ED must address patient neglect at hospitals

It cannot be for wilful hardening of hearts that doctors and nurses in the public health sector have become cold towards patients, with some being sinister and malignant. Reports of patient neglect are now a common occurrence, fast becoming topical.

guest column: Cyprian M Ndawana

Obviously, there are dispiriting factors wearying public health service deliverers. However, while it is appropriate to acknowledge the prevalence of untoward attention to patients, as I see it, it is equally appropriate to establish the disruptive influence on their work ethics.

True, patient care at Parirenyatwa Group of Hospitals (PGH) runs at tangent with the medical essence of alleviating pain and suffering. It is indeed a cause for grave concern as oftentimes, patients are heartlessly abandoned as if intentionally hung to dry.

Despite being named after a national hero, the late Dr Samuel Parirenyatwa, a colossal pioneer indigenous medical doctor, care and attention at the referral institution is basically casual. Over the years, medical personnel have become considerably disquieted.

They are wearied such that they now suffer from perpetual malaise. Consequently, their conscience was deadened. Little wonder, they vent frustrations on patients. It has long been a public profound concern that patient care had ebbed dangerously low.

Recent complains of patient neglect in Ward C which prompted a visit to the institution by First Lady Auxillia Mnangagwa, are, however, not new. Several have been raised before. Amid widespread patient neglect, she is best advised to guard against grandstanding.

Prior to her appointment as ambassador to the Health and Child Care ministry, Auxillia went on a tour of public hospitals with television crews in tow. While her objective was not expressly clear, her strategy was untowardly attention-seeking, hence risking being maladroit.

How a government handles vulnerable citizenry such as the elderly, the sick and those on fringes of the economy, to mention but a few, speaks eloquently about the disposition of the ruling elite than rhetoric like that of a new dispensation and second republic.

Despite his tall story of Zimbabwe being open for business, it is against the worrisome backdrop of the prevalence of patient neglect, among a host of other mounting social challenges that President Emmerson Mnangagwa clocked his first anniversary at the helm.

Show me a person who has not experienced patient neglect and I will show you an elite who traverses borders for medical care. It is common knowledge that seeking medical care at public hospitals has become as dreadful as imprisonment.

Last week’s Sunday Mail published a letter under the headline, Reign in on Parirenyatwa, penned by an aggrieved person over the neglect of his brother who had suffered a fracture. He was abandoned on the hospital bed for days, yet all he needed was just a plaster.

He had to transfer to D floor private wards, where he received treatment upon admission. Sadly, it is only a few who are brave enough to publicly complain as did the patient from Ward C who cried out to Auxillia and his brother who sounded alarm bells through the newspaper.

Commonly, the generality of citizenry endure and even die in silence. Although PGH principal nursing officer, Dr Lilian Dodzo apologised for the neglect and promised a full investigation, she ought to be told that the challenge is massively transcendent.

With all due rest, patient neglect is entrenched beyond her sphere of authority. It is not a herd instinct behavioural trait like skin bleaching. As I see it, it spans to the era of the first post-colonial Health minister, Herbert Ushewokunze.

There is more to the prevalence of patient neglect than meets the eye. It augurs well for Mnangagwa to step out of the eyrie. Since taking helm of government, he is yet to hit the ground running to the public health sector as he did to the military.

His fellow Zanu PF bigwigs, who suffered injuries following a blast at the White City Stadium while on campaign trail in Bulawayo, were actually spared the agony of being treated in public hospitals. They were initially admitted at a private hospital before being airlifted to South Africa.

Hence, from the dawn of independence, the history of public health delivery service has been anything but healthy. It is littered with one strike after another. As recent as a few months back, nurses went on strike, only to be summarily dismissed en masse.

One truth that is crying out to be told is that public sector health caregivers are victims of government’s scant attention to the development of the sector. All public health facilities across the country are conspicuous by dilapidation.

Besides infrastructure dereliction, they all have been systematically underfunded over the years such that the wherewithal that constitutes a medical facility like ambulances, linen, dressings and drugs is either not available, or is so scant to be of significance.

Whichever public hospital one might mention, be it Mpilo, Gweru, Harare or Mutare, they all stand as symbols of neglect as opposed to care and hope. If you have been to one, you have been to all. And, to compound to this dilemma is high patient-caregiver ratio.

By all accounts, doctors and nurses are overwhelmed. They wish if they were ubiquitous like Jesus. Their overall working conditions have been on the agenda since the early 1980s. And, relations with their employers are not mutual, with no prospects ever for amity.

Many packed their bags for the great trek to the diaspora. Hence, it is inexplicable grace that there is a remnant of practitioners still weathering the storm. Yet, by virtue of being the coalface of public health delivery service, doctors and nurses bear the brunt of the public.

When the First Lady responded to the Ward C patient’s plea, her approach was a simplistic notion that the solution was within easy reach like low-hanging fruits. She pursued the elementary option of imploring nurses and doctors to render service with a smile.

She missed the opportunity to understand the extent of the problem by hastily proffering advice. Ever since her appointment as ambassador for the health ministry, it has been my conviction that she was too blinded by partisanship to add value to the ministry.

Given that she is a former parliamentarian, it stands to reason that she is in good stead to acknowledge that the public health sector has been gradually wilting due to under funding. She knows that were it not for the support of the international donors, by now, the public health sector could be in the intensive care unit, if not actually interred.

My four-month-long futile search for treatment at PGH’s Wednesday orthopaedic clinic, offered me a window of opportunity to see firsthand the extent to which service delivery had fallen. No wonder, the ruling elite fly to South Africa and beyond for treatment.

What started off as quest for treatment of my fractured foot degenerated into a wild goose chase with each subsequent visit. Eventually, I appealed to the clinical director. Yet, in spite of his intervention, all I got were three operation appointments which all were never honoured.

One surgeon whose name is intentionally withheld was particularly sinister. He always snarled, oblivious to time honoured patient-doctor reciprocal sentiments. It could have been a dance too close to the sun had I insisted on being put under the knife by him.

Agony accounts of patients, who, like myself end up saddled by shortfall bills at private surgeons are many. It is a known fact that surgeons who run clinics under the government auspices give theatre preference to patients they attend to at their private consulting rooms.

Goings on in public health institutions are an antithesis of ideals Parirenyatwa adhered to. Granted, patient neglect is a tip of the iceberg. There is an urgent need for an Operation Restore Ethical Conduct. As I see it, the ambassadorial role demands absolute probity.

Cyprian Muketiwa Ndawana is a public speaking coach, motivational speaker, speechwriter and newspaper columnist. He can be contacted on muketiwa.mmsb@gmail.com or +263776413010