Restoring Zimbabwean’s Health Care.

Kesaobaka Modukanele

BLOG POST FOR TUESDAY OCTOBER 27 2009

Rebuilding an entire nation from scratch is a daunting thought. What took 29 years to be established is definitely not going to take a few years to re-establish. This article focuses on ways to revive Zimbabwe’s health care through a national and international approach. Some of the international initiatives that this article proposes include international advocacy from resources such as the Global Fund, the UN and the WHO. At national level, the article’s focus lies in encouraging doctors that had emigrated from the country to return,“retaining user fees at local level”, launching a “100-day action plan and craft a budgeted, medium-term health-care recovery plan” , training healthcare professionals, and tackling the country’s human rights issues. All of these are excellent proposals in my view. However, I fear that it might be a bit idealistic to tackle health care issues from a national level. I will focus my discussion on the unrealistic proposal of "encouraging” doctors to return to Zimbabwe.”

In a place where a government doctor’s salary has fallen to a mere $1 per month, where doctors are harassed for treating some victims of violence, holding on to the hope that “the Government will remove bureaucratic hurdles” is not enough to encourage the return of professional Zimbabwean doctors. Zimbabwe has now become to Africa, America’s Haiti, which faced very similar problems of political upheaval drowning the country’s health care system. In such countries, it is not worth it trying to impact health care change from a national level, but rather from a community based approach, a point that this paper only makes in passing. In Haiti, doctors like Paul Farmer, who took a personal risk of restoring healthcare have really made an impact. It was through his initiative to found Zanmi Lasante, that adopted a community based approach at healthcare did change became evident. Paul Farmer’s Partners in Health intiative made access to primary health care more accessible by firstly, getting rid of user fees, which usually resulted in empty clinics. Furthermore, PIH incorporated community members, who could be “family members, friends, or even patients, to provide health education, refer people who are ill to a clinic, or deliver medicines and social support to patients in their homes (PIH)”. These community health workers acted as an interface between the clinic and community. Also, PIH tried to address basic social and economic needs of communities in addition to tackling their health problems. I believe that change is not dependent merely on availability of funds and doctors, however, it also lies in the work of social workers who meet the community’s needs through public service.

For these reasons and many more, I believe that a Zimbabwe’s approach should be more community based rather than national. Obviously it would take brave doctors like Dr Paul Farmer, who are willing to take such risks, to implement initiatives like this. However, talking about change on a governmental level is not worth it at this point.