MDC Alliance Weekly Health Alert (8th Edition)
The government’s response to the covid-19 pandemic was characterized by failure to test the people, failure to manage immigration, failure to provide necessary resources like Personal Protective Equipment (PPE), COVID-19 admission facilities, oxygen, ventilators, failure to support and appreciate healthcare workers, poor or non-existent messaging, abuse of the pandemic to score cheap political gains at the expense of the people, failure to provide social safety nets and failure to deal with corruption like the Drax scandal and others. Lately, the government has also shown that it has no vaccine plan and only depending on knee jerk reflexes. On a scale of “A” to “E”, with A being the best score, we give the government of Zimbabwe a score of “D” for its performance in the first year of this pandemic because of the aforementioned.
As we commemorate the first anniversary of the worst pandemic in a century, we need to introspect as a nation on what we could have done better. “An unexamined life is not worth living”, as someone has already said. The first cluster of cases of COVID-19 were reported on December 31 2019 in Wuhan, China, and on March 11 2020, the WHO declared COVID-19 “a public health emergency of international concern”. All systems in Zimbabwe then should have gone into overdrive to avert a national disaster. Mortality in China and some European countries had already started showing sinister trends. The Government of Zimbabwe declared its preparedness for the pandemic, with Wilkins hospital completely kitted up and ready to admit patients, with ventilators and oxygen in place.
The first wake-up call was on March the 20th, 2020, when we had our first real case of COVID-19, a young promising journalist, who passed on three days later under deplorable conditions. The nakedness of both the government and the purported national isolation centre, Wilkins hospital, was exposed. Health workers did not have adequate PPE, they did not quite know what to do with the case, and there was no single ventilator available, though the patient could easily have afforded one. This was a chaotic and traumatic experience for both the family and all Zimbabweans. We all started weighing our chances of survival in the face of this new reality, with much trepidation, considering that this first fatality did not come from a family of meager means.
These are the lessons learnt from this experience:
- Government should never lie to the people that we are prepared when in fact we are not. Complete transparency and honesty have no substitute.
- A caring attitude is important, and cover-ups stink.
- All resources should have been channeled to life saving technologies and human resources in a pandemic of this magnitude.
- Government has no power to stop death, but government has the power to avail the best possible service to its citizens, so that at the end we can all say, “Well, all that could be done was done. This was now purely in the hands of The Maker”.
The failure of government to resolve a labour dispute with the doctors & nurses contributed much to our poor state of preparedness. Government should have dealt speedily with the health-workers’ industrial action and restored normalcy ahead of this pandemic. There was enough time to do that. The militarization of housemanship is not an answer to our human resources problem, and is bound to backfire with time. Government must reconsider.
Politicization of COVID-19 lockdowns was a serious miscalculation on the part of government, as this only served to spread the virus. The March 31 Supreme court ruling, now commonly known as the COVID-19 judgement, is a good example of the abuse of lockdown measures. The selective harassment, abuse and fining of citizens throughout this period is another example. These did not serve the interests of the nation in dealing with the pandemic. Instead, we saw Zanu PF functionaries holding parties and posting pictures on social media, supposedly to show that they were in power, without any legal repercussions. But COVID-19 did not understand that, and the events were unfortunately not without their own adverse consequences.
Institutionalized corruption and the looting of the covid-19 funds emasculated government’s response to the pandemic. Government continues to pay lip service to the fight against corruption as real looters of COVID-19 funds continue to roam the streets scot free and we have not heard about any recoveries, especially from the Drax scandal. Sadly, government has not been able to provide adequate free testing to the population, consequently no contact tracing was possible, and many cases went undiagnosed. Without testing, there is no isolation and containment of the pandemic. One year later, free testing is still not available to the majority of Zimbabweans. The result is that there has been no science in mapping the epidemic, and targeted lockdown measures and other data informed decisions could not be made. Blanket lockdown measures brought untold suffering to people who did not even need a lockdown in their locality. Government should take healthcare seriously, and make sure adequate resources are availed for the people’s healthcare, in keeping with section 76 of the constitution.
Failure to provide social safety nets in spite of pronouncements by the minister of finance was a monumental failure for this government. People were locked down into hunger and starvation, because the majority of our people live on hand to mouth budgets. We all watched with envy as other nations provided relief to their citizens in these trying times. Locking down the nation without providing food relief was the most cruel thing government did in response to this pandemic. The promised stimulus package to industry did not filter down to the intended recipients. One wonders who benefited.
There were many policy failures in the approach to this pandemic, chief of which was immigration control. Quarantine centres did not work as expected, they were porous and inmates were able to bribe their way out, use political influence to avoid quarantine, or simply escape from the centres through unknown channels. That is how we domesticated a disease that otherwise could have been kept out of Zimbabwe. It is important to move in tandem with international trends when dealing with a pandemic. The visit by the so-called Chinese COVID-19 specialist doctors was suspicious and certainly added no value to our response to the pandemic.
