Winstone Zulu Speaks Up: Who is Really Sick?
By Winstone Zulu
More than a decade ago a colleague of mine, Linda Shikabonga died at the University Teaching Hospital (UTH). She had an infection that quickly left her dehydrated and in urgent need of fluid transfusion. She was admitted to the hospital, which happens to be the biggest and final referral institution in the country, on a Sunday. Health workers knew what was needed to help Linda but they had a problem. The hospital did not have a canola to link Linda to the life-saving fluids that she so much needed. Her relatives rushed into town, three kilometers away, to buy one from a drugstore but when they came back it was already late, Linda was dead.
|The author standing next to one of the damaged elevators at the UTH.
Linda was a courageous young woman who was amongst the first to join me in our outreach program that involved only those that lived openly with HIV. She was the wife of an officer in the Zambia Air Force (ZAF), which meant a lot of sacrifice as the military did not openly reveal the extent of the epidemic amongst its ranks for fear of compromising the security of the country. But she defied that and told the world she lived with HIV. Yes, Linda was special, and both Dr. Rachel Baggaley and Professor Peter-Godfrey Faussett would attest to this. She did not deserve to die for lack of a canola.
About five years ago, Dr. Faussett took a tour of several districts to check on the state of TB treatment. He was shocked that many clinics in the districts could not carry out TB screening because they did not have sputum pots. Even more shocking was the fact that the country had the pots stacked to the roof at the Medical Stores in Lusaka. But the pots got stuck somewhere between Lusaka and the district. Either the district did not submit their requests in time or, if they did, the person responsible in Lusaka just sat on the papers, or the guy with the keys to where pots were kept was having a great weekend in the Southern Province resort town of Siavonga and forgot to leave the keys. Whatever the case, the districts could not screen patients, and the TB bacilli were freely spreading amongst family members and the community.
That was then, one could be pardoned for saying. But have things changed now? Not at all. If anything we are in even more serious danger of creating multi-drug resistance strains of not only TB, but also AIDS. The country is experiencing a stock-out of Nevirapine, one of the key first-line AIDS treatment drugs. The second half of last year there were intermittent shortages of TB drugs, and until a few days ago there was still no streptomycin. Patients were made to take their drugs from the TB clinic on a daily basis. Given the poor economic status of most TB patients, coupled with the long distances to health centres, many patients defaulted on their treatment. Few clinics are close to a bus station, and anyone who has had pulmonary TB knows how difficult walking even a short distance can be. In the midst of this misery the government keeps denying that there is a crisis. In fact, the Deputy-Minister of Health was quoted as saying there were so much drugs at the Medical Stores he did not have enough room to keep them. The Minister of Health himself Simbao stood by his denial that there was a shortage of ARVs.
|A sign hanging in UTH underlines the challenges created by the health worker shortage.
While the government continues to deny these deficiencies some things speak for themselves. For example, most elevators in the UTH do not function. When I was there about a month ago I had to walk long distances to find a working one then walk all the way back to the clinic. For persons with a physical disability, the UTH is currently a most unfriendly facility to get help from.
The other persistent challenge is the acute shortage of health workers. This problem has been there for so long that many people think it is normal. Even at the UTH there are permanent signs on the wall asking patients to bear with the hospital about this. This should cause outrage.
The current government boasts of having over $2 billion in reserve. The price of copper on the international market is at its highest, and we are Africa’s largest producer of the commodity. We are rich… so rich that when one of our political leaders get sick they are immediately whisked to a private clinic in South Africa. Meanwhile, the majority of people continue to suffer and die for lack of simple things such as a canola? Why keep huge amounts of people’s money in reserve when children are not growing because of malnutrition? Why send leaders to Johannesburg when the money could be used to upgrade the standard of our own hospitals?
While it is true that disease burden has created a lot of strain for health workers, the sickest patient in the Zambian health system is the Ministry of Health itself. It must be cured of its inefficiencies, corruption and denial.