Zambia's Health Facilities In Coma

*In July last year, I wrote this piece for Africa Hadithi. Following the evacuation of President Edgar Lungu for specialist treatment in South Africa, I felt I should reproduce it.

The prognosis for the health sector in the week running to July 21 was not very good for the Zambian health sector.
After a survey conducted in February this year, the Zambia Medical Association, in its report, disclosed that an average of 20 women gave birth on the maternity ward floor per day at the University Teaching Hospital (UTH), the country’s biggest referral health institution.
The association also found that there was an acute shortage of midwives at the institution. One of the reasons could be that in the first 18 months of its administration, the Patriotic Front (PF) government, voted into office in September 2011, dismissed over 500 nurses who had gone on strike demanding a pay rise.
Another disturbing news item was the announcement that the PF government would not go ahead with its much touted programme of building 650 health centres countrywide due to lack of funds. Before this, PF cadres ranging from Facebook-based cadres to the office-bearing politicians, this was one of the potential successes on which the 2016 elections would have hinged.
In the same week, President Michael Sata’s son, Kazimu, was unfortunately involved in a road traffic accident in which he and three other passengers were seriously injured in the Copperbelt Province city of Kitwe. Kazimu and other casualties were initially admitted to the former mining hospital, Wusakile, three to four kilometres from the accident scene.

Kitwe Central Hospital, one of three main referal hospitals in Zambia.

Either the injuries were so serious local health experts would not manage treating them or simply the conditions obtaining in the hospital were not befitting a president’s progeny. Whatever the case, millions of Zambians face the situation where their ailments are untreatable because of lack of adequate manpower, equipment and drugs, and above all, poor general conditions.
Like the privileged few who are evacuated to hospitals abroad, there are two well-known private hospitals of choice in South Africa that these people are taken to, mainly at government expense. There has, however, been a shift lately with a number of patients evacuated to India for treatment of cardiac, liver, kidney and prostate-related conditions.
The country’s health minister, Joseph Kasonde disclosed in June that the government spent about US$1 million annually sending people abroad for treatment.

“As you know, we are talking of something like a million US Dollars a year on sending patients abroad and we are obliged to do that because we know that in some cases we are unable to treat certain conditions, particularly child heart surgery and so we must ask other people to do it for us."

Blogger Chola Mukanga, who runs Zambian Economist, reproduced part of the letter then opposition leader Sata wrote President Rupiah Banda thanking him for sending Mrs Sata to South Africa for treatment. Sata himself was in 2008 evacuated to South Africa after he suffered a heart condition:

"I would like to re-state my long held view about access to specialist treatment abroad. I said it after my return from South Africa in April 2008 following my heart condition that our government must invest in this area both in terms of human capital and equipment so that access to such specialist treatment does not continue to be a preserve of the privileged few in our country. It is, therefore, my considered view Your Excellency that health care must become a human right by law for our people and not a privilege after 46 years of independence.”

It would appear that Zambia’s first president Kenneth Kaunda had a lot of confidence in the local medical facilities. Zambians never heard of him or members of his family being sent abroad for treatment. In fact, the UTH had a presidential suite under 24 hour guard, occupied or not. One of Kaunda’s children, Masuzgyo, who was diagnosed with AIDS in the mid-1980s, received all the treatment and care within Zambia before he died.
It was after the MMD came into power and barely two months into office that President Frederick Chiluba’s Vice President, Levy Mwanawasa, was involved in a fatal road traffic accident in which his aide died. Mwanawasa was evacuated to South Africa a few hours after the accident. That was the beginning of the flood of what one Zambian news website calls medical tourism.

Death From Treatable Conditions

Human Rights activist, Laura Miti, did not mince her words in a Facebook post on Kazimu’s evacuation:

“We all know how the children of ordinary mortals routinely die from malaria, diarrhoea and other very treatable conditions - why because we have administration after administration using millions in dollars to evacuate the well connected for treatment abroad. They don't care what happens to the rest of us. They have no idea (or have quickly forgotten, [as] now they are in power) how it feels to watch helplessly as someone you love toughs it through our medical system and probably dies because basic care was not available.”

In 2009, a Facebook group called Zambians Against Treatment of Leaders in South Africa (ZATLESA) was created to try and stop the treatment of leaders abroad:

“For the last 18 years of the MMD in power, a number of government leader… have at various times been evacuated to South Africa when they fell ill. Coincidentally during this period, health service delivery within the country has deteriorated leaving institutions such as the UTH, shells of themselves.
“As a result, poor citizens with no connections to corridors of power have died from diseases that would normally be treated locally. Because of the lack of transparency in the evacuation of leaders and those close to them, it is not known how much of tax payers money has been spent during this period. This same money could have been used not only to build hospitals, but also to acquire equipment that the local health institutions lack.
“The objective of ZATLESA is to campaign against unnecessary medical evacuations and channelling the money to local health service delivery.”

Until politicians and their families start going to UTH and local health facilities, even wheelchairs will be in short supply.