Maravi

donors withhold support to health

donors withhold support to health
Written by Patson Chilemba and Chibaula Silwamba
Thursday, April 30, 2009 2:53:58 PM

INTERNATIONAL donors to the Ministry of Health have cancelled a signing ceremony for their support to the ministry which was slated for today pending a satisfactory explanation from the government over the planned procurement of mobile hospital units from China.

Highly-placed sources within the donor community yesterday revealed that they [donors] had called off the signing ceremony of the memorandum of understanding [for support] at the high level forum with the government because they needed a satisfactory explanation from the health ministry on the matter.

"We were supposed to have a signing ceremony of an MoU with the Zambian government tomorrow [today] but we have refused to go ahead with the signing ceremony until the Ministry of Health puts its house in order," the source said. "We have refused. We need a written satisfactory explanation on the mobile hospitals."

And the United Kingdom's Department for International Development (DFID) health and HIV/AIDS advisor Angela Spilsbury said pressure for the Ministry of Health (MoH) to procure mobile hospital units from a Chinese company is coming from outside the health sector.

According to an email dated April 23, 2009 addressed to various stakeholders, Spilsbury disclosed that the permission to proceed with the procurement of mobile hospitals had been granted by the national tender board and the contract was currently being examined by the Ministry of Justice. She stated that the decision on the matter was expected before the end of the week.

"It has come to our attention that the MoH are procuring mobile hospital units from a Chinese company with a Chinese loan worth $52 million. We understand that the pressure to do this is coming from outside of the health sector," Spilsbury stated. "As it is a loan, the money will not come out of the health sector budget but it does have wider budgetary implications and will have opportunity costs for the sector. I have been trying to find out more information but the issue is very sensitive.

"Please do not approach MoH staff individually on this as it may put them at risk. It has been decided to send a formal request to Mrs Kaphiya, the acting PS, for follow up with Dr Mtonga once she returns on Monday."

Spilsbury stated that the question had been raised as to whether partners would be willing to sign the MoU addendum at the High Level Forum this week.

"We can discuss this in more detail at the health CP meeting on Tuesday," Salisbury stated.

And in a letter dated April 23, 2009 and addressed to acting permanent secretary Margaret Kaphiya, Spilsbury stated that it had been brought to the donors' attention that the Ministry of Health were considering the procurement of mobile hospital units to the value of US $52 million.

She stated that it was noted that this activity was not included in the Ministry of Health's 2009 action plan and was not discussed with partners at the Sector Advisory Group earlier this month.

"On behalf of the health cooperating partners, I would like to request further information on this proposed procurement. In particular how these mobile clinics will meet the needs and priorities identified in the National Health Strategic Plan 2006 - 2010; the terms and conditions of the loan and its implications on the financing of the health sector," Splisbury stated.

She stated that donor partners were concerned that this was not part of the Ministry of Health's procurement plan and that it had not been discussed in the procurement technical working group.

"We request an opportunity to discuss this with you as soon as possible as this may affect partners' ability to sign the MoU Addendum at the High Level Forum on 30th April," stated Spilsbury.

When contacted for comment yesterday, Spilsbury said the donors had received a response from the Ministry of Health over their concerns.

She said in the response, Kaphiya had outlined the processes involved before arriving at the final decision. Asked to elaborate further on the ministry's response, Spilsbury declined to give further details.

She also said the donors had not given the government an ultimatum.

Asked if the donors would go ahead to sign the MoU addendum at the high level forum slated for today, Spilsbury said the matter was still under discussion.

And the parliamentary committee on health said the government's intention to buy mobile hospital units at a cost of US $53 million [about K301 billion] does not make sense.

Commenting on the Zambian government's intention to purchase nine mobile hospitals for all the nine provinces at a cost of US $53 million from China and plans to borrow the same money from EX-IM Bank of China, parliamentary committee on health chairperson Munji Habeenzu said mobile hospitals were not necessary in Zambia.

"I don't understand why the government should buy these mobile hospitals or whatever services they want to get. What they should have done is to embark on putting up structures," said Habeenzu, who is also UPND Chikankata member of parliament. "In rural areas there are hospitals and if they buy these mobile hospitals, are they going to service the rural areas? So to me it doesn't make sense. The government should have embarked on rehabilitating health service facilities in rural areas, which have been affected and building more hospitals to curb the problem of shortage of medical facilities."

He urged the government not to go ahead with the project because it would not benefit the majority of Zambians.

"Actually, there is no way... To tell you the truth, people in rural areas will never access these mobile hospitals. So it doesn't make sense for government to come up with such a facility," Habeenzu said. "Why purchase a facility that will not help other sectors of society?"

Meanwhile, chief government spokesperson Lieutenant General Ronnie Shikapwasha yesterday said a technical team had been set up to examine whether the mobile hospitals would answer the needs of Zambians or not.

"The position is that the mobile hospitals, a group of people came to the Ministry of Health to suggest the government could find a solution where there are no hospitals and that mobile hospitals can then be undertaken," Lt Gen Shikapwasha said.

He said at the moment mobile hospitals were just a suggestion and no decision had been concluded yet.

"It's a blueprint that has been put to the government to consider. A technical team is going through that and as soon as the government will agree or doesn't agree, we will let the nation know," Lt Gen Shikapwasha said. "[As] at now the technical experts are going through to make sure it answers the needs of Zambians for example, will it be able to answer the needs? This is a total mobile hospital that is going to move for example into a district where there is no hospital and then carry out operations, carry out treatments, carry out areas where facilities are not available like in the normal hospital. The mobile hospital would answer those needs. So the examination is to find out whether it is going to answer the needs for the people of Zambia or it will not answer the needs."

He said the nation would be told as soon as the government completes the evaluations.

Asked about concerns that mobile hospitals would be difficult to operate in Zambia because most roads especially in rural areas were dilapidated, Lt Gen Shikapwasha dismissed those concerns.

"When you say that the rural constituencies don't have good roads, as you are aware that the government during the term of the [late] president [Levy] Mwanawasa bought hundreds of pieces of equipment to do the rural roads," said Lt Gen Shikapwasha. "So on that score we can answer that the rural roads are going to be revamped with the equipment that is in place and mobile hospitals can move on those roads."

On Tuesday, the Zambia Medical Association (ZMA) opposed the government's intention to purchase mobile hospitals, describing it as a misplaced priority.

According to sources within the donor community, the Zambian government is in the process of acquiring a US$53 million loan from EX-IM Bank of China to facilitate the acquisition of the mobile hospitals from a Chinese firm called China National Aero-Technology Import and Export Corporation (CATIC).

The source disclosed that donors held meetings last week in Lusaka to discuss this pending transaction between the Ministry of Health, on behalf of the Zambian government, and CATIC concerning the mobile hospitals.

Labels: CORRUPTION, DONORS, MINISTRY OF HEALTH

posted by MrK @ 1:55 PM