health talk:with Dr Johannes Marisa
Covid-19 remains a nuisance in the world with close to 500 000 deaths so far and close to 10 million cases. Brazil is sweating with a mortality of more than 1 000 people daily while total cases in the country have surpassed 1,2 million people. Brazil is a developing country in South America and is the biggest economy in South America with a somewhat sound health delivery system.
For such disasters like the Covid-19 pandemic, what is needed is a strong health system that includes doctors, nurses, physiotherapists, pharmacists and many more to provide candid health support to patients. Unfortunately, the past week has been a poignant one in our beloved country with nurses downing tools citing gross incapacitation considering the raucous economic environment.
Patients have been left with minimal attention as only matrons have been left to man the wards. Working without nurses can be cumbersome because they constitute one of the most important pillars of a sound health system as they are part of very important health personnel.
With Covid-19 knocking on our doors from South Africa and other countries, we need to remain highly alert as a nation. Complacency and ignorance can wipe the entire nation.
The ongoing industrial action by some health workers has been a thorn lately if we are to succeed on Covid-19. Parirenyatwa General Hospital is a Covid-19 centre where both screening, testing and treatment are supposed to be given. Nurses have been at the forefront in the processes and their absence is easily felt as gate entrance screening has just vanished with patients now walking freely into the hospital wards and territories.
The situation can worsen if the industrial action continues and the Covid-19 catastrophe will not hesitate to strike. It is a pity that doctors alone cannot cope with the pressure of Covid-19 screening and testing as they are also overwhelmed in wards, theatres and casualty department. The country should not be caught unaware. No one wants to perish, so action should be taken to avert a potential disaster in our country. We rejoice as a nation as we remain with one of the lowest Covid-19 mortalities in the world with only six confirmed deaths. Although some doubters may want to dispute this figure, we have not seen street deaths or witnessed suspicious deaths. It seems the average deaths in hospitals remain static in the past six months.
Absence of nurses in the wards has caused disaster in terms of patient observation and monitoring. Nurses play an important role in patient care and management. All the admitted patients in the wards need regular BP and temperature checks as well as examinations. The industrial action has compromised patient monitoring and observation as these important tasks have been abruptly delegated to nurse aides and some student nurses. The student nurses are still at school and their education is a mountain to climb without supervision by the senior colleagues. Nurses also administer oral, intramuscular and intravenous drugs as prescribed by doctors to the admitted patients in the wards and in casualty on top of placing drug orders for each and every patient from pharmacies.
Some drugs are supposed to be given several times a day, for example, three to four times a day. This becomes a hurdle for patients as clinicians fail to administer the required drugs at the stipulated times. Some patients who require admission are no longer admitted as the nurses’ absence becomes an inevitable hindrance.
The casualty department has not been spared as well. The situation is dire with the conspicuous absence of nurses who play a crucial role together with doctors in resuscitating patients especially those who require emergency care and treatment. Critically ill patients who need urgent treatment are now left stranded in casualty to be attended after a long time of waiting because there are no nurses to assist the doctors.
If the situation in government hospitals continues like this, maternal mortality and neonatal mortality rates may sky-rocket in the near future. Pregnancy is usually associated with a lot of complications that include severe hypertension (PIH), eclampsia, antepartum haemorrhage, post-partum haemorrhage and foetal distress. The central hospitals like Parirenyatwa General Hospital and Sally Mugabe Central Hospital play a significant role in reducing maternal mortality as they are the referral centres that tackle difficult cases the majority of which would have been referred from primary care centres like council clinics.
Operations like caesarean section are done at such hospitals and nurses are of paramount importance as they are the frontliners in theatres, deliveries and post-surgical care.
Therefore, it is prudent that warring parties come to the negotiating table to find a lasting solution to the impasse as most of Zimbabwe’s population relies on the public health system because people cannot afford private health service. In short, government should consider the following: lProvision of adequate PPEs to all health personnel.
lAdequate remuneration considering the current harsh economic climate.
lAvailing non-monetary benefits to personnel which includes residential stands as the majority of medical personnel are tenants, fuel coupons etc.
lStabilising micro and macro-economic environments.
lDr Johannes Marisa is a medical practitioner, public health practitioner and educationist who can be accessed on: firstname.lastname@example.org.