Keep Us Strong WikiLeaks logo

Currently released so far... 64621 / 251,287

Articles

Browse latest releases

Browse by creation date

Browse by origin

A B C D F G H I J K L M N O P Q R S T U V W Y Z

Browse by tag

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Browse by classification

Community resources

courage is contagious

Viewing cable 09HARARE105, ZIMBABWE REGIONAL HOSPITAL STRUGGLES TO PROVIDE CARE

If you are new to these pages, please read an introduction on the structure of a cable as well as how to discuss them with others. See also the FAQs
Reference ID Created Released Classification Origin
09HARARE105 2009-02-10 13:22 2011-08-24 16:30 UNCLASSIFIED Embassy Harare
VZCZCXRO7326
RR RUEHBZ RUEHDU RUEHJO RUEHMR RUEHRN
DE RUEHSB #0105/01 0411322
ZNR UUUUU ZZH
R 101322Z FEB 09
FM AMEMBASSY HARARE
TO RUEHC/SECSTATE WASHDC 4019
INFO RUCNSAD/SOUTHERN AF DEVELOPMENT COMMUNITY COLLECTIVE
RUEHJO/AMCONSUL JOHANNESBURG 0558
UNCLAS SECTION 01 OF 02 HARARE 000105 
 
AF/S FOR B. WALCH 
INR FOR T. CHOJNACKI 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: PHUM PREL PGOV SCUL SMIG ELAB KPAO ZI
SUBJECT: ZIMBABWE REGIONAL HOSPITAL STRUGGLES TO PROVIDE CARE 
 
REF: 08 HARARE 1007 
 
HARARE 00000105  001.2 OF 002 
 
 
1.  SUMMARY:  As reported reftel, Zimbabwe's public hospitals remain 
closed in most parts of the country, with the few remaining open 
without adequate medical supplies and services.  Instead of filling 
the void left by the closed public hospitals, many private hospitals 
have begun a policy of turning away patients, even during medical 
emergencies, unless a substantial payment in U.S. dollars (around 
US$2,000 at Avenues Clinic, the premier hospital in Harare) can be 
provided at the time of admission.  Mater Dei Hospital, a private 
hospital in Bulawayo, is the only large private hospital in the 
country that still admits patients without admission payment. 
According to Mater Dei's director, both private and public hospitals 
have to deal with a severe shortage of trained staff, nurses, 
doctors, clean water, and electricity.  END SUMMARY. 
 
Innovative Leadership 
--------------------- 
 
2.  During a consular outreach trip to the area on January 21, Mater 
Dei Hospital director Sister Jameson described Mater Dei's unique 
status.  Mater Dei is a Catholic hospital that has been operating in 
the city of Bulawayo for more than 50 years. Founded by a group of 
Franciscan nuns as a private hospital, the hospital has operated as 
a quasi-public hospital since 2000 when the Franciscan order 
transferred ownership to a private trust in Zimbabwe.  Because of 
innovative leadership, the 180-bed hospital has only had to close 
two of its wards due to infrastructure and staffing issues. Mater 
Dei has worked diligently to become as self-sustaining as possible. 
The hospital has two generators, three private wells, and has 
installed solar heating panels for heating purposes in the kitchen, 
laundry, and the nursery. Currently, the hospital is in negotiations 
with several private companies and NGOs to provide medical services 
to their employees now that the medical insurance industry has 
collapsed.  World Vision, Population Services International, and the 
International Development Bank are in the process of making 
arrangements to pay a monthly stipend to the hospital to guarantee 
that their employees can continue to receive timely and quality 
medical treatment. 
 
3.  In an effort to retain doctors, Mater Dei now permits physicians 
to have private offices in the hospital, supplementing their 
hospital salaries while retaining the benefit of having them on 
scene for emergencies.  This cooperative approach between the 
hospital and physicians has allowed Mater Dei to retain almost all 
of its doctors. The hospital reported that it lost only 3 doctors in 
2008 compared to the more than 120 nurses they lost during this same 
time period.  It has also begun to pay the transport costs for its 
entire staff and to provide additional supplemental pay in South 
African Rand (approx $50 USD for staff that are not nurses or 
doctors) in an effort to retain its workforce. 
 
The Challenges 
-------------- 
 
4.  Facing critical nursing shortages, the hospital continues to 
recruit and explore other short-term gap measures. Mater Dei doesn't 
believe it will be able to recruit additional nursing staff given 
the hospital's inability to compete with the financial incentives 
being offered to nurses from hospitals in Australia and the U.S. 
The hospital also lost four pharmacists this year and now has only 
one pharmacist, two technicians, and volunteer pharmacists staffing 
the pharmacy.  Hospital officials estimate that they have between 
four to six weeks of pharmaceutical drugs on hand at any given time 
Qfour to six weeks of pharmaceutical drugs on hand at any given time 
and complain that they would stock more but are limited by South 
African pharmaceutical companies who generally don't stock enough 
drugs to meet the hospital's demands.  The hospital routinely pays 
additional shipping costs for basic drugs because the companies 
cannot meet the requested shipping order. Although Botswana is 
geographically closer to Bulawayo than South Africa, cost concerns 
force them to buy all of their drugs from South Africa. 
 
