Island Hospice and Healthcare Zimbabwe are very grateful for the support that they have continued to receive from St John’s as they tackle the day to day problems that are associated with existing in Zimbabwe today.
Recently a team from Hospice UK travelled to Zimbabwe on a monitoring visit for a project led in-country by Island Hospice and Healthcare Zimbabwe and listed the principal challenges as….
“Food
“Hunger is the biggest challenge. They [the patients] don’t have anything to eat and so they can’t take their medications. But sometimes the caregiver doesn’t have food either.” (Caregiver).
With Zimbabwe experiencing its second drought in two years, one of the major challenges is the lack of food. We saw patches of maize, the staple diet of most Zimbabweans, which were wilting, bare and dying, when they should have been large, ripe and ready to harvest. While communities were able to get through one year on food stores, the fear following this second drought is palpable and real. Solutions are not forthcoming.
Lack of Medicines
“Sometimes it is hard to go back to patients because there are no medications in the clinic. They are short of anti-biotics and pain killers.” (Caregiver).
The supply chain for medications is complex. From community health centres to the district hospitals, medications are in short supply if not funded by external bodies (like ARVs). There has been significant success in getting morphine to be stocked and dispensed from the district hospital in Makumbe. However, there are profound challenges in influencing the national system to ensure availability of medications across communities.
Distance and Transport
“The clinic doesn’t have a vehicle and some patients are bedridden. How will the nurse get there?” (Caregiver).
We witnessed first-hand the long distances caregivers have to travel to reach their patients and the health centres. Patients who need to go to healthcare centres or the district hospital face huge distances and costly transport, which will often be completely unaffordable.
Poverty
“We are willing to continue [as a caregiver], but sometimes I need the money to buy food and a grinding mill. There are other pressing needs.” (Caregiver).
While the exact figures for unemployment in Zimbabwe are unclear and complicated by work in the informal sector, some have estimated that it may be as high as 95%. The poverty in Zimbabwe is acute. Some health centres now charge nominal fees for consultations, a situation which may make access to care prohibitive for many in the population.
Management of acute pain
“Major problems are referred to Island e.g. patients with acute pain. Where will we refer when Island is gone?” (Caregiver).
The combination of the issue of access to medications alongside the distance to the district hospital creates challenges in patients with acute pain.
Island (Hospice and Healthcare) is doing a tremendous job in increasing access to morphine and building the skills and knowledge of caregivers and health providers to identify, refer and treat pain”.
The full article can be seen on http://www.ehospice.com/articlepreview.aspx?articleid=20011
Island Hospice
Alan Brooks