Regina Pasipanodya
Themba Moyo (37) desperately gazes at the faded photograph of his mother during her happier days when laughter was common at their home.
The happy years full of laughter are however now a distant memory.
Moyo works as a caretaker at a farm in Mavise in Midlands province, 193 kilometres from Harare.
His mother was recently diagnosed with stage two cervical adenocarcinoma a very rare type of cancer at Parirenyatwa Hospital. Before the diagnosis she was in agony for almost two years experiencing backaches and irregular bleeding.
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“Although doctor consultations were free of charge, my mother was referred to go for a biopsy, ultrasound, and CT scan which needed about USD560 in total. The tests were done at private institutions since public hospitals do not have the equipment. However, due to my poor earnings, I am failing to raise money for her treatment,” Moyo told She Corresponds Africa.
Cervical cancer can be cured if diagnosed at an early stage and treated promptly. Moyo’s earnings are however far from being enough to save the woman who gave him life.
“I earn peanuts. I cannot even afford basics let alone pay for the hospital bills for my mother,” he said with his eyes full of despair.
Moyo is one of the domestic workers in Zimbabwe whose earnings have become worthless—a mockery of survival.
In 2022 the Labour Employment Regulation of Zimbabwe gazetted that a gardener is entitled to ZW$10 000 a month, but, due to the ever-rising inflation in Zimbabwe, this meagre salary is not enough for anything considering that at the prevailing rate, the amount is less than a USD1.
The struggle of Zimbabwe’s healthcare sector.
For decades Zimbabwe’s economy has been caught in a relentless tempest of hyperinflation, with prices rising far faster than salaries. This include healthcare fees.
Moyo feels that the government of Zimbabwe has failed him.
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The World Health Organisation (WHO), regards cervical cancer as the fourth most common cancer in women globally with an estimated 604 000 new cases and 342 000 deaths in 2020. The highest rates of incidence and mortality are in low- and middle-income countries. They have been attributed to lack of access to national HPV vaccination, cervical screening, treatment services among other socio-economic determinants.
Vaccination, screening, and treatment can be done in Zimbabwe, but the economic downturn has militated against this. Cancer patients are often forced to pay for treatment and tests at private health institutions.
The healthcare system in Zimbabwe has been inadequately funded, which has far-reaching implications for both public health and the overall economy.
In Zimbabwe, surgeries for cleft, tuberculosis, cancer other chronic diseases, medication for the elderly, children and pregnant women and other patients referred by social welfare should be free but due to the underfunding, patients have been struggling to get treatment.
A healthcare professional from the Ministry of Health and Childcare who spoke to She Corresponds Africa on condition of anonymity for ethical reasons painted a gloomy picture of Zimbabwe’s state of preparedness for cancer treatment at government facilities.
The official attributed the challenges to the referring hospitals’ inability to purchase consumables needed for medical procedures due to a lack of funding.
“The nation once had five specialized cancer therapy equipment. Two were at Mpilo Central Hospital in Bulawayo, and three were at the Parirenyatwa Group of Hospitals in Harare.
“However, they are all broken down,” said the official.
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This sorry state of the public healthcare sector has disadvantaged the poor who cannot afford the exorbitant fees charged at private institutions.
Private hospitals charge between US$45 and US$200 for a biopsy, about US$400 for a CT scan and between US$80-100 for an ultrasound. Surgery costs around US$2000.
Mavis Jonasi (71) from Kuwadzana, in Harare has also suffered the consequences of the crumbling healthcare sector.
She has been diabetic for more than 15 years. Over the years, she has been getting her monthly prescriptions glibenclamine and metformin tablets and insulins at a local clinic.
Jonasi is a widow.
She has been living on US$25 from NSSA and US$100 from her two rented rooms in Kuwadzana. This is however not enough for her to have basics as a senior citizen in Zimbabwe.
“Considering that at this age I must receive free medical services, I have been facing challenges of not being able to get all my medication at our local clinic due to lack of drugs. I should always have my insulin but I end up buying those from the pharmacy at US$15, US$3 for glibenclamine, and US$45 per flexpen for insulins and use more than 3 doses per month since there won’t be any at the clinic,” she said.
Health and Child Care Hon Douglas Mombeshora admitted drug shortages were severe while making submissions at the pre-budget seminar in Parliament last year. He said Zimbabwe is facing a serious shortage of medicine and drugs at public hospitals which has left patients at the mercy of private health facilities.
“Our ministry acknowledges that the country is facing a serious shortage of medicine and drugs, which is culminating into a crisis, especially at the lower level, and has left patients at the mercy of private hospitals,” said Hon. Mombeshora.
“We do not have enough drugs for even a month in our stores and allocations are not in line with the ministry requirements.
“For instance, we made a request for US$129 million for 2023, but the Treasury responded by reducing the budget to US$52 million and you can see the gap.
Hon. Mombeshora said the ministry requires approximately US$17 million worth of medicine per month.
How health sector performance affects economic growth
During the engagement meeting between the Parliament of Zimbabwe’s Portfolio Committee (PPC) on Health and the Zimbabwe Coalition on Debt and Development (ZIMCODD)-a socio-economic justice coalition, the Ministry of Health and Child Care’s Health Financing and Expenditure Tracking in Zimbabwe report highlighted that the government of Zimbabwe increased health funding from Zw$117million in 2020 to an average of Zw$463 million over the 2021-2023 period which shows commitment in increasing domestic funding for health.
However domestic budgets has been vulnerable to inflation and exchange rate volatility.
The report further highlighted that Zimbabwe is regarded as a lower-middle income economy which according to the World Bank classification of income ranges from US$1 046 to US$4 095 based on 2020 gross national income (GNI) per capita per annum.
However, presenting the Health Expenditure Oversight and Accountability report on the same occasion, an advocacy consultant, Diana Mailosi explained to the legislators that the government should take note of the important link between the public healthcare sector and economic growth in a country.
“When the health sector is performing well there is economic growth, however, Zimbabwe government expenditure on health has been standing at US$40 on the day of the budget presentation but in reality, it could be far less than that compared to other lower-middle income economies like Lesotho which has an annual health expenditure of US$124 per person,” said Mailosi.
A local economist, Esther Mapungwana shared the same sentiments highlighting that human capital has always been the critical component of economic growth.
“Human capital is serviced by health facilities is important to note that every person falls sick and when they are sick the economic productivity will be disturbed. This means that for the economy to perform well, human capital should be well and fit.
“This Zimbabwean situation has been complex, considering that the status of lower-middle income is given to a country due to its foreign trade on the international map, then the country is regarded as the lower-middle income country based on figures. However, the challenge is that the foreign currency flows in Zimbabwe have not been servicing the whole population but only a certain group of people who are involved in illicit funds. This means that although the country is seen internationally moving stake of USDs, in reality, there are inequality gaps in terms of wealth. That is why Zimbabwe has been ranked lower-middle income economy with the worst performing economy due to severe corruption,” Mapungwana told She Corresponds Africa.
Midlands proportional representative MP for Zanu PF, Hon. Tsitsi Zhou requested the Ministry of Health to establish health posts considering that about 6600 posts are required across the country.
In an interview with She Corresponds Africa, Zvikomborero Sibanda Zimcodd Economist highlighted the need for the government to make healthcare expenditure because of impact on the economy.
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