By Dr Henry Madzorera
Zimbabwe faces a grim future if government does not immediately step up efforts to prevent a full scale corona virus outbreak in Zimbabwe. The fact that COVID-19 is spreading so fast around the globe, and that our neighbour South Africa has already reported 7 cases should send a cold chill down our spine, for many reasons. The question is when, not if, COVID-19 will come to Zimbabwe.
COVID-19 outbreak comes at a time when our health delivery system is weak and lacks resilience. Even the most basic day to day health care delivery is virtually non-existent to the citizenry. Public confidence and trust in our healthcare system is at an all-time low. Routine surveillance and epidemic intelligence has suffered greatly due to the challenges bedevilling the system.
Zimbabweans are extremely worried by the possibility that we may already have had cases that went undetected and unreported. Poor surveillance will yield very dangerous statistics. The bungling in the handling of the few cases reported in the media betrays high levels of unpreparedness on the part of government. Citizens are worried by the track record of our government over the past forty years.
This government’s default position in the face of any threatening epidemic is denial and false reassurances to the populace, presumably to cover up for their perpetual unpreparedness. That’s how HIV took over Zimbabwe, and that’s why cholera killed over 4000 citizens in 2008-9. A good government should be transparent and keep its citizens correctly informed.
Citizens are gravely worried about mis-information regarding detail of suspected cases. And if a suspected case flees from hospital untested, that is serious bungling and unpreparedness on the part of the whole system.
As a people’s party , we are here to help government manage this complex outbreak of international concern. This is not a partisan issue, but a matter for all Zimbabweans. When this pandemic is over, we all want to look back and proudly say we did all we could as a people, we prevented all cases that could be prevented, we detected early all cases that came into the country, and we successfully prevented all loss of life through astute and well-resourced clinical management. We also want to boast that there was no loss of life among our health care workers due to this exposure. Then we will have matured as a nation, regardless of all our other toxic politics.
Currently we are not prepared to handle a single case of COVID-19. This is evidenced by the panic and confusion that attends the arrival of a potential case at any of our institutions, whether that be in Harare, Masvingo, or anywhere else in the country.
The health care workers are still asking questions about what to do if a suspected case should come to their institution. There are no national guidelines. Health workers don’t even know where and how to send pathology specimens for diagnostic workout, and where to quarantine a case. The two isolation centres in the two major cities are not adequate to service the nation. It seems to us that the Personal Protective Equipment for health workers has not yet been prepositioned in all districts.
We are behind time.
Training of trainers in COVID-19 screening, detection and management is only underway now and this is late! Our ports of entry are poorly staffed and poorly equipped, and our self-quarantine procedures are useless, because there is no adequate monitoring and enforcement.
What should be done?
As the people’s party, we advocate for a health system that is resilient. Such a system is vigilant in disease surveillance, supported by a universal comprehensive primary care coverage. That health system should be able to quickly identify and isolate a disease outbreak and target resources to it. There should be minimisation of disruptions to provisions of essential health services during the outbreak.
We urge the government to work closely with the citizens, and keep correct and accurate information flowing. Government should work hard to have an informed public who will take prevention confidently into their own hands. There should be established call centres in every district which people will use to inform the system that they suspect they are infected.
We should not wait for people to come to institutions. We should test them at home. Resources must be availed for that and our community nursing and environmental health technician departments should be capacitated to carry out their duties.
For the life of this pandemic, government should have clear guidelines on travel curtailment, particularly to and from the affected areas. Bear in mind that the whole world is potentially affected now, but there are some hot spots. Government should continue to assess the situation and advise the nation on when to cut down on public gatherings.
The issue of the incapacitation of doctors and other health workers continues to linger in the shadows. Our health workers need to be well resourced and motivated so that they show up for work that may be difficult and dangerous. This is already a national emergency. During the 2008-9 cholera outbreak we had to incentivise the health workers to undertake the risky work they were expected to do. That was part of the secret of our success. Now is the time to improve the morale of health workers, before disaster strikes!
What is the nation’s budget for COVID-19 response? Do we have enough resources, have we declared a national emergency, have we asked for international help where we need it? There are doubts in the population about the efficacy of our laboratory testing capacity, because the government just says we got kits from this donor and that donor. Zimbabweans are literate! Tell us the kits. We want to know their sensitivity and specificity. We also want to know how many of the tests you have done were confirmed negative by the World Health Organisation collaborating laboratory in South Africa. We don’t want COVID-19 to end up with its epicenter in Zimbabwe, as did HIV, because of poor and delayed responses.
We wish to assure the current government that the MDC and its President stand ready to assist in any manner possible to ensure that COVID-19 does not become a major problem in Zimbabwe. The COVID-19 response must be multi-sectoral AND non-partisan. Complete transparency and accountability to the nation are key.