Stir The Pot Lessons from COVID-19, cholera pandemics
ZIMBABWE since the turn of the century, 2000, has experienced three public health pandemics. Twice it suffered the full brunt of medieval diseases — cholera and typhoid in its urban areas and currently is battling the global COVID-19 pandemic. However, the leaders have not learnt anything and the public health system is still the same with minimal funding.
There is a common saying attributed to Talleyrand about the Bourbons when they were in exile. It reads: “Ils n’ont rien appris, ni rien oublié. (They have learnt nothing, and forgotten nothing.” This quotation may be precise to Zanu PF leadership, particularly after it embraced neoliberal economic policies in 1990 by embarking on the ill-fated International Monetary Fund-sponsored economic structural adjustment programme (Esap).
Zimbabwe’s public health system, then one of the best in Sadc, started collapsing and survived on the benevolence of donors and development partners. Annually, donors and the private sector carry the burden of supporting health delivery. This was made clear in an incident in Mount Darwin on Thursday. Presidential spokesperson George Charamba tweeted about the opening of the Karanda Bridge and how it will assist people access health services at Karanda Mission Hospital.
“His Excellency the President (Emmerson Mnangagwa) in the Nyakasikana area of Mt Darwin where he is set to launch the Karanda Bridge. This 300m bridge straddles Ruya and links Mt Darwin, Rushinga and the rest of the country to the legendary Karanda Hospital which has become a subregional medical facility, in recognition of its varied competencies in handling different ailments.
“President revealed his keen interest in capacitation of Karanda Hospital, hinting he will fundraise for its capitalisation once the Health and Child Care minister (and Vice-President Constantino Chiwenga) draws up a priority list with the Evangelical Church who are the owners of the iconic hospital,” he tweeted.
It is interesting that medical superintendent doctor Paul Thistle has been in Zimbabwe for over 20 years. He started at Howard Mission Hospital in Chiweshe and is now at Karanda Hospital. He has dedicated his life to help the poor communities even if he could live better in his native Canada.
It is noteworthy that Mnangagwa through Charamba described Karanda as “iconic”. Karanda is not iconic because of its buildings. It is iconic because of the services it offers that are now a rarity at State-owned public hospitals. Zimbabweans feel safer to traverse the country to get good service at Karanda than provincial hospitals with empty shelves and uninterested staff.
Cholera and typhoid are a result of poor hygiene. Major urban centres in Zimbabwe have been struggling to supply potable water to residents. Many have turned to digging unprotected wells or fetching the precious liquid from streams. The cities and towns have not built any new water infrastructure and these diseases remain a threat, a ticking time bomb.
The central government has failed to adequately fund the health delivery system. It has over the years politicked about universal healthcare and Mnangagwa in in his 2018 manifesto promised affordable healthcare. Getting into the third year of his term, Mnangagwa is still to deliver on that score.
International Labour Organisation (ILO) in a 2008 paper titled “An ILO strategy towards universal access to health care,” said: “Social health protection coverage also reduces the indirect costs of disease and disability, such as lost years of income due to short and long-term disability, care of family members, lower productivity, and the impaired education and social development of children due to sickness. Hence it plays a significant role in poverty alleviation.”
It is in line with the above international standard that last week the National Social Security Authority (NSSA) decided to start offering medical facilities for pensioners. This falls short of universal standards because it is only targeting pensioners, and yet all the young formally employed have to pay for healthcare. This is a discussion that should be held here and now, since NSSA is sitting on a pile of cash and some useless investment portfolios.
The pandemics have shown how precarious Zimbabwe sits. They have also revealed how dependent Zimbabwe is on donors in the area of healthcare. They have also proven that the rich will build their own health silos during pandemics. During the ongoing COVID-19 pandemic, two new private health facilities owned by Sakunda Holdings were immediately approved as COVID-19 centres.
The rich did not have faith with City of Harare’s Wilkins Hospital or the biggest referral hospitals — Harare Central and Parirenyatwa. The class division was further widened and thanks to mother nature, no major disaster happened among the poor.
Healthcare is a human right. Cuba, despite being under the United States economic embargo for over 60 years, it has built a health system that is the envy of many in the developed world. Even the Barack Obama administration fought hard to give Obamacare against embedded capital in the US system.
In Europe, the United Kingdom has had the National Health Services since the 1950s, yet they are a capitalist economy. These examples were cited to show what universal healthcare is. It is important that Zimbabweans engage in a frank debate about universal health insurance and improvement of water and sanitation not only in urban areas but also in rural areas.
We remain in danger as Zimbabweans if the Mnangagwa administration does not change course on public health funding, creation of a sustainable universal health insurance and improving the water and sanitation projects.