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Demanding cash upfront for medical emergencies costing lives

By Jacob Ngwenya

Many medical facilities in Zimbabwe are demanding cash upfront for emergency health care services and this is making those who can’t pay to pay with their very lives.

Private players in the Zimbabwean medical sector are more expensive and cater for those in the high income bracket.

Sadly, those from low resource settings, that naturally pick public hospitals are further reffered to the private medical centers to access services that are should ordinarily be available in the public sector.

Zimbabwe has an ill-equipment public health infrastructure.

What further complicates the case is that the referring hospitals cease to attend to victims until they purchase some medical resources from the private sector to use at the public hospital.

This scenario leaves the families of patients with two options; to helplessly watch their loved one slowly drifting to the world of the dead or if lucky, the emergency case will grow cold and leave the victim suffering for the rest of their life.

The right to health care is essential for everyone to fully enjoy their lives. The health care services must be accessible, available, affordable, acceptable and of good quality as provided for in Section 76 of the Zimbabwe Constitution.

Section 76 (1)  states that  every citizen and permanent resident of Zimbabwe has the right to access basic health-care services, which include reproductive healthcare services.

Section 76 (2) has provisions that say every person living with a chronic illness has a right to have access to basic health-care services for their illness.

The provisions of section 76 (3)  boldly declare that no person may be refused emergency medical treatment in any healthcare institution.

Despite the boldness in this section of the supreme law of our land, it is vague as to whom is it directed to whether it is directed to the public health sector only or to both public and private sectors as the later is profit based and needs payment mostly upfront.

Section 76 4) implores the state to take reasonable legislative and other measures, within the limits of resources available to it, to achieve progressive realisation of the rights set out in this section of the constitution.

One wonders how this clause which if read together with the Abuja Declaration exposes the government’s failure to uphold its constitution. What the health sector needs is at least 15% of the national budgetary allocation, no matter how little.

This is what any country with a functional health system is allocating to its health sector.

The government has to take positive steps to make sure that everyone will eventually enjoy access to health care. It is only a constitutional obligation that the government has to fulfill but it also speaks to a number of human rights treaties and conventions that Harare is signatory to.

For the right to health care to become a reality in Zimbabwe, the government must put in place policies, laws and resources for the right to basic health care to be enjoyed by all and sundry.

People living with chronic conditions always interface with health care service providers amid the now perennial drug shortages and either unavailable or broken down diagnostic equipment. In some council clinics there is a shortage of basic equipment such as BP machines, thermometers and scales which obviously make diagnosis difficult in the absence of these vitals.

All Provincial public hospitals should at least be equipped with a CT scan machine among other centralized equipment. This is however not the case, which forces people to travel to Harare and Bulawayo for such basic services.

Essential drugs should be availed to those who need them, whenever they need them, especially those of life-long conditions where they have to access medicines monthly. For someone afflicted by about three non-communicable diseases, they are forced to buy medication from private pharmacies which might cost them no less than US$80 per month, for the rest of their life. If they default, this increases their risk of death or disability.

Some specialized health care services like neurological services are centralized in Harare or Bulawayo, with some people failing to get there on time and lose their lives in the process.

Government should at least provide one functional ambulance, with state of art equipment, manned by qualified staff if lives are to be saved.

Most of the available medical insurance schemes have lost their essence of being an insurance to their members when the economy migrated from a multi currency since patients have to pay short-falls for most medical services. People are now forced to go to the public hospitals where they encounter poor service delivery, drug stockouts, lack of qualified medical staff and equipment.

Health care is a human right. Allocating enough resources to the health sector will impact positively the Pandemic Preparedness Prevention and Response(PPPR), and the Universal Health Coverage(UHC) which Zimbabwe was negotiating at the the United Nations high level meetings held in New York recently.

Jacob Ngwenya is a health policy entrepreneur with Beat NCDs Zimbabwe who has wealth of lived experiences in disability, HIV and noncommunicable diseases(NCDs) and dedicates his time to creating an enabling environment for these vulnerable groups to foster the principle of inclusion of people with lived experiences in co-creation, implementation, monitoring and evaluation of policies, programs and services that affect them. He can be contacted on: mobile +263785837994, email [email protected]

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