Health crisis deepens

Zambia's University Teaching Hospital (UTH), the country's main health institution, is eerily quiet these days. The calm does not denote silent efficiency, but a crisis in which essential drugs are not available, junior doctors have been locked out, and all but emergency cases go elsewhere for treatment. The hospital's 143 demoralised junior doctors went on strike last month in protest over conditions and the lack of essential drugs. The government responded by sacking 81 of them. It called in some 30 doctors from provincial hospitals and recruited five foreign doctors to help out at UTH, in addition to Cuban and Russian medical personnel already assisting at the hospital. It has promised to open negotiations with the sacked doctors, but so far has set no date. "We feel we are coping. You know why? Because most patients have stopped coming here and have gone to private clinics. Only the critically ill are coming," a hospital staff member who asked not to be named told IRIN. "It was bad before, now it is worse," one nurse said. But she added that she fully supported the strike. "The patients don't have drugs, what they have, they have to buy. If the government doesn't believe the doctors, they should have done their own investigations. The truth is people are suffering." On Wednesday, Zambia's parliament debated a private member's bill calling for the unconditional reinstatement of the sacked doctors and a commitment to improve the "deplorable" conditions at UTH. In proposing the motion, independent MP Crispin Sibetta said the government should listen "to the voices of the people" and resolve the impasse. He added that money spent on foreign doctors would be better spent on Zambian medical personnel. Since January last year, UTH has operated on a monthly budget but allocations are only made as and when the government has the revenue to spend. The result has been that the hospital has faced serious shortfalls. "It's just like the doctors said in their demands, we need medical equipment and drugs," a hospital official said. "If you want quality you need to have the money to buy it. With erratic funding most of the important drugs were not being bought." The situation at UTH is symptomatic of a wider health crisis confronting Zambia. The government, saddled with repayment obligations on its US $7 billion debt, has cut social spending to around 6 percent of its overall budget, UN sources told IRIN. Debt servicing absorbs more than health and education spending combined. The debt burden represents 185 percent of Zambia's GNP compared to an average for Africa of 69 percent of GNP. According to UNICEF, 49 percent of Zambian rural children are stunted, while WHO estimates that per 1,000 pregnant women, 70 die before giving birth. A Zambian government and UN Population Fund (UNFPA) study last year reported an overall maternal mortality rate of 800 per 100,000, but with significant regional variations. The devastating impact of HIV/AIDS is in part responsible for the sharp fall in life expectancy from 49 years in 1992 to an estimated 37 years at present.