Can Zimbabwe fight COVID-19 without doctors and nurses?

On July 30th, Zimbabwe’s president, Emmerson Mnangagwa, revealed that the country’s influential Lands and Agriculture minister, Perrence Shiri, who had died the day before, had succumbed to the deadly COVID-19 virus. Shiri was the commander of the Air Force of Zimbabwe for 25 years before his elevation to a ministerial post after the November 2017 coup that toppled long-time ruler Robert Mugabe. 

That such a prominent public official, one of the privileged few with access to exclusive private health facilities, had fallen to the pandemic sent shivers down the spines of ordinary citizens who depend entirely on the country’s decrepit public health facilities that are now practically closed.

Health professionals’grievances

On June 17, public sector nurses went on strike – the second this year – over poor salaries and lack of Personal Protective Equipment & Clothing (PPE&Cs), the critical shortage of drugs, equipment and even food for patients in the government hospitals. 

On July 31 senior doctors joined the strike in sympathy with the other health professionals that had already been on strike for more than six weeks. The now routine grievances range from ridiculously poor salaries to a critical shortage of drugs, equipment and consumables. The doctors have always argued that even if they remain at work, it breaks their hearts to see people dying en masse, as they cannot save them because of the facilities are now hospitals in name only. 

Even before the on-set of the Coronavirus pandemic, so critical was the situation in public hospitals that nurses were washing bandages for reuse while in some cases the doctors were forced to perform surgical operations with bare hands.

COVID-19 infections increasing

The latest tussle comes at a time when the country has seen an uptick in the numbers of COVID-19 infection cases, which are now rising by hundreds daily, with indications that the worse is yet to come. There are less than 100 ventilators in a country with a population of over 16 million.

As of July 31, Zimbabwe’s official COVID statistics stood at 3,092 total infections, 53 deaths and 924 recovering. Of these infections, more than 300 of them are those of nurses and others health professionals who have been made to work without even the most basic of PPE&Cs. 

Eyebrows have been raised on the veracity of the statistics amid allegations that the government, which stands accused of neglecting the health and other social services sectors, is downplaying the magnitude of the crisis. 

Long-running dispute 

For the past two years nurses, Zimbabwe’s nurses, doctors, radiographers and other health professionals have had more than half-a-dozen strikes, fighting for better remuneration and improved working conditions. A record four-month strike ended in January before another one started in March.

The sudden switch from the use of the United States dollar as the country’s primary currency to the use of the Zimbabwe dollar from October 2018 has seen the impoverishment of workers in Zimbabwe as the value of the local currency fell from 1:1 to the US dollar to below 1:100 on the thriving black market which determines the prices of all goods and services.

The latest strike was triggered by a 50 percent cut on nurses’ salaries from Z$7,000 ($70) to Z$3,500 ($35) at a time when they were expecting a huge salary hike that they had been promised when they went on strike in March. 

“We were taken by surprise that at a time when we expected the government to increase salaries because of inflation, they decided to slash our meagre earnings,” said Enock Dongo of the 15,000-member Zimbabwe Nurses Association (ZINA). “We want money that can buy [protection] so that we can satisfactorily deal with COVID-19 coming from our homes.”

Intimidation instead of negotiation

Douglas Chikobvu, the secretary general of the Zimbabwe Professional Nurses Union told FairPlanet in an interview that since the strike started more than six weeks ago, there had been no attempt by the government to end it by addressing their grievances. He said, instead, the government had resorted to intimidatory tactics in an attempt to blackmail some nurses to return to work.

“The nurses’ strike is still on-going until a time the government honours nurses genuine demands for a living wage in US dollars,” Chikobvu said.

“To this day, no formal, normal and genuine call for an amicable solution has been made, but we have noted with serious concern the continued machinations against nurses in form of fear-mobilisation antics through plucking of nurses who are on strike from the payroll. They have further escalated that mode through giving a notice of intention to fire all nurses who are on strike if they don’t report for duty.”

Heavy-handed approach

Attempts by the health professionals to protests were met with repression as they were accused of violating COVID-19 regulations. Some of the nurses spent a few nights in police cells before they were released.

Unlike during previous strikes when the government appeared to show concern by continuously engaging the striking medical professionals in negotiations and making small concessions to end the work stoppages, this time around the nurses and doctors have largely been ignored.

The government’s response has been to arrest the striking nurses, to evict them from subsidised government houses and replacing them with skeletal staff seconded from the army and prisons, in addition to crude nursing aides recruited on the streets by youths from the ruling ZANU-PF party. 

While a few major hospitals remain open, they are not admitting patients, save for a few emergence cases, because the strike has crippled operations.

Small concessions

A day after the nurses’ strike started, the government responded by announcing that it was giving all its workers, including the health professionals, an interim salary increase of 50 percent and an across-the-board COVID-19 allowance of US$75.

“With immediate effect all Civil Servants salaries will be adjusted upwards by 50 percent, in addition all civil servants will be paid a flat non-taxable COVID-19 allowance of $75 per month,” a Finance Ministry statement said.

“The interim arrangement is for three months starting from June 2020.”

While most sectors rejected the offer as too little in light of the fact that Zimbabwe’s inflation is now hovering around 1,000 percent, there was also haggling over how the US dollar COVID-19 allowance was to be paid after the government indicated that it would not be paid in cash, but can only be accessed through online purchases. 

Gravity of the crisis now acknowledged

With the situation fast deteriorating, President Mnangagwa, whose government has been playing hide and seek with the neglected doctors and nurses, appears to be sobering up to the gravity of the situation. 

While addressing mourners at the burial of Shiri at the National Heroes Acre on July 31, Mnangagwa implored the striking medical professionals “to act in the national interest and exhibit a great sense of responsibility.”

 “My government hears your cries, listens to your concerns, but the time to serve is now,” Mnangagwa said. “Your grievances, which we acknowledge and continue to address, cannot be enjoyed at the loss of lives. When the pandemic spreads and the death toll rises, there are no winners at all. None at all!”

Grievances politicised?

“As nurses, our demands shouldn’t be politicised in any form because we only want our salaries in US dollars, adequate personal protective equipment and clothing (PPE&C) and a sound COVID-19 risk allowances,” said Chikobvu, who went to describe the avoidable deaths that are taking place in the country’s health institutions as a form of “genocide”.

The country is facing this pandemic without a Health minister after Obadiah Moyo – a fake medical doctor who was implicated in the US$60 million drugs supply scandal – was fired in early July after a spirited campaign by citizens.

Before the mass-dismissal of striking doctors last year, Zimbabwe had only three doctors for every 20 000 of its citizens. It is hard to tell what the ratio stands at now.