Dr Stamps: Poor people’s doctor The attitudes of doctors to poverty matters. In their individual behaviour and in the work of their medical associations, doctors can either contribute to the health of the poor or help to undermine it.
Epitome of caring and devotion to the poor
THIS was the message that was at the heart of one of Zimbabwe's eminent medical practitioner and former health minister Dr Timothy Stamps who died recently at age 81.
There is no doubt to most Zimbabweans and others in the medical fraternity, that the calm and ever smiling eminent doctor, leaves behind a legacy of compassion and unparalleled devotion to the health of the poor.
At the time of his death at a trauma centre in the capital, Dr Stamps was still working in advisory role to the President and Cabinet on health matters.
At best, Dr Stamps will be remembered as an extraordinary person who wanted nothing more than to help poor people access healthcare services for free.
“His whole life, he worked serving everybody and showing a rare devotion to the poor,” said Ambuya Viola Chimhete, an elderly woman of Mufakose.
“When he was still a minister, he was loved by the poor. He cared for them and fought for programmes that positively responded to their needs.”
Despite criticisms from some elements in the medical profession, Dr Stamps was vocal and stood by his principles of promoting health policies that sought to help improve the health care of the majority of the poor. This happened when he was minister of health from 1986 to 2002.
His voice particularly stood out in the 1990s as the World Bank coerced governments to reduce investment in state health sectors in the name of structural adjustment.
This push by the World Bank led to the collapse of public health care services and poor remuneration of doctors.
As a result of the ESAP policies, there was a flight of doctors from the public sector while many dissatisfied patients were driven into the private sector.
This damaged the health of the poor and created a sense that doctors are withdrawing from the care of those whom society excludes - the poor.
The policies killed the elusive goal of “Health for All,” which Dr Stamps firmly believed in.
“His death is a terrible blow to the medical fraternity,” says renowned Zimbabwe biochemist Prof Christopher Chetsanga who still teaches at the University of Zimbabwe Medical School.
“He is going to be missed by everyone. When I used to sit on the Parirenyatwa Hospital Board, I was particularly struck by his unusual keenness to have the poor served and served properly.
“He used to emphasise the need to serve the poor. He was concerned about their health needs and survival as a people. The poor were always on top of his agenda.”
Dr Stamps believed in the welfare of the poor and that if the cycle of poverty and ill health was to be broken, doctors must support access to health care as a universal human right.
This, he firmly believed could be achieved only if communities and governments are committed to paying for health care for the poor and sharing the burden with the rich.
Throughout his medical career right from the 1960s when he was as Deputy Medical Officer for the municipality of Salisbury in 1968 and when he was promoted to Chief Medical Officer in 1970, his stressed the importance of equity in health outcomes.
He always wanted to improve the level and distribution of key health, nutrition and population outcomes that favoured the poor the poor and the vulnerable.
This incensed the white settler regime.
Dr Stamps was dismissed from this last post in 1974 for allegedly trying to switch the emphasis in healthcare provision slightly more towards the disadvantaged black community.
At that time, the white minority only constituted no more than 15 percent of the population of Salisbury, now Harare.
At that time, 60 percent of municipal spending on social services in the city was directed towards meeting the needs of the white minority.
“He was a true profession. He sympathised with poor who had no easy access to healthcare services,” says Prof Chetsanga.
“He was humane, professional and passionate about serving the poor. His work transcended the racial divide. He fought against racism in the medical sector. I have very high regard for him in terms of professionalism and for putting the poor first.”
Adds Dr Max Hove, director of pathology services in the Ministry of Health and Child Care: “Dr Stamps had a far reaching vision of the healthcare system in Zimbabwe for both the preventative and curative aspects.
“As one of his junior doctors in the early 1990s, he personally assisted me to have my pathology specialising studies in the US, approved by the Public Service Commission. The nation is now enjoying the dividends of his vision through improvement of capacity and quality of laboratory diagnostic services in the public sector.
“We will forever cherish his contributions to the health sector in this country.”
A mentor to many of the current generation of leading healthcare professionals, Dr Stamps also pushed for the decentralisation of healthcare services to remote parts of the country.
Under his tenure, a number of rural health-care centres were opened.
This endeared him to the majority of the poor who could not access medical services easily.
“People here loved Dr Stamps,” says Wilfred Mukarakate, of Musami in Murehwa district.
“He was not corrupt and served the poor honestly and professionally. Many lives were saved during his time unlike what later happened when he retired.”
At all levels, at community, city, national and global levels he profoundly influenced the way in which the healthcare sector should operate and save the lives of the poor.
