this year, Lilian Chitongo (30) from Glenwood had to return back home with her mother from Sally Mugabe Hospital after she was admitted for three days without receiving treatment. Doctors wanted a scan done, before treating her.
Just like Gatsi she offered to ferry her mother using her own car for an X-ray and scan but was told the functional ambulance had gone for a call in Mabvuku.
She was told that she could not use her car because a patient admitted at the hospital must be transported by an ambulance.
“The place we found for the scan was just outside the hospital’s gate, but we were told that she had to be ferried by an ambulance since she is still a patient at the hospital. So, I was asked to pay for the ambulance, and it appeared like the ambulance was ready, but after finishing all the paperwork, I was told that we had to wait until the ambulance come back from the call in Mabvuku,” Chitongo said.
She said she waited for hours, to no avail.
The staff that was on duty knocked off while she was still waiting for the ambulance. The institution at which she could do the scan was closed before the ambulance returned.
Left with no option she went home, hoping to do the procedure the next day.
“The following day I was told that the payments I made the previous day expired, so I should pay again. I complied, but after that I was told the ambulance was not there again,” she said.
“For three days we were told different stories, until the doctor discharged her and gave us a date for review, but she couldn’t make it to the day,” she told She Corresponds Africa.
On the review date they were supposed to bring results from the scan and X-ray since they were allowed to use their own transport.
The majority of Zimbabweans rely on public ambulances services in emergencies. But as seen through Gatsi and Chitongo’s cases they are often not available when required.
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This clearly indicate how vulnerable is the ordinary citizens given the country’s economic situation.
Parliamentary Portfolio Committee of Health chair Honourable Daniel Molokele called for the government to invest more on ambulances as the country is facing an acute shortage.
“As things stand right now our emergency medical rescue system needs a complete overhaul,” he said.
“Unfortunately, as a parliamentarian, it is not my duty to buy ambulances, but I will definitely keep the pressure on the ministry,” said Honourable Molokele.
As per the World Health Organization (WHO), there should be at least one ambulance per 100 000 people.
In 2020 Vice President Constantino Chiwenga, who doubled as the Health Minister revealed that there was a shortage of functioning ambulances and that the country had a fleet of 134 ambulances out of 200 that are required.
Gatsi and Chitongo’s cases demonstrate the impact on citizens.
In his 2024 budget allocations Finance minister Mthuli Ncube allocated 9.2% of the budget to health which falls 6% short of the Abuja Declaration of 2001 where African countries set a target of allocating at least 15% of their budget each year to the health sector.
Zimbabwe is among the countries that has failed to meet the target over the years as also witnessed by the 2023 budget whereby the health sector was allocated 11%.
Zimbabwe Ambulances Professionals Association Chairperson Guide Micheal Muwunganirwa said staff recklessness is affecting the system.
“There is some inhumane element with our people, once we receive new ambulances, the available one then succumbs, I don’t know if it’s witchcraft or what. What lacks is the service of these vehicles as some government drivers vandalize these vehicles during personal use which lacks monitoring from the station office bearers,” Muwunganirwa said.
“Some ambulance equipment for public ambulances is being stolen hence replacement is difficult due to unavailability of reports of broken and stolen equipment. Despite all this, these ambulances still providing better services using the available resources.”
His comment concurs the 2021 Auditor General’s Report on Parirenyatwa Group of Hospitals which found only one out of four ambulances functional.
” The Hospital had an aged vehicle fleet, with only four (4) out of the sixteen (16) vehicles functioning. As a result, the Hospital incurred repairs and maintenance costs of ZWL 11.2 million. In addition, the Hospital had only one (1) out of four (4) ambulances which was functional,” reads the report.
Many people are dying because of the failure to be ferried by ambulances on time.
In September, a medical doctor Dr Mthabisi Nembaware died at Victoria Chitepo Hospital after he was involved in an accident on his way from Hauna to Mutare.
He died whilst awaiting for an air ambulance to be transferred to Harare for specialised care as the Victoria Chitepo Hospital lacked functional Intensive Care Unit and city to city ambulance.
Despite the family having raised the required US$ 5 000 to airlift him the plane couldn’t go because Mutare airport does not have working land lights.
Barely a month after Dr Nembaware’s death, musician Gary Mapanzure died after he was involved in an accident in Masvingo. One of the private emergency services refused to airlift him before payments made.
The accident occurred more than three months after the arrival of medical helicopters from Russia, but they both died while waiting for private air ambulance services.
Honourable Molokele said the country needs to station helicopters in all provinces.
“When you have an accident far away from Harare, the chances of you surviving are very low because of the lack of services. It’s very expensive if you hire a private company, so we need to make sure that the helicopters we saw from Russia are put to good use and stationed across the country,” said Honourable Molokele.
Muwunganirwa said air ambulance is expensive to run and to maintain.
“Air ambulance is still for the rich yet it should be for the real emergency,” he said.
“Zimbabwe is yet to provide this service for free, we are not there yet. However, those with cash can have the service.”
Many Zimbabweans cannot afford to hire a private ambulance.
Most of those who are capable to access private ambulances are medical aid holders especially those who pay in US dollars.
However, non-holders endure the agony of delayed assistance in public institutions as they cannot afford the costs.
CIMAS one of the medical aid society in Zimbabwe charges US$100 for ambulance road services around Harare and for areas outside the city its US$150 and above.
Muwunganirwa called for businesses to invest more on emergency medical services.
“Business people sometimes lack vision, we lack donations of such critical area yet we rush to donate on certain needless areas,” he said.
“Imagine donating money to rich musicians rather than ambulances. Who am I to tell them what to do with their finances, that’s why we remain static,” said Muwunganirwa.
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