Maravi

The crisis of our health sector

The crisis of our health sector
By Editor
Wednesday May 14, 2008 [04:00]

LIFE is sacred and should similarly be valued from the moment of conception until death. And one cannot claim to uphold the sanctity of life if there is no provision for minimal health care for all. Looked at in this way, it is clear that caring for the sick is a calling of a special dignity and importance, and not just another job.
It is therefore important that we pay special attention to those who have recognised as their calling the caring for the sick.

We need to devote more resources and time to our health care system. We say this because there is no future development without healthy citizens.

We may not be able to miraculously cure our sick sisters and brothers around us, but we can share the charity of tender arms and promote the justice of good health policies and adequate facilities and medicines. As Zambia Medical Association president Dr Swebby Macha observed yesterday, inadequate requisites and human resource remain a major crisis in our health sector. It is not possible for our nurses and other health workers to perform to the expected standards under these conditions. Inadequate requisites have given an impression that our nurses are inefficient. But for all their deficiencies, our nurses – given the poor and tough conditions under which they work – deserve our understanding, sympathy and support. They are making extraordinary contribution to our health system.

It is true we are not getting the service that we desire, and indeed deserve, from our nurses and other health workers. But is it really their fault that things have turned out this way? There are not enough nurses in Zambia and this causes a lot of problems in the work of those few who have to attend to patients and work long hours.

Health minister Dr Brian Chituwo says presently Zambia has only 10,000 nurses countrywide, for a population of over 11 million, against the requirement of about 22,000 nurses.

This huge deficit, of more than 50 per cent, negatively impacts on the quality of health care in the country. And we are told by Ministry of Health spokesperson Dr Canisius Banda that the human resource crisis in our health care sector is only expected to be over in the next five to 10 years. So, we are in for a long haul and this situation will continue to haunt Zambia for another five to ten years. And there is no guarantee that even then things will improve. We say this because this is just what is on the plans and the outcome will depend on how successful the implementation will be.

The situation is too tight for a country that requires close to 52,000 health workers to only have about 40,000.

And the situation has been compounded by the exodus of nurses and other health workers to other countries that are offering them better pay and other conditions of service. We have a high migration of health workers to developed countries like Britain that offer better conditions of service.

This migration of nurses and other health workers is increasing fast and aggravating our health crisis. Opportunities abroad that provide higher salaries and less workloads are decreasing our workforce in the health sector and could seriously damage healthcare in our country. While we appreciate the fact that nurses and other health workers cannot and should not be prevented from seeking better options in life, we nonetheless stress that this brain drain will not come without serious consequences on our country and its healthcare system. The already poor healthcare in our country will further decline.

If we don’t correct this trend, the ability of our health system to function will be seriously jeopardised. What we need to do is realise reality and turn it into an opportunity instead of mourning about it. We have mourned for years and it has not helped because it is a question of willing offer and willing acceptor.

Instead, we should find out how many healthcare workers – instead of just nurses alone – we ourselves need and what the demand for export is. We should gear ourselves towards increasing production both for home consumption and export. A few countries are already doing that and Egypt alone is making US$ 5 billion annually by exporting this manpower abroad. India, Pakistan and the Philippines are also doing the same. The returns for this investment are in fact lucrative and let us exploit the market instead of stifling the process, which we cannot control. And countries such as Thailand have responded to this growing threat by granting its healthcare professionals with generous research funding and other monetary incentives to make them think twice about seeking employment abroad.

We do not have much money to be able to compete in terms of pay and other conditions of service with countries like Britain, the United States, New Zealand and Canada. But we can give our healthcare workers a sense of dignity that comes with a feeling of being equal and being treated fairly. Our health workers are really receiving a very raw deal. What they are receiving today is not enough to enable them meet the basic requirements of life. What the nurses and other health workers are demanding are things within the possibility or ability of our government to meet. There is need to improve the conditions under which our nurses and other health workers work if we want to get a better service from them. To get the best out of them, we must improve the conditions under which they operate and make their work easier.

To do this, we need to spend more of our budget on health. Working conditions are important in motivating our nurses and other health workers to perform their tasks. And satisfactory working conditions comprise a clean and safe environment, innovative management, availability of medical equipment, medicines and other supplies. They need to work reasonable hours and take vacations regularly when required. Our health workers are de-motivated by so many things, which include the rundown working conditions and heavy workloads. We should increase their wages to levels that would enable them to meet the basic rights of adequate food, shelter, clothing and communication.

And we must realise that improving conditions for our nurses and other health workers is not a favour to them; it is a service to the Zambian people who depend on the services offered by nurses and other health workers. Every person in this country has a right to receive health care and we have a duty as a nation to take care of our people who are sick.

And if conditions in our health sector improved even by a fraction of a percentage over those in other countries where our nurses and other health workers have been flocking, they would take the next flight back home. They miss home, they would want to be home, they long to come back but they are unable to do so because of poor pay. As Dr Macha has advised, we need to retain health workers by offering them better conditions of service. And we have no choice but to do this because they are the cornerstone of any health system.

Labels: GOVERNANCE, HEALTHCARE

posted by MrK @ 3:56 AM