The high cost of healthcare in most cities has created a reverse migration. Kundai Marunya writes about his experiences at a rural hospital.
I recently traveled to Howard Hospital in Chiweshe to get medical assistance for my sister-in-law. She had been diagnosed, elsewhere, with genital warts but could not afford the costly treatment at the nearby public health institutes. For three months after diagnosis she stayed home getting help from herbalists but to no avail.
When we finally took notice of the illness, after a visit to her home, things were at their worst. Her genitals were riddled with finger-long warts that hung from her groin. The infestation of warts was so bad that her anus was almost sealed shut. Relieving herself had become difficult. Because she was too shy to reveal her condition to close relatives, she suffered in silence.
Driven by fear of societal onslaught on men who fail to provide for their families, her unemployed husband kept the sickness a secret, despite not being able to provide for his ailing wife. This compounded her already dire condition.
Howard is some 80 km from Harare. This was my first visit to the institute. As we drove along the bumpy gravel road, carefully navigating our way round potholes, I couldn’t help but wonder if we had wasted our time and money travelling all the way to the rural areas. I saw no signs of civilisation; now and again we overtook ox-drawn carts, most of them headed in the same direction. Some were ferrying the sick and infirm, including women who looked heavily pregnant.
Arriving at the institution, we were greeted by old rundown buildings that looked like they belonged to the early ’70s. Disappointment set in. Looking at the state of the buildings, I wondered if any good could come from this journey.
The doors were closed, giving the impression that the hospital had shut down for good. I peeped through a window, looking signs of life. All I saw were rats running around.
As I was lost in thought, regret flooding my mind, I heard movement behind me. I turned to see a shabbily dressed old man, in drenched pants. He stank of excrement and urine. His appearance further confirmed my doubts about the institution, so I started back to the car. The old man called after me.
‘Varwere varikurapwa kuseri!’ (go round the back for medical assistance).
It did not make any sense but I figured what do we have to loose? We had all this way, so we may as well check it out. I walked in the direction in which he had pointed. Not too long after, life started unravelling itself. I saw a handful of pregnant women walking around.
The women directed us to the newly built facility which is miles ahead of Harare’s ill-maintained public hospitals. It is a magnificent building which I had not expected to find in the middle of nowhere. It is sad that we do not have such facilities, here in Harare, where hospitals continue to crumble, along with the service delivery. The nursing staff attended to us with urgency, something I had never experienced on visits to the country’s biggest health institutions (Parirenyatwa and Harare Hospital) where one can spend well over six hours before receiving any help.
The toilets and bathing facilities were all in good working order. The hospital even has homes where pregnant women stay as they wait for delivery. Having on site accommodation means that heavily pregnant women do not have to travel long distances at the last minute. We arrived at a time when food was being served to patients, a good plate of sadza with vegetables cooked with peanut butter; a good healthy meal suitable for expectant mothers.
Adapting to community’s needs
Howard is one of many mission hospitals that are playing a vital role in serving the sick in a nation with a failing health system. It is a good example of an institution that adapts to the prevailing environment while moving forward to address people’s needs. Even their pricing policy suggests they are in health care for the service, not for money, unlike many private hospitals that seem only motivated by profits.
They realised women were walking long distances in labour, and they set up homes for expecting mothers. Upon realisation of economic hardships, they adopted a pricing system where one pays only $30, which covers bed, meals and medication per day.
Failing old systems
As old systems fail, we need new ones to replace them, or at least improve the old for efficiency. We live in a country where, since independence, most public facilities including toilets, housing (Mbare Hostels), and even schools have not been upgraded. Even the mind-set in public sector remains unchanged. Anyway, how can we expect change when the same old administration is in place?
We often call for political leadership renewal, while ignoring the other leaders in public administration. Maybe it’s time we start moving on from the old systems, employ young thinkers with fresh perspectives to take over and drive us forward.
Come to think of it, if it wasn’t for old cultures, maybe my brother-in-law would had come forward earlier and got help before it was too late. We could have saved all the money we now have to fork out for surgery and other advanced treatment.
We get that there is no money to construct new hospitals in both rural and urban areas to ease pressure on existing facilities. But there is no reason for not improving services at the local clinics. Why not then have doctors attending to patients instead of just nurses? Some of the people that are then referred to the major hospitals can be dealt with at primary health care facilities, thereby improving efficiency.
Let’s fully utilise what we have, think forward, adapt to the changing times so that our sick may stand a better chance of survival.