By Dr Raymond Chamba
Nothing riles me more like the endless maneuvers and political point scoring around the pandemic of COVID-19.
The health professionals are quick to blame the fiscus for under-resourcing them, the opposition parties turning to misgovernance as root cause, the security sector turning on civilians for indiscipline, the NGOs and multi-lateral agencies imagining presenting themselves as better positioned to respond to the crisis.
Let me tell you a little story. In 2010 we started Community Healthcare Options as a private initiative to provide primary care that was affordable, accessible and acceptable care for the broader generality of our people. We were told that it was too bold, too broad, too ambitious and we had to get buy in from key stake holders to make this work.
We went for unending presentations to parliamentary caucuses, senate, opposition parties, embassies, NGOs, health professional councils, medical control authority, and indeed the security sector. I became a career presenter of note and drafted a cadre of amazing professionals to help us through this process. We even went to the late great Oliver Mtukudzi for permission to use his amazing old song “Nyarara Mwanawe”, which he gladly agreed to.
Privately, it was reported at the highest levels the same refrain of “who does he think he is”. Many finally took the position of “munyudzei- financially drown them” by insisting on 60% of the centres being in rural areas understanding that the new currency was not circulating in the rural areas. By divine fortuitous happenstance it proved to be a roaring success when we started charging the USD$3 consultancy fees in wild fruits, grains and chickens. We even had goat insurance for covering up to 7 family members for 6 months!!
There is no MP we didnt write to or major constituency we didnt visit and deploy our equipment and people. Rural District Councils openly gave us land (we insisted on 5ha) for them to show commitment the cause. We ended up having such an impressive land bank of prime rural growth point land (vakuru vakavhunduka).
The idea behind this initiative was simple, get the largest pool of people to access healthcare at the lowest price possible and recoup your costs through pharmaceuticals. Our money was on the drugs which we got on international credit lines and at the lowest price imaginable because of bulk buying discounting.
We recruited about two thousand nurses and over 100 doctors. In order to subsidize our operational costs for recruitment they paid an admin fee. At our optimum levels of operation we had put together 185 centres and clientele was coming in hard and fast.
Special programs like Welfare Wednesday and Seniors Saturday for zero consultation fee access for the first 50 qualifying people was instituted. Select NGOs like Padare Mens Forum were supporting us by prepaying us money for their clients.
Everyone got to have a drink before they got to narrate their health issues, as in the African culture of giving visitors water before listening to their stories (it was mazoe, raspberry, cream soda or water from big dispensers). Our clients set on sofas made by the local furniture industry folks. The success unsettled the powers that be.
Health Professional Authorities were spooked about a johnny come lately with ideas, madness and a bag of money invading and reconstituting their industry by doing strange things like massive advertising with flyers and on the bulk sms system. Politicians on the ground felt threatened by someone they cant control actually doing what they long promised by tradition election cycle after cycle.
Certain foreign embassies and their interests were riled about an indigenous solution to health access making their sanctions and leverage thereof through healthcare powerless. Having understood our strident submissions that all healthcare and primary health care in particular is a national security issue securocrats were curiously unsettled by our success and military momentum in opening at least one clinic everyday somewhere. It is noted that one of them remarked “ndiyani akasiya munhu uyu achiita zvese izvi takatarisa. Nyika inoenda…”.
We were ordered closed by a combined operation of ZRP Support Unit, PISI, CIO, MID, MCAZ, etal in one sad day across all centers. I lost more than USD$7 million in family investments into this. There was absolutely near noone to sell the equipment to, the drugs to. Staff was baying for my head in salaries from doctors, nurses, painters, plumbers, builders, security and yes police hounding me for every imagined crime. Principally the crime of daring to do something so bold in brazen militant fashion to help our people.
So in summary from painful practical experience nobody really wants ordinary people to get affordable, accessible and acceptable unless they are controlling the structure. Healthcare is big politics and the citizens hapless and useful pawns in all designs around the subject.
So for every new voice of make believe outrage and concern around healthcare access in Zimbabwe i boldly say “shut the fuck up”.Where were you when i was getting persecuted and hounded for daring to provide health care access for all.
All reasonable people must understand that there are no angels around our current state of healthcare inacess. Hapana mutsvene apa from government, health professionals, health authorities, multi-lateral financial institutions, NGOs every fuckin’ one of them.
Now we have COVID-19 but the public administration of healthcare was always the existing and primary VIRUS.
Tine varoyi in the system
Dr Raymond Chamba