ZIMBABWE’S largest referral hospital, Parirenyatwa Group of Hospitals, which services Harare and other nearby provinces, has been operating with only one functional ambulance, reflecting the country’s continually crumbling healthcare services.
The hospital was established in terms of the Health Service Act [Chapter 15:16], and is a principal referral centre located in Harare, consisting of Mbuya Nehanda Maternity Hospital, Sekuru Kaguvi Eye Unit, Annex Hospital for the Mentally Disabled and the Main Hospital.
Findings by acting Auditor-General Rheah Kujinga in her report on State-Owned Parastatals for the year ended 31 December 2022 have revealed that the institution was operating with an aged vehicle fleet of 16 vehicles, with only four functioning.
“As a result, the Hospital incurred repairs and maintenance costs of ZW$11.2 million. In addition, the Hospital had only one out of four ambulances which was functional,” reads the report.
The hospital’s infrastructure is dilapidated, with four out of 21 functional theatres, two out of eight functional X-Ray machines and one non-functional CT Scan as at 31 December 2021, which saw patients being referred elsewhere for services such as computerised tomography (CT) scans. The remaining functional theatres have been in dire need of re pairs.
Parirenyatwa has also been operating without analysing tools for maintenance and calibration of medical equipment to ensure safe and effective use in the diagnosis, monitoring and treatment of patients.
The equipment includes: “Biomedical Devices Electrical Safety Tester, Electrosurgical Analyser, Incubator Performance Analyser, Intravenous (IV), Pum Analyser, Non-Invasive Blood Pressure Monitor Analyser, Pressure and temperature Measurement Device, Ventilator Performance Analyser, Bio-Signal Simulator, Radiation Compliance Testing Device and Defibrillator Analyser.” The hospital’s residential facilities are also in a shambles, in need of immediate renovations, with 27 rooms now uninhabitable.
“The residential buildings’ plumbing works, floors, ceilings and cardboards were damaged and needed to be repaired. As a result, some students were now sharing rooms while some of them had been on the waiting list for a long time whilst other occupants were now renovating their rooms contrary to the lease agreements. Upon enquiry, management indicated that the capital budget for 2021 was released in October 2021 and was inadequate to fund the renovations,” reads the report.
Parirenyatwa’s accounting system has also been under scrutiny, with the hospital failing to settle in time money owed suppliers.
“The Hospital was offering services to those who were exempt from paying. The cost of offering such services during the year was ZW$370.4 million and the budgetary support for these services amounted to ZW$117.6 million leaving a funding gap of ZW$253.1 million (68%),” reads the report.
“The Hospital was not settling its payables as and when they fell due. The Hospital had payables amounting to ZW$113.7 million which were more than 120 days. As a result, the Hospital experienced periods of stock-outs of essential medicines. This was contrary to the Essential Drugs List of Zimbabwe (EDLIZ) which requires the minimum quantities of drugs to be available at the Hospital at all times.”
Things are also not looking good at other hospitals, with the AG’s report showing other key referral hospitals such as the United Bulawayo Hospitals (UBH) and Sally Mugabe Central Hospital incurring losses.
“I draw your attention to the fact that the Hospital (UBH) incurred a deficit amounting to ZW$86.5 million during the year ended December 31, 2020 and it had accumulated losses amounting to ZW$251.3 million as at year end,” reads the report.
“These factors indicate that a material uncertainty exists that may cast doubt on the Hospital’s ability to continue operating as a going concern. However, the financial statements have been prepared on a going concern basis.”
The UBH consists of four hospitals that have different service lines, namely Richard Morris Eye Unit, Lady Rodwell Maternity Hospital, Robbie Gibson, an infectious diseases hospital and the Main hospital.
On Sally Mugabe Hospital, Kujinga said: “In my opinion, because of the significance of the matters described in the Basis for Adverse Opinion section of my report, the financial statements do not present fairly, the financial position of Sally Mugabe Central Hospital as at December 31, 2021, and its financial performance and cash flows for the year then ended in accordance with International Financial Reporting Standards (IFRSs).”
In June, the parliamentary portfolio committee on Health also revealed the state of dereliction in Zimbabwe’s healthcare facilities, after it emerged that radiotherapy cancer treatment machines at Mpilo Hospital — purchased by the taxpayer for US$2 million — have not functioned for four years because central government has not bought spares worth US$80 000. The chairperson of the committee, Dr Ruth Labode, described the negligence and dereliction of duty as “sad”.
Mpilo Central Hospital in Bulawayo is a referral institution serving patients from Bulawayo and the Matabeleland region.
A public resource management situation report by the Zimbabwe Coalition on Debt and Development (Zimcodd) released in June showed that only a paltry 4% of 57 districts surveyed have good healthcare facilities, with the majority (85%) reporting poor medical facilities.