From: barnhart@ddsw1.MCS.COM (Mr. Aaron Barnhart)
Subject: IPS:ZIMBABWE: HEALTH OF THE NATION REELS UNDER ECONOMIC ADJUSTMENT
Date: Fri, 18 Dec 1992 03:05:41 GMT
Organization: Evanston, Illinois, U.S.A.

Copyright Inter Press Service 1992, all rights reserved.  Permission to re-
print within 7 days of original date only with permission from 'newsdesk'.

Area: Asia, eastern
Reference: Africa, southern; Trade & Finance
Title: ZIMBABWE: HEALTH OF THE NATION REELS UNDER ECONOMIC ADJUSTMENT


an inter press service feature

by gumisai mutume

harare, dec 8 -- just over a year after its inception,
zimbabwe's economic structural adjustment programme (esap) is
playing havoc with the health of the nation.

''it is difficult to avoid the conclusion that esap is having
a severe and deleterious effect on health care in this
country'', says anne renfrew, in a recently published booklet on
esap and health.

renfrew is a general medical officer and one of only two
medical doctors at st. paul's mission hospital in the murehwa
district, 75 kilometres east of the capital, harare.

her findings, based on data from the district of
approximately 54,000 people and from harare central hospital,
are indicative of the general trend in other rural and urban
hospitals -- a serious decline in the standards of health under
esap.

''esap is a clear shift of the resources from the priority
areas of human development, from health and education, to the
commercial and industrial sectors. esap includes real cuts in
social expenditure and cost recovery in health through the
implementation of fees'', says renfrew.

the adjustment programme, implemented in 1991, has resulted
in the re-introduction of medical fees, previously done away
with by the avowedly socialist government of president robert
mugabe that sought to achieve health for all by the year 2000.

the result has been a drop in the number of people seeking
medical attention at health centres.

statistics at harare central hospital show an average fall of
25 percent in bed occupancy at the end of 1991 -- under esap --
as compared to the previous year.

the situation is particularly taxing for zimbabwe's majority
rural population subsisting on the land.

baba chiomasi has eleven children in murehwa and lives on
about 80 u.s. dollars which he earns once a year from his
harvest.

it is an income which can barely clothe, feed and educate
his family, let alone meet medical bills.

''many of us will end up dying in our homes as we cannot
afford to pay hospital fees'', says chiomasi. (more/ips)


zimbabwe: health (2)

according to the government, people like chiomasi who earn
less than 80 u.s. dollars per month are entitled to free medical
treatment, if they can prove it by producing a pay slip.

if they cannot, a social worker should confirm they are
unemployed. for chiomasi, this means travelling more than 40
kilometres to the nearest social welfare office.

esap has also resulted in unprecedented increases in the cost
of drugs. the devaluation of the local currency in 1991
raised prices by over 64 percent.

''this caused us to increase our premiums by 22 percent in
february and a further 13 percent in august'', macdonald
chawora, an assistant general manager of the largest medical aid
society in the country told ips.

''we are also experiencing an increasing loss of membership
as people lose their jobs under the retrenchment policy''.

according to chawora, due to the tight monetary environment,
premiums were coming in much later than their due dates. if a
client fell sick before his premiums were received, the society
would not pay claims.

local authorities throughout the country have responded to
government's cut in subsidies to medical institutions by hiking
medical fees -- by between 65 and 105 percent in the case of
kwekwe, a small town south of harare.

the secretary for health and child welfare, rufaro chatora
admits that over the last two years health services have
deteriorated.

statistics from his ministry, although showing an
increase in the amount of money spent by government on each
person, from about 2 u.s. dollars in 1980 to 14 u.s. dollars
this year, in real terms represents a rise of only 60 cents.

''compared with other countries in africa, zimbabwe is one of
the three countries which spends a lot on health services, the
others being botswana and lesotho'', says chatora.

however, health for all by the year 2000 still remains a
dream for the majority of zimbabwe's estimated 12-million
people.

the bottom line is money, aptly put by health minister
timothy stamps: ''all health services cost money and money is
not unlimited''. (end/ips/gm/oa/92)
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