5.  As with other hospitals and organizations, accessing bank funds 
has been a challenge for Mater Dei. In January 2008, the hospital 
requested permission to withdraw US$6,000 to buy equipment to keep 
elevators and telephone lines working. When we visited, the Reserve 
Bank of Zimbabwe had still not approved this request. 
 
6.  Finally, faced with the prospect of either having to turn 
patients away at the door (a common practice at the private 
hospitals in Harare) or go bankrupt from providing free medical care 
to an entire region, Mater Dei tries to bolster the resources of the 
local public hospital by providing free anesthesia for critical 
surgeries, fuel to transport the public hospitals' most critical 
patients, and free use of its autoclaving machines (used to 
sterilize medical tools). Unfortunately, even with this support, the 
two public hospitals in Bulawayo have had to close their maternity 
wards and are turning most patients away because they can not 
provide the requested medical care. 
 
HARARE 00000105  002.2 OF 002 
 
 
 
Government Harassment 
--------------------- 
 
7.  Amazingly, even though Mater Dei Hospital is the only hospital 
in Matabeleland with a functioning emergency room and doctors 
trained in trauma care, the hospital still is routinely harassed by 
the government. The Reserve Bank of Zimbabwe audits its accounts on 
a weekly basis and on January 14 threatened the director of the 
hospital, a Franciscan nun, with jail for not accepting checks 
written in Zimbabwean currency, a practice all private and public 
hospitals have adopted because of the continued devaluation of the 
Zimbabwe dollar. 
 
8.  This pattern of harassment and intimidation was also evident 
during the December hospitalization of ZANU-PF Political Commissar 
Elliot Manyika who later died from injuries reportedly received in a 
car accident. During Manyika's hospitalization, all of the staff's 
cell phones were confiscated by the local authorities and were not 
returned until many days after his death. All incoming and outgoing 
calls on the hospital's phone lines were also monitored, and the 
hospital was repeatedly warned against releasing any information 
regarding Mr. Manyika's case.  The hospital was also not permitted 
to admit anyone other than the family and authorities into the 
hospital ward where he was treated. After his death, the family 
refused to pay the medical bills incurred by Manyika as did other 
local ZANU-PF authorities. 
 
Long-term prospects 
------------------- 
 
 
9.  Mater Dei Hospital credits its ability to still operate to its 
"amazingly generous and committed donors."  In 2006, the hospital 
suffered a major electrical fire that burned down the entire fifth 
floor. Through a major fundraising program, the hospital was able to 
completely rebuild the wing. These same funds, over US$30,000, have 
also financed the hospital's operating costs for the past 18 months. 
 Without this money, the hospital could not have rovided the 
supplemental pay needed to retain staff. 
 
10.  The hospital admits that it will have to rely on continued 
grants from organizations outside Zimbabwe in order to meet future 
operational costs. The director of the hospital went on a 
fundraising tour to the U.S. in 2002 and expects that she will have 
to do another fundraising tour in the near future. In the past three 
years, the hospital has also received substantial grants from the 
Catholic Church and Rotary International to help underwrite its 
operational costs. 
 
 
11.  Mater Dei continues to explore avenues to expand clinical care 
while containing rising medical costs.  It is actively working with 
Rotary International to begin a radiology program that would allow 
the hospital to send its x-rays by computer to doctors in the UK or 
U.S. to lower expenses and wait-time since radiologists in Zimbabwe 
charge significantly more for their services than their USA and UK 
counterparts. The hospital also hopes that by partnering with local 
businesses to develop a plan for employees no longer covered by 
medical insurance that it can continue to maintain a significant 
revenue stream while providing good community care. 
 
COMMENT 
------- 
 
12.  While the long-term future of Mater Dei Hospital remains 
uncertain, it is clear that the closure of this hospital would 
effectively leave the western half of Zimbabwe without adequate 
medical care, particularly in the event of an emergency.  This is a 
concern from a consular perspective given that many, if not most, 
American tourists visit Victoria Falls and Hwange National Park. 
QAmerican tourists visit Victoria Falls and Hwange National Park. 
Also from a consular perspective, Mater Dei retains adequate 
facilities to provide urgent and standard care for an American 
citizen, should the need arise.  Mater Dei is a long-standing, 
well-run private institution; other smaller, less resilient 
institutions are surely faring much worse if they have not already 
failed.  Nevertheless, the continued threats of rising costs, lack 
of medical insurance schemes, and patients without the ability - or 
will - to pay may be the hospital's demise. END COMMENT. 
 
MCGEE