Do I work in a Hospital of Death? – Response to DailyNews Articles by a Doctor

The 2-part headline stories published on 17 and 18 September 2013 in the Zimbabwean paper DailyNews, a paper with a reputation for ‘telling it like it is’, were entitled “Hospitals of Death “ and “Health Horror”.

The articles were describing the failure of medical service delivery in the two top government hospitals of Zimbabwe; Parirenyatwa Hospital and Harare Central Hospital. 

The political editor, Thelma Chikwanha, who wrote the article about Harare Hospital, mentioned overcrowding of mothers who have just delivered babies, bad attitude of staff, lack of warm water or heaters, long-waits in the outpatient department, heavy charges for investigations, doctors sending patients to their private wards, neglect and misuse of funds by hospital administration.

Did I miss anything?

Although many people felt that these pieces were displaying good journalism - finally exposing the essential elements of human suffering by the generality of Zimbabweans, I felt they were sensationalized and misinformed. Whilst it was good for her to highlight the plight of the people and massive challenges at our hospitals I think this is a very complex issue.

I am a doctor who works at Harare Central Hospital and as I read that article I couldn’t help but feel the blame-game ebbing its way into my veins. Medical services are far from perfect. Far from average even but the root cause is multi-factorial.

Attacking health-workers who have stayed to work in a failing system despite the working conditions, very poor pay compared to anywhere else in the world and overwhelming doctor-to-patient ratio is pointless. Doctors are not politicians. We are not journalists. You may never know how hard doctors work to make a plan for every single patient they encounter, going out of their way, even into personal funds to cater to the needy patients. Just the other day 2 heaters were donated by medical personnel in the Children's Ward. For every story printed about how a patient has succumbed due to perhaps unavailability of diagnostic investigations, there are a hundred more of patients who have been saved by tireless work put in by these government doctors being accused of all sorts of unethical practices. The media has the advantage of being seen and heard which is why it is their responsibility to represent the facts holistically.

"KuGomu"

But what really is the problem? A popular Zimbabwean blogger explains that the media encourages people to believe and demand free health.

“The people think that free health is possible, in reality nothing is for free. Someone somewhere has to pay,” he states. 

It is a fallacy to believe that the government can offer free health funding. It is impossible. If 85% of the population is not formerly employed it means 15% has to pay for them. How do u explain a woman who decides to get pregnant for 9 months and fails to raise 50 dollars user fee in 9months then goes on to have 5 kids under similar conditions? Or a 75yr old with a pig farm or company demanding free health? Or a man who drinks alcohol daily and is not on medical aid (cheapest 3dollars a month)? Overall the responsibility is with the people. It is the responsibility of government to help but not give handouts. The media should educate the lay-people; tell them about alternative funding not encourage to expect free health. Lastly it is the responsibility of the individual to plan. We all dream of buying car, plan to build houses, save to go to school, marry, have kids; but how many plan for a day of ill health? Why is it compulsory to pay car insurance, radio and TV licence, alcohol tax but not health insurance?

It is important for the media to highlight on health funding and how it works and the models which would be suitable for this society.

Digital Pathology Equipment - available but expensive to maintain

There really is no institution in the public sector in Zimbabwe which has access to all the required resources, in the form of equipment and manpower. This is not news. 

Most doctors in this situation either fight or flee. My colleagues and I have decided to fight; with our knowledge, time and skills. The goal is health for all Zimbabweans. It is everyone’s responsibility, not just the government, as most people find easy to blame. The media needs to build up and explore ways of communicating these needs with positive suggestions for the situation to change for better. Messages of disease prevention and creative developing country innovations may do more in educating the people. The people need to take charge of their health by seeking medical care early and not leaving things too late when very little can be done. The government really needs to reconsider increasing funding in the health ministry which would be directed to the hospitals so that they are fully functioning and salaries of health workers which would motivate them and increase morale. And doctors working in neighbouring countries and abroad need to come back and save their own people.

Let's improve health of Zimbabweans together. I’m in, are you?