The dilemma of Zambia’s health care system

Tue, 30 May 2017 10:36:50 +0000

By Simon Mwanza

STORIES of health personnel ill-treating patients are overflowing in Zambia and there is absolutely nothing to suggest that the picture will change any time soon.

It has become crystal clear that no matter how good the training or the trainee, returning such individuals to a system that is hostile to practitioners’ desire to act ethically and professionally still remains a big defy.

Some schools of thought have admitted that the health professional actually faces two totally conflicting orders.

To have the characteristics of doctor, nurse, etc, he or she must be both inhuman and human; a device made of steel that has no empathy, and a person made of flesh that feels and emotes.

But the story of a mother who died at Lusaka’s Chilenje level one Hospital last Friday due to sheer negligence of medical personnel did not come much as a tremor because such events have been allowed to go on for years by those charged with the responsibility of providing quality health services to Zambians. It is not witty either.

For some of you who may not know, at the time President Edgar Lungu went to commission Chilenje Hospital during the same week, there were murmurs of discontent because of the eerie attitude of medical staff at the institution towards patients.

“If only the President knew what is going on at  this hospital, he should not have wasted his precious time to come over because this is not a hospital but a place where people come to die due to bad care and attitude of medical staff,” one woman was heard in the background.

True to this, a woman who gave birth around 07.00 hours was left to bleed to death around 23.00 because reportedly a doctor and a nurse on duty were still waiting for a ‘consultant’ to refer the matter to UTH. This mother has since been buried in Kabwe and the rest is history.

If that was not the most injudicious form of line of duty by the doctor and nurse on duty on that particular day, the two must surely have been chatting with Lucifer himself to neglect their duties in that fashion.

Unfortunately the death of that woman is perhaps just a tip of the iceberg on how rotten health service delivery has become in our country.

Those who have survived the hardships from these health institutions have horrid memories and stories to tell.

Others have made up their mind not to bother about going to government clinics and hospitals because it does not make any difference.

The maternity wards in Zambia are death lines for expectant mothers who have continued to be treated like wild animals in their own country by people paid by tax payers’ money.

Prescriptions have also formed a bad fashions by our health institutions for other ailments because they claim they have no drugs to dispense to deserving patients.

Those attending ante-natal services have not been spared either as often times they have been asked extremely disconcerting questions on how they were made pregnant by either their husbands or boyfriends.

Some of the favourable questions asked include: “How many rounds did you have to become pregnant? Did you enjoy sex with your partners for you to become pregnant?” The list is endless. The questions are always worse off for single mothers.

Alternatively some mothers have opted to give birth in their homes and risk childbirth complications because to them it does not make any difference.

One such mother is Ms Margaret Changwata who says she once was reduced to a piece of bread by some nurses when she went to deliver her third child.

“Imagine, I am in labour pains and a midwife who is supposed to be my comforter and helper is busy telling me to shut up because she was not there when I fell pregnant,

“It is worse when you mess yourself up. It is like the whole world just hates you. No, I will not attempt to seek maternal service in any of our medical institutions. They are hell and helpless and better off shut,” said Ms Changwata.

Another woman who chose to remain anonymous said she had the misfortune to deliver at Kanyama clinic a few years ago and what she went through would even shock the Devil himself, as she narrated between sobs.

“I don’t thinks there is adequate supervision in our heath institutions. Those appointed to preside over these institutions just want to enjoy authority and comfort of their offices. For example, I doubt if any managing director at UTH has made any surprise visits to the wards at night to see what goes on,” she said.

She says if for some reason Florence Nightingale, who founded the nursing profession had to wake up, she would soon die on witnessing what is going on in our hospitals today.

Apparently this shoddy service is not limited to expecting mothers alone but transcends to other areas of treatment.

“I went to Chawama clinic after I contracted an STI. My God, it was hell on earth. This nurse attending to me made sure that all other patients, if not the whole world, knew I was the lame duck who loved unprotected sex through her tirade of demeaning insults”, quipped a man who fell victim of bad health services.

Another man Maxwell Sipambuleki said even when the medical staff are supposed to be attending patients, they are always seen chatting or drinking tea with fritters while queues of patients continue to grow.

“ It is clear to me that a good number of our nurses and midwives in particular are in the profession purely for monetary gains not because of the calling as you all know very well that nursing is a noble career not just for every Mary, Joan or Jack,” said Mr Sipambuleki.

Those needing theatrical operations and other special attention have to be on waiting list for months and years in some cases.

“One has to visit some of our clinics to appreciate the kind of poor services the citizens are being subjected to daily,” he says

Now perhaps you will appreciate why our Lusaka City Council (LCC) bragged about interring 980 bodies in three weeks, giving an average of 50 burials a day during the same period and still nobody is worried with the state of affairs in Zambia.

In the ‘civilized’ Western world heads would have rolled over that report but because dying in our health institutions in Zambia is normal business, it is wishful thinking to expect the same. Nobody can be bothered.

But who is going to provide possible solutions to the worsening state of health care in Zambia in the absence of medical intelligence and surveillance in our health care system?

There is no doubt in many of Zambian minds that our health care system is poorly developed and lacks adequate and functional surveillance systems.

To achieve success in health care in this modern era, a system well-grounded in routine surveillance and medical intelligence as the backbone of the health sector is necessary, besides adequate management couple with strong leadership principles.

Even President Edgar Lungu on November 7 last year hinted on the need for Zambia to have an equity of access to quality health care services which should be as close to the family as possible.

But alas, what is obtaining on the ground is pathetic if not a national scandal. And it will not be an exaggeration to state that health services in Zambia collapsed many years ago.

This has been evidence by lacking health facilities inadequate personnel, and medical equipment especially in rural areas.

Our health care system remains scrawny as shown by lack of management, disintegration of services, and shortage of resources, including drug and supplies, inequity in resource distribution, and access to care and very appalling quality of care.

So the need for quality and professional health care has been a begging prayer as the opposite has been the order of the day in many of our heath institutions.

The appeal, therefore, made by Mr Brian Musonda on his reaction to the death of the same mother on this newspaper’s’ ‘text messages’ column of May 25 on page 8 to health Minister Dr Chitalu Chilufya to take interest in the Chilenje Hospital case should not be ignored  or taken lightly.

Mr Musonda wrote: “Dr Chilufya, Minister of Health kindly take interest in this case, we are watching. We cannot afford to be losing lives negligently. Government spends a lot of money educating those personnel who must pay back in form of good service to the general public. Those who are not called for that service better they are gotten rid of. It is not just about getting a salary and gossiping around. It is about working.”

Is there any chance of a better health care system in Zambia? The answer lies in the manner government is going to handle the death of that mother at Chilenje Level One Hospital. May Her Soul Rest In Eternal Peace.