news in depth:BY MOSES MATENGA
The outbreak of coronavirus has left millions of Zimbabweans suffering from chronic diseases struggling to access life-saving treatment, amid warnings by doctors that more people could be dying in their homes.
For the past two months since the country went into lockdown to control the spread of coronavirus, public and private health facilities have been scaling down on admissions for non-coronavirus cases.
The government, which is struggling to roll out an effective Covid-19 response, has been accused of neglecting other health conditions as it scrambles to deal with the novel coronavirus.
Already, Zimbabwe is staring at potentially one of the worst malaria outbreaks in years.
Between January and May 3, 262 968 malaria cases and 246 deaths had been recorded in the country.
A staggering 20 deaths were reported during the week of April 27 and May 4 from a total of 26 103 cases, with the highest number of cases recorded in Mashonaland Central and Mashonaland East provinces.
According to the United Nations’ latest situational report on Zimbabwe, the number of pellagra cases reported in the first quarter of 2020 doubled to 482, compared to 264 cases in the same period in 2019.
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Maxwell Kapachawo — a preacher — has been living positively with HIV/Aids since 2005, but he describes the past two months as the most difficult period for him.
Kapachawo said like millions of Zimbabweans living with HIV/Aids and other chronic illness, he was struggling to access life-saving medication after health authorities shifted their focus to deal with coronavirus.
“The health authorities have taken all energy and focus away from chronic diseases to Covid-19 and we have become much more vulnerable,” he said.
“We are suffering and you meet people on security checkpoints, who don’t understand our situation and sometimes when you produce a doctor’s appointment note they turn you back.”
Norman Matara, secretary for the Zimbabwe Hospital Doctors Association, said more people were dying from other conditions as authorities switched their attention to coronavirus.
“We have a very serious problem with other illnesses outside Covid-19,” Matara said.
“We are witnessing a lot of morbidity and mortality from other diseases, which are now being neglected as the focus is now only on the coronavirus.”
The Harare-based doctor said health facilities had turned their backs on patients with other conditions following the outbreak of coronavirus when Zimbabwe recorded its first cases in March.
He said the situation of people with chronic diseases and other life-threatening ailments had become dire.
“There are several factors affecting other diseases,” Matara said.
“The first one is that because of Covid-19 and lack of resources in terms of personal protective equipment (PPEs), health workers have scaled down their operations, like outpatients departments are closed.
“We are doing theatres only and all other activities have been postponed indefinitely and all those people who are waiting to have operations have had their appointments postponed indefinitely.
“All those patients being followed up for hypertension, diabetes and things like that are not getting proper care because no one is serving the outpatients departments.”
The situation has been worsened by some health facilities that demand Covid-19 test results before attending to patients.
Government does not have enough test kits for coronavirus and this means patients can only access them from private health care providers that charge US$65 for a single test, which is beyond the reach of the majority of Zimbabweans.
“We also have a situation where some people are saying you should have Covid-19 results for you to be admitted,” Matara added.
“Some people can’t afford that, so there is gross lack of access to health care for other diseases and it is a very big concern.”
He said patients that need blood transfusions were also in a fix because the two-month-long lockdown had seen donations drying up.
“Another issue, which is of huge concern is that of our national blood bank, which is dry at the moment,” Matara said.
“We are still discussing with other doctors and everyone is telling horror stories of patients, who need blood and we can’t access it because of the lockdown as people cannot donate blood.
“That is a major crisis that we are faced with at the moment more than anything else.”
A visit to Sally Mugabe Central Hospital, formerly Harare Central Hospital, showed that only critically ill patients were being attended to.
Those that had come for reviews were being turned away.
An official at the hospital said they were not admitting patients with chronic conditions.
“It is not the proper review that they are getting because clinics are closed,” said the official, who requested to remain anonymous as he was not cleared to speak to journalists.
“Under normal circumstances, patients, who come to the hospital for reviews must be assessed to check if they are recovering,” he added.
“What is happening now is that patients can even send anyone for a prescription to get refills. A patient cannot be attended to and this is not the ideal situation and process.
“There is nothing as difficult as writing a prescription for a chronic patient, who is not there without a proper review of their condition. What if their condition has worsened?”
Former Health minister Henry Madzorera said the lockdown conditions made it difficult for most people to access health care and warned that this was causing unnecessary deaths.
“They have put measures that are making it impossible for people to get health care for other diseases even pregnancy-related issues and ordinary pneumonia as well as other ordinary diseases, including HIV/Aids,” Madzorera said.
“You have people who are supposed to get their tablets. They are failing to access medication because they are blocked at some roadblocks.
“We have people, who have died because they couldn’t access their usual treatment centres and we have police officers that are demanding to see patients’ medical records even if they can’t read and interpret what the doctors would have written, so they end up forcing people to go back home.
“They are reading confidential information, which they can’t read properly and some people have died.
“We have people dying because of ordinary diseases such as malaria, for example, because they can’t access treatment. There should still be access for treatment for other diseases.”
Fortune Nyamande, the Zimbabwe Association for Doctors for Human Rights chairman, said the country’s health delivery system was already strained prior to the Covid-19 outbreak and the situation had become worse.
Nyamande said thousands of people were now vulnerable to preventable diseases.
“Previously, there was already a burden with some illnesses and some conditions like HIV, tuberculosis, hypertension and other diseases and now resources are strained further and this poses a challenge,” he said.
“If minimum attention is not given to other diseases, we may have high morbidity and mortality rates due to other diseases.”
Itai Rusike, the Community Working Group on Health executive director, said Zimbabwe could not afford to ignore other health conditions even if the country was faced with an emergency.
“In the midst of the emergency response, the country cannot afford to ignore people’s broader health needs — including vaccinations; reproductive, maternal and child health care; HIV/Aids, TB and malaria services; mental health and treatment for chronic diseases,” Rusike said.
“Doing so will cause a deadly ripple effect, leaving thousands more vulnerable to preventable illness and death.”
He expressed concerns that vaccinations for other deadly diseases had also ground to a halt.
“Due to Covid-19, vaccination campaigns for polio, measles, cholera and HPV have already been postponed,” Rusike added.
“Though Covid-19 is affecting rich and poor countries alike, those with fewer resources and people with greater burden of ongoing health issues such as in Zimbabwe will be hit hardest by the virus’s collateral damage.”
The Zimbabwe Election Support Network (Zesn), which has been carrying out regular monitoring of the lockdown, said women were being disproportionately affected by the restricted access to health care.
“There are reports of cases of clinics not providing antenatal care, even after the lockdown restrictions were eased,” Zesn said in one of its latest reports.
“Such reports were received from Kwekwe Central to the effect that Amaveni Clinic was not admitting pregnant women, but instead referring them to Kwekwe General Hospital.
“The clinic is not providing most health services because their personnel do not have any PPEs.
“Reports from Chitungwiza South also indicate that some clinics were not providing most antenatal services, but only attending to emergency cases and that antenatal services were only available for after the babies have reached six weeks of age.”
As of Friday, Zimbabwe had recorded 160 coronavirus cases with four deaths and 29 recoveries.
