By Ray Mwareya
In May, Anna Muwa, 31, entered a clinic in Bulawayo, Zimbabwe second capital, to give birth, but failed. The hospital needed $US70, sanitary pads, water bucket, and a soft razor to cut the baby’s umbilical cord.
“I walked out and delivered my baby in a bedroom. My grandmother supervised everything. Clinic fees punish us here,” reveals Anna who sells reed mats in Chimanimani, district over 400 kilometers away from Bulawayo city.
According to the Genderlinks Barometer for 2015, only 66% of child births in Zimbabwe are attended by skilled personnel unlike say neighbouring Botswana at 99%. Zimbabwe’s child birth mortality rate is sadly the second highest in the SADC region.
In a move that worsens this scenario, service fees in Zimbabwe’s hospitals were hiked by 100 percent in June 2015. At Parirenyatwa – Zimbabwe’s largest health institution – patients will fork out $140 to $180 on admission compared to $50 in the past. Fears are high – a country with one of Africa’s most expensive clinics may cut off its citizens from formal health services.
Dr. Fortune Nyamande of the Zimbabwe Doctors For Human Rights captures this fear. “The right to healthcare will remain a pipeline dream particularly for our downtrodden women.”
The decay of Zimbabwe’s health care conflicts with the situation in its neighbouring countries.
After Zimbabwe’s economy collapsed and its currency became worthless in 2008, nurses, doctors and professional helpers ran away to South Africa, Botswana, Australia or the US to seek improved job.
Now, the country’s finance minister Mr. Patrick Chinamasa says he’s struggling to maintain a $4 billion budget and spread money to the critical health sector. Zimbabwe now has the unenviable position of having the most expensive healthcare in Southern African Development Community (SADC) region for some procedures. For example, a hip and knee replacement surgery in Zimbabwe costs $13000 while in Zambia, up north, it is only $4500. For one to receive a cataract eye surgery in Zimbabwe, $1775 must be produced. Next door in South Africa the same procedure would be carried out for free at a state institution or $322 elsewhere.
“Imagine as a nurse I’m only paid $0, 50 cents per hour each night I work,” frowned Amos Bonga a 37 year old pediatric hospital assistant in the city of Gweru.
The country’s clinics gripped the world’s attention when it was revealed in 2013 that a certain maternity was imposing a $5 punishment each time a woman cried during childbirth. The UN says that on average 8 women die everyday in Zimbabwe while giving birth because it costs between $10 and $50.
Many Zimbabwean women, living on as street vendors feel chucked out by costs.
“Blood transfusion is $60 per tube. Couldn’t afford it man!” moans Sheila, a laundry lady who was injured a bus accident in January. “I almost died under a hospital drip for lack of money after surviving a bus plunge into a cliff.”
Desperation in Zimbabwe, it seems, drives entrepreneurs. Unregistered herbalists have spotted a chance.
Some young women in the capital are buying traditional herbs at the Mupedzanhamo Market, the country’s biggest open air market, to wash away unwanted pregnancies.
Beauty, a 23 year old student who withdrew her surname because abortion is illegal in Zimbabwe, confesses: “With root herbs I killed off my first pregnancy. Just $29. The taste is bitter but the results are painless.”
Herbalists claim their services straightforward. Ishmael Makoya of the Zimbabwe Traditional Healers Association (ZINATHA) boasts: “doctors demand up to $400 to perform safe abortions backdoor. Girls seek herbalists. In other words they seek traditional medicine herbalists.”
Traditional medicine healers in Zimbabwe are lawfully organised under the Traditional Medical Practitioners Council.
City pavements balloon with cheeky advertisements promising cures for flu, cancer or diabetes.
“Vagina tumors cleared with one herb mix drink. Phone here….” trumpet the road signs.
Business is lively, says Sekuru Mbada a herbalist, who only revealed his first name for fear of jeopardizing his medicine business chances. “For leaves to cure syphilis I take $70 every week,” he says refusing to reveal the chemical properties of his medicine.
The state led National Aids Council of Zimbabwe says sexual infections like syphilis are soaring in the capital, fueled by student poverty and an 80% national jobless rate.
When challenged that he was prescribing the same medicine for sexual infections and flu, Sekuru Mbada was evasive. “One leaf can cure twelve diseases. I’m not fake doctor.”
Chester Zviko, an economist with the Zimbabwe Social Mobility Research charity is not surprised. “Street medicines are popular when state clinics decline. Anything like a health relief can be a best seller.”
Foreign herbalists from Malawi, Ghana, Kenya the continent have smelled the money route too, camping in towns. “Doctor Mama Lee – best from Congo. $230, I remove your Tuberculosis….” read pub wall signs in irregular English.
Licensed herbalists like Peter Sibanda, secretary of the Zimbabwe Traditional Healers Association are alarmed. “We are losing revenue. Surely. We are losing…”
In January his organization announced plans to open the country’s first line of traditional medicine pharmacies.
“Fake herbalists are killing our trade,” he says. He lampoons a poster that claims: “Increase your buttocks. One herb. Results One week! $90.”
Encouraged customers, herbalists now demand vast powers to write “sick notes” letters for their working patients.
The National Aids Council obliged, and encouraged herbalists to compile treatment statistics about their patients.
Confident as they are, herbalists in Zimbabwe still bring resentment.
“Herbs are good. Their minerals and vitamins revive bodies but we worry about their toxicity levels,” says Pious Nale, a gynecologist in Bulawayo the country’s second largest city. “These guys are not trained doctors. Big dangers lurk.”
In the capital herbalists selling “vagina tightening oils” and “skin lightening creams” for women are blamed for a steep rise in cervical cancers and other health defects.
In 2014 the Zimbabwe Cancer Registry said the rise of cervical cancer infection among the country’s black women had reached 34.6 percent. The Genderlinks health barometer confirms that cervical cancer is the leading cause of death among young women in the country.
There are rays of hope though. For instance, Zimbabwe has achieved near universal knowledge of contraceptive use with 99% of women and 98% holding some knowledge. This is in contrast to the other SADC countries like Angola that has a world record low of 6% in family planning device use.
RAY MWAREYA IS A HUMANITARIAN REPORTER FOR THE Global South Development Magazine