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The recently reported shortage of medicines at Bulawayo’s Ingutsheni Central Hospital is an example of a prevailing situation at virtually all Zimbabwean public health institutions. The Ingutsheni case is of greater concern most probably because of the type of patients the hospital treats: mentally disturbed people some of whom can be quite dangerous to the public as well as to themselves if they are not given appropriate drugs.

It has now been a couple of years since the country’s public health centres have been short of medicines. That is most inconvenient to the public.

In Bulawayo, both Mpilo Central and the United Bulawayo Hospitals (UBH) give most of their patients prescriptions and advise them to go and buy the medicines from privately-owned pharmacies. A few medicines are, however, available at the hospitals occasionally.
Ingutsheni refers some of its patients to the UBH where they are given beds in general wards and are treated in more or less the normal way as other patients.

The author of this article had a very frightening experience in November last year when he was an in-patient for a few days at the UBH. A couple of patients were brought into the ward from Ingutsheni late at night. One of them was given a bed next to that of this writer.
In the early hours of the following morning, he (the Ingutsheni patient) left his bed, climbed onto this writer’s and sat on him. It was fortunate that the writer was lying on his side and not on his back, and that the Ingutsheni mental patient was a man of light build.

When this writer called the nurse-in-charge of Forrester Ward, she apologised on behalf of the Ingutsheni patient without as much as asking him why he did what he had done.

Meanwhile, the Ingutsheni patient was loudly praising the nurse for her beauty, saying how nice it would be to share a bed with her. Another of the Ingutsheni patients seemed to be disoriented and did not know whether to lie down or to walk out of the ward. It was a great relief to this writer that his doctor, a very impressive professional, decided to discharge him the very following morning.

A month or so before being admitted to the UBH, this article’s author had spent almost a week at Parirenyatwa Hospital in Harare.
A cumulative experience of these two hospitals admissions showed that whereas the two hospitals have a group of highly able and devoted young medical doctors, the administration leaves a great deal of work to obviously unprofessional and irresponsible people.

If that were not the case, a service like giving patients breakfast could be provided in the usual early morning hours instead of mid-morning at both Parirenyatwa and the UBH.

One day at Parirenyatwa, a worker came to this article’s author at 10AM and asked “Ko breakfast nhayi mdara?” (I have brought you breakfast).  He was holding a plate of cold porridge with a dash of fresh milk.

At the UBH, for the few days the author was in Forrester Ward, breakfast (mealie-meal porridge) was served later than 9AM and was as cold as if it had been cooked in Gweru and brought to Bulawayo overnight by a refrigerated train.

These experiences indicated poor administration as opposed to professional services which could be divided into stages:

• Casualty Department Services
• Ward Services
• Post-Discharge Services

Both UBH and Parirenyatwa offered excellent services in the casualty departments. The doctors are without any doubt committed to their work.

It is not possible to say the same about the nursing staff as some of them appeared to have an attitude that they were more important than the patients instead of the other way round. Many of these nurses can do with a course in public relations.

Service in the wards was absolutely wonderful as far as doctors’ rounds are concerned. The doctors told the accompanying nurses what to do with each patient. However, much of what the doctors instructed nurses to do was either not done or was done late. “Much” does not mean “all”.

Post-discharge services are given by the out-patients department (OPD) where in both cases observed by this author, doctors seemed to excel.

Institutions such as hospitals work very well provided they have suitable manpower, adequate material resources, enough money, efficient management, and last but not least sufficient motivation. Zimbabwean hospitals have the manpower, especially the professionals. What is lacking are material resources comprising equipment and medicines.

Those responsible for this unfortunate weakness are the people in the various management levels, especially those in the responsible ministry.

The hospitals cannot run efficiently without adequate funding, hence the acute shortage of medicines, at all government medical centres. Attractive salaries are a motivation for efficient service delivery. Nurses may not give their all because they feel that they are not adequately remunerated.

A frustrating factor for staff in the country’s public health institutions is lack of equipment and the deteriorating condition of the sector’s infrastructure.

Efficiently managed and well-equipped hospitals have laboratories, X-ray departments, facilities for physiotherapy plus, of course, adequately stocked pharmacies.

It is also vital that every hospital should have properly working ablution facilities, including toilets and a well managed kitchen and refrigeration system. Some hospitals employ dieticians to ensure that their patients are given well balanced foods and beverages.
Let us all urge our national health service management authorities to increase and resuscitate the system at the same rate, if not faster than, as our higher educational institutions are producing medical doctors and health workers of their categories.

Saul Gwakuba Ndlovu is a Bulawayo-based retired journalist. He can be contacted on cell 073438136 or through email [email protected]