Volunteer doctors and nurses provide health care

A number of initiatives aimed at extending medical services to the rural poor have been launched by enterprising doctors in Zimbabwe. Many Zimbabweans are finding it harder to pay for medical treatment as inflation of around 600 percent translates into soaring fees for private doctors and shortages of medicines in public hospitals. Private hospitals, doctors and dentists increased their fees by between 50 percent and 100 percent at the beginning of April, hard on the heels of a similar price hike three months ago. General consultation fees have leaped to almost Zim $70,000 (about US $13.80), with specialist doctors demanding Zim $150,000 (US $29.70). Deposit fees at private hospitals, which offer better services than poorly resourced state hospitals, now range from Zim $220,000 (US $43.50) to Zim $1.6 million (US $317). Recognising the gap in health care provision for the rural poor, a group of doctors started the Community Medical Outreach Service Trust (CMOST), in which doctors and nurses volunteer their services, time and expertise free of charge. The organisation extends health care services to the unemployed and low-income groups in rural areas. "As medical practitioners, we are cognisant of the fact that there are thousands of underprivileged people who cannot access medical services. The plight is particularly marked in remote rural areas," said CMOST chairman Dr Edwin Muguti. Since its inception in October last year, CMOST has conducted general consultations for more than a thousand ill people in Masvingo, Mashonaland Central and Matabeleland provinces, Chitungwiza town and Harare. The organisation has 80 medical doctors, drawn mostly from the capital, Harare, who are assisted by a group of nurses. The doctors include ear, nose and throat specialists, gynaecologists, urologists and paediatricians. "Specialist doctors tend to be concentrated in the big urban centres. They shun rural areas because they are afraid that their surgeries might collapse, since the general rural population lacks the capacity to pay for medical services. In addition, rural hospitals are mostly understaffed and are inaccessible to many," Muguti added. "We therefore decided to offer these marginalised people, who could otherwise die due to conditions that require simple attention, free and voluntary medical help. Busy as we are, we have resolved to spare one day every month to do an outreach programme in which we visit [rural] areas and attend to the sick," Muguti explained. CMOST has also assisted 73 patients requiring specialist attention. Local communities help to identify people needing CMOST's services, and voluntary community health workers gather the patients at specified points for treatment by the CMOST team. "We try as much as possible to be comprehensive and versatile. We also try to touch base with pharmacists and drug manufacturers so that, after we have attended to our patients, they are guaranteed of [receiving] the prescribed drugs," Muguti said. One of the main obstacles to the CMOST outreach programme is a scarcity of resources. "Reaching out to needy communities is a costly exercise that requires a lot of funding. Money is needed for transport, fuel and members' food. In addition, the patients camp at designated points well in advance of our arrival and they should be provided with food," Muguti explained. The Zimbabwe Medical Association (ZIMA), to which most Zimbabwean doctors are affiliated, runs a similar project aimed at benefiting low-income groups. Their initiative started early this year and has so far helped about 900 people in Masvingo, Mashonaland Central and the country's second city of Bulawayo. "Our programme was born out of the philosophy that we should not wait for outsiders to help out the needy people in this country," said ZIMA president Dr Paul Chimedza. He told IRIN that his organisation was currently negotiating with one of the country's largest referral hospitals for the donation of an unused operating theatre, while the army has provided manpower and tents for visiting teams and the patients seeking medical attention. Chimedza said his organisation had approached the corporate world for help in cash or kind, but the "response so far was not good enough". He bemoaned the lack of infrastructure on newly resettled farms, adding that most general hospitals were also inadequately furnished. "Even though we focus on rural communities, we also try as much as possible to help the poor in urban areas by identifying poverty-stricken suburbs," he said. Eyes for Africa is yet another voluntary organisation assisting those unable to afford or access health care. They conduct outreach programmes every last weekend of the month, devoting three days to an area. "We have been offering free eye services for a number of years, but of late we have witnessed a growing number of people coming to us for help as the economic situation declines and medical costs rise dramatically," said Eyes for Africa chairman Dr Solomon Guramatunhu. The ZIMA chairman also told IRIN that the organisation intended to inform policy on medical aid provision by identifying gaps during their visits, and advising the government and other stakeholders accordingly.