Feature International Health

Zimbabwe’s health challenges

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b930 (Published 16 March 2009) Cite this as: BMJ 2009;338:b930
  1. Ryan Truscott, freelance journalist
  1. 1Harare
  1. truscottryan{at}hotmail.com

    With the formation of a unity government in February, Zimbabwe is hoping that years of crisis and mismanagement are finally over. But rebuilding the country’s shattered health system will be a mammoth task, as Ryan Truscott reports

    The much publicised cholera epidemic that has killed nearly 4000 people and infected 88 000 since August has highlighted the dire state of Zimbabwe’s health system. Once the envy of the southern African region, Zimbabwe’s public hospitals are now often little more than stripped shells. Harare’s Central Hospital closed down its intensive care unit six years ago, and lack of food, drugs, and equipment forced the closure of the children’s ward in October.1 Patients lucky enough to find a functioning hospital to admit them have reported being asked to bring blankets, food, drips, and bandages. Some rural clinics do not even stock paracetamol.

    In the past few years doctors and nurses have repeatedly gone on strike over wages, which often fell below $10 (£7; €8) a month. Many have joined the steady exodus of professionals from the country, seeking employment in neighbouring South Africa and further afield in Europe and the United States: 10 000 Zimbabwean nurses are employed in Britain alone and 80% of medical graduates are working abroad.2

    Doctors and health professionals still working in Zimbabwe echo new prime minister Morgan Tsvangirai’s plea for outside help. Mr Tsvangirai has told donors that Zimbabwe needs $5bn for reconstruction.3 A large portion of that would need to be spent on health. But local officials say much more than just money is called for.

    Bringing back health workers

    It’s not hard to see why so many health workers have left, says Geoff Foster, the provincial paediatrician for eastern Manicaland province. His December salary came to less than …

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