Friday, January 12, 2007

Zimbabwe: health care in a tailspin

Observers of southern Africa have noticed two major factors that are negatively affecting development in the region. One is a deadly virus: HIV/AIDS. Another is a devastated country: Zimbabwe. The latter has devolved rapidly from breadbasket to basket case over the last two decades: life expectancy, a standard measure of human development, has plummetted from nearly 62 years in 1990 to around 37 years for men and 34 for women in 2006. According to the UN Food and Agriculture Organization, Zimbabwean women currently have the lowest life expectancy of all humans in the world. Naturally, the Zimbabwean government denied the validity of the statistics, and expressed its displeasure by cancelling a crop and food survey designed to assess the country's needs and avoid famine. Nothing new there: they rejected life expectancy figures back in 2001 too. Government denial seems to be growing in inverse proportion to the GDP.

How does this downward spiral play itself out within the Zimbabwean health care system? There are statistics that can be trotted out, but a piece today from the Zimbabwe Independent puts a human face on some of the inhuman conditions unfolding there. Junior resident doctors, grossly underpaid, terribly underequiped and with little promise of future employment, are on strike in order to leverage better working conditons. The more it is described, the more you can sympathize, until you witness the effect of the strike on the patients:

A junior resident medical officer stands in the consulting room doorway. He alternates between bobbing his head to register comprehension and twiddling with his stethoscope, while the younger son of a patient pleads: "He has been a regular patient here and has his medical records with him, please doctor."

He is one of the few striking junior doctors who decided they should only attend to emergency cases on a rotational basis.

A few paces from the doorway, the pleading man's brother tries to suppress spasmodic jerks from a languid body slumped in a wheelchair.

The sick man tries to draw his son's head down to tell him something, but the groping hand collapses into his lap in vain.

Moments earlier, the emptiness of the admissions ward at Harare Hospital had echoed with the tearless wail of a middle aged woman who had stomped out, too shocked to witness the tear-jerking spectacle of an equally disposed relative.

"The doctor says he cannot help," the son reports back to a group of relatives huddled in a corner.

What does medical ethics come to when medical practitioners are abandoned by their own goverment, and patients are abandoned by both?


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