ZANU PF MANIFESTO ON HEALTH
By Dr Brighton Chireka
We are now about 2 years away from another general election and soon we will be reading manifestos from different political parties. I have started the ball rolling by looking at what we were promised before the 2013 general election. Very few of us and me included read these manifestos but we should read them. They give us a basis to engage with our political parties and also allow us the opportunity to influence things. This only comes if we have a committed leadership that value the contributions of its population. The general public must also be willing to be fully engaged with issues that affect their lives.
A manifesto is a public statement stating your views or your intention to do something. If you feel you should be voted “Most Likely to Succeed,” you could issue a manifesto describing all the reasons why you deserve to win. You’ll most often hear about a manifesto that’s been issued by a group, like a political party or government — for example, a set of new rules that an incoming regime is going to enforce.
It is important to note that manifesto promises are not binding meaning that political parties can decide not to do anything they said they would in their manifesto if they get elected. Political parties have to be careful , because failing to implement certain polices can leave voters feeling betrayed. This can lead to a negative backlash so we hope political parties stick to their manifestos.
Let us look at ZANU PF MANIFESTO ON HEALTH
ZANU PF in their manifesto before the 2013 election stated the following:
Health for all
An overaching goal of the people is the improvement of the health delivery system to attain health for all. This is particularly important in view of the numerous challenges facing Zimbabwe’s health sector such as shortage of skilled professionals and health- care staff, an eroded infrastructure with ill-equiped hospitals or clinics and lack of critical medicines and commodities. As part of its policy of health for all, Zanu PF will address these challenges as a matter of top priority over the next five years.
(g) v 76(1)(2)(3) on Zanu PF’s widely acknowledged promotion of health care for everyone in Zimbabwe which provides that (1) “Every citizen and permanent resident of Zimbabwe has the right to have access to basic healthcare services, including reproductive healthcare services; (2) Every person living with a chronic illness has the right to have access to basic healthcare services for the illness; and (3) “No person may be refused emergency medical treatment in any healthcare institution”.
This is encouraging that the ruling party envisioned health for all and acknowledges that there is staff shortages, ill equipped hospitals and lack of medicines. ZANU PF made a commitment that as part of its policy of health for all, it will address these challenges as a matter of top priority over the next five years. We are now halfway into the five years and it’s the right time to see where we are now.
Staff shortages and welfare of health professionals
Dr Parirenyatwa was reported in the Herald to have said that our health system needs 8000 nurses yet we have 3000 nurses unemployed. I am also reliably informed that we have over 400 medical students doing 4th year this year at the University of Zimbabwe. This means that we are now training more health professionals than in the past . During my days as a medical student our class was comprised of about 80 students only . It’s good to train enough health professionals but the problem is that we may not be able to employ all of them as shown by the crisis we have with nurses . The country need more health professionals but posts are frozen due to underfunding by the government or are based on the population of the 80’s. This need to be addressed as a matter of priority in keeping with the manifesto of the ruling party.
Doctors have been on strike on several occasions asking for their working conditions to be improved. It seems nothing has been done to improve the moral of our health professionals. Some are going for months without their salaries and to expect them to offer a caring service is a joke to say the least .
Not enough resources by Government of Zimbabwe but donor community helping
Monday the 25th April Malaria was Malaria World day and I was surprised to learn about how much the government of Zimbabwe has been putting to fund the management of malaria. It is sad that we are relying on donor funds to run our health system . It is reported that in 2014 the government of Zimbabwe only allocated one million for the management of malaria whilst the donors paid over 17 million .
Malaria is a major health problem in Zimbabwe with 50% of the population at risk, although its epidemiology varies in the different regions of the country, ranging from year-round transmission in the lowland areas to epidemic-prone areas in the highlands. The WHO estimates that there are more than 400,000 malaria cases among all age groups each year.
Zimbabwe has seen robust declines in malaria transmission and disease burden thanks to the dedicated health professionals and the donor community . Today, malaria is the 5th leading cause of morbidity (compared to 2nd leading cause in 2009). In 2013, incidence was reported at 29 per 1,000 (down from 58 per 1,000 in 2009); 351 malaria deaths were recorded (down from 375 deaths in 2009).
Easy access and affordable quality healthcare
It is right that the manifesto talks about access and affordability but is silent on quality. It is still a dream to have free emergency medical treatment. Last week a relatively was involved in an accident and was taken to a government health institute but no treatment could be started until money was paid. I had to read the ruling party manifesto again and it states that no person shall be denied emergency medical treatment. The sad reality is that we are miles away from achieving that and sadly we may not achieve it if no lobbying is done to remind the government of its promise it made to us .
I urge the government , health professionals and patients to work together and deliver a quality healthcare in Zimbabwe. On quality we are looking at three things , is it safe ? Is it effective ? and are patients having a positive patient experience in using the system?. Patients must be at the heart of decision making so they must be consulted fully. We are the patients and we are the ones using these public health institutes so our views matters most.
Committed leadership with patients at the heart of decision making
We have got dedicated health professionals who are currently working on the ground doing a fantastic job. They need good and committed leadership that put the welfare of patients at its centre. I hope that there is going to be more emphasis on clinical leadership and less on political leadership. The people that matters most must also be involved in the shaping of our health care. These are the patients who travel the journey of our health care. We should value them by genuine engagement in decision making. We should adopt the motto ” nothing about my care without me” and ” no decision about me without me”. It is easy to have these policies on paper but if there are not fully implemented then we will continue to suffer as a nation. We are waiting patiently for this manifesto to be implemented so that lives can be saved.
We need to remember that as we eat today and get on with our lives there are thousands Zimbabweans who wish they could afford a single meal , who wish they could afford to buy a tablet of paracetamol , who wish they could raise enough cash to be operated , who wish they could get a visa to go and get treatment overseas, who wish their fundraising efforts are not in vain and who wish to have you refocus and commit all resources to resuscitate our health system.
What can we do ?
Something has to be done to lobby our government. Instead of the war veterans only asking for more personal benefits , they should be asking for more resources to be allocated to the Ministry of Health. Very few of us can afford private health care so we have to rely on the public health system.
I call upon each individual to write to their local Member of Parliament ( MP)and ask them to support Dr Parirenyatwa in having more resources allocated to his ministry . If all MPs support the call for more resources in our health system, maybe we may have more funding. There is power in numbers and the government will listen to the voice of the crowd. If the war veterans as a group are managing to have their needs looked into, then we should also do the same . The same war veterans use the same public hospitals as us so they must join us in our call for more funding.
I also welcome to hear from those within ZANU PF to explain how they are implementing their manifesto and the milestones covered so far. We are in this together as I personal support the vision but I am seriously concerned as I am not seeing us moving forward. I need to see the evidence that we are implementing this manifesto.
This article was compiled by Dr Brighton Chireka, who is a GP and a Former Health Commissioner in South Kent Coast in the United Kingdom. You can contact him at: firstname.lastname@example.org and can read more of his work on his blog at DR CHIREKA’S BLOG
Disclaimer: Some names and identifying details have been changed to protect the privacy of individuals. This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Dr Chireka has used all reasonable care in compiling the information but makes no warranty as to its accuracy. Consult a doctor or other health-care professional for diagnosis and treatment of medical conditions. Views expressed here are personal and do not in any way, shape or form represents the views of organisations that Dr Chireka work for or is associated with