In the medical sector, he also profoundly influenced the teaching, research and practice medicine leaving a legacy that continues to benefit the country's health system today.
Dr Stamps devoted his medical career to serving the poor and paying particular attention to addressing vulnerability that arises from health shocks.
At local level, he always wanted doctors to learn to value the knowledge and skills of poor communities themselves.
Some health professionals hailed Dr Stamps for pushing for evidence - based medicine that could lead to more patient-centred care, rather than reduce medicine to simply the calculating of numbers and milking profits.
“The hallmark of his work was centred on reducing inequalities in the healthcare sector,” says a urologist at Parirenyatwa Hospital, who once worked with Dr Stamps.
“In all his work, he focused more on reducing distance the poor travel to access services, subsidising medical costs and removing conditional treatment of the poor.
“He was against detaining mothers who failed to pay maternity fees after they had given birth.
“Dr Stamps was quite outspoken on this and he also opposed unfair practices of nepotism and bribery in the medical sector.”
Dr Stamps was against all forms of racism and discrimination.
“He could have pursued a brilliant academic and professional career in private practice earning more money, but he preferred to continue working with the new government, striving to improve the healthcare system that favoured the poor,” says another medical researcher at UZ.
Says prominent pathologist Dr Salvator Mapunda: “He should be declared a national hero. He has been a steward in all health welfare issues for the masses of Zimbabwe - in primary healthcare, preventive care, training and research.”
Around 2000, Dr Stamps went to Cuba and secured 127 doctors to help alleviate the shortage of doctors in the country, especially in rural areas.
“I am very impressed at the way the Cubans are so committed to their work and not money. All of them are ready to work in the rural areas,” Dr Stamps once remarked in January 2000.
He also encountered significant resistance over his career to his idea that developed countries carried out “ethnic cleansing processes” by withholding available HIV and Aids therapies from the poor who are the most affected by the disease.
“The question we ask is: Is this merely lack of understanding or a new form of racial discrimination, another ethnic cleansing process? . . . Is this not an offence against human rights, the right to health being one of the paramount, universal rights,” Dr Stamps said addressing the UN Security Council meeting in 2000.
He was also vocal about the role of biological warfare in the emergence of the deadly HIV virus, at times pointing a finger to the Rhodesian anthrax biological experiments targeting freedom fighters penetrating the country from Zambia and Mozambique.
At best, Dr Stamps became known as a man who worked hard to prevent disease, promoting public awareness of the dangers and prevention of tuberculosis, HIV and Aids, malaria and other non-communicable diseases which impacted lower income populations primarily.
Throughout his entire medical career he demonstrated a profound understanding of the social factors of those less fortunate and how they struggled to overcome poverty and the indifference of the upper classes.
He often didn't want clinics and hospitals to charge the poor who had no way to pay for medical services.
In all intent and purposes, he became the “poor people's doctor” developing a reputation as a man who cared and was beloved in those diverse communities dotted around remote rural areas in the country.
“But as for me I don't regard myself as a white person but just as a member of the human race, The problem with white people in Zimbabwe is that they still suffer from nostalgia and the Smith legacy is still alive in the minds,” Dr Stamps once remarked in 2000.
Dr Stamps was born in Wales in 1936 and after qualifying as a doctor in the UK, he came to colonial Rhodesia in 1962 to join its Public Health Service.
He served in various capacities in the medical sector until 1974 when he was sacked for calling for increased health expenditure on black communities in then Salisbury.
After his dismissal, Stamps worked as a doctor in a number of community projects while becoming increasingly interested in development and political activities. He became Chairman of the “Freedom from Hunger” campaign (a UN -sponsored organisation) in Rhodesia.
In May 1976, he was elected to Salisbury City Council.
After independence, he served in various boards and government arms until his appointment as minister of health in 1986.
In the early 1980s, Dr Stamps played an active role mobilising resources from overseas sources to fund the construction of clinics and community hospitals in rural areas, where the effects of war were devastating.
He suffered a stroke in 2001 but remained resilient working as an advisor to government and numerous other institutions.
Dr Stamps will be remembered for championing the initiative to prevent mother-to-child transmission (PMTCT) of HIV, the creation of the National Aids Council (NAC) in 1999 and the establishment of the AIDS levy to help fight the HIV and Aids epidemic.
In 2004, Dr Stamps founded the Dr Timothy Stamps Trust for people living with chronic conditions after being touched by the plight of people living with such diseases.
He died on November 26 this year. He is survived by his wife Cindy, six children and eight grandchildren.