Failure to anticipate the second wave and prevent it was a monumental failure by the government. We all knew that the infection figures and deaths in our neighbouring South Africa were high. We also knew that a new more vicious strain in terms of transmissibility had been identified. It is common knowledge that we have a few million Zimbabweans in South Africa many of whom always want to come home for the festive season. The government took no thought of that to avert disaster, and we ended up with our worst two months, the nasty second wave which was both completely predictable and preventable.
Failure to set up COVID-19 isolation and treatment facilities resulted in untold suffering and unnecessary mortality. Patients requiring moderate interventions like oxygen supplementation could not get it for there was no place to admit them. Until now, there are many towns without a single COVID-19 admission facility and patients are still turned away to go and die at home without any attempt to supportive therapy. But by far, the greatest looser was the ordinary non-COVID patient who could not be attended to because staff did not have PPE and had no capability to screen for COVID-19. Chronic disease patients were hardest hit, as many could not access their usual medication.
Communication and information dissemination has been very poor throughout this pandemic. The whole response was shrouded in mystery. This is now manifesting in the low vaccine uptake, which is largely caused by the people’s mistrust of government’s choices and failure to deal with conspiracy theories and other legitimate questions pertaining to vaccine safety and efficacy. The lack of transparency regarding the cost of the vaccine is a potential loophole for corruption and looting. The science behind choice of vaccine should be made plain, and full information should be disseminated, first to health care workers who have to deal with the public’s questions and doubts, and then to everybody in the country. No heavy-handed tactics like withholding social benefits from those who are vaccine hesitant should be used, as previously intimated by Mr Mnangagwa. The vaccine is our final weapon in the fight against COVID-19 and no effort should be spared in educating the public and allaying all related anxieties, to ensure that all eligible people receive the vaccine. Bringing in other vaccines as announced is a welcome move, but still information dissemination is key to dealing with mis-information and conspiracy theories, which remain rampant. We cannot just wish them away.
Bringing in private laboratory services as a substitute to free government testing sent the cost of all tests spiraling upwards. It was a serious abdication of duty by the government. We have always had private laboratory services in Zimbabwe, and they have their place, but they cannot become the mainstay of service delivery in such a massive public health emergency without a government subsidy. The poor are automatically excluded, and that is 90% of Zimbabweans. Contact tracing and routine surveillance died right there.
The rapid response teams were one of the weakest links in the government’s response strategy. They had a serious mandate without the necessary financing and equipment, notably PPE and diagnostic consumables like nasal swabs. They therefore failed dismally in their execution of duty. These are well-trained cadres by the way, but it is like a good soldier going to war without a gun and basic supplies.
How do we summarize government’s response to this pandemic? In a few words, government was not prepared to spend money on healthcare and on feeding the people during the very necessary lockdowns. Corruption was rife and crippled the response to COVID-19. The ruling party was the chief architect of super-spreader events, in the form of political party meetings and extravagant pleasure parties. Politicization of the lockdowns was rampant and led to much suffering, unnecessary arrests with consequent unnecessary exposure of citizens to COVID-19 in prisons. When it comes to pandemics of this nature, we admonish the government to put aside all partisan behavior, and all Zimbabweans should work together for the common good.
On the basis of this assessment, the government failed dismally in protecting Zimbabweans from this pandemic. We are all here today by a sovereign act of God. We give the government a score of “D”, with “A” being the best score and “E” the worst. The whole nation wants to help government get a score of “A” in this second year, so please, work with the people, and be completely transparent. All eyes are on the vaccine issue.
Going forward, here are our recommendations for the government to take Zimbabwe to a better place and avert a third wave as we open up the economy. Government should vigorously promote COVID-19 safe practices in all languages and on all media platforms. These include hand washing, sanitization, social distancing and avoiding close contact, avoiding supper spreader events, avoiding large gatherings, cough etiquette, and masking up as the new normal (not as a way of avoiding fines!), at least for the next one year as we measure progress. Health workers should be thoroughly equipped with knowledge so that they become the champions for vaccination and other interventions. Vaccine procurement is not the domain of private companies. Government must do its duty. As we move forward, government needs to concentrate on taking the people with it on all issues to do with vaccination and vaccine choice regarding safety, efficacy cost and other factors.
COVID-19 isolation and treatment facilities should be set up in every town, and a generous supply of PPE should be delivered to all health institutions. Schools should be properly equipped, and liaison with teachers’ unions should be intense. Businesses should be appropriately equipped and empowered to prevent infection.
Government needs to ramp up vaccination, and take professional advice seriously, particularly from the national immunization technical advisory group. Educate health workers and the population, procure vaccines in a transparent manner, distribute and administer to all. Convince health workers first and everything else will fall into place.
Dr. Henry Madzorera.
Secretary for Health and Child Welfare.