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How nurses recruited from Zimbabwe are being caught in UK ‘bonded labour’ schemes

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BY RAY MWAREYA

Zimbabwean care workers are being tricked into coming to the UK by unscrupulous middlemen who withhold up to half their wages and force them to live in squalor.

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The scam, which plays on the acute shortages of nursing and care staff across Britain’s hospitals and care homes, has echoes of the debt bondage schemes recently revealed to be impacting Indonesian farmers.

Zimbabwe is in economic crisis and thousands of trained care professionals are seeking employment abroad.

However agencies – often run by Zimbabweans in the UK and unregulated – are exploiting them, a Telegraph investigation has found.

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“When you are working for an agency [in the UK], they pay you 50 per cent of your total salary,” said Jim Moyo*, who moved to the UK from Harare in November 2018 to work in a care home in Margate.

“You are getting paid £14 per hour, but then these guys will pay you £7.”

He added that, once tax was deducted, he was left with just £4 per hour for “rent, food and all sorts of expenses”.

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“[The agency] tells you: ‘I paid for your accommodation, flights, visa, [I’m] your sponsor’. It’s like a hideous loan,” said  Moyo.

While Zimbabwe’s nurses have found work in Britain for years, hiring care workers is a new phenomenon, and experts told the Telegraph that a lucrative ecosystem of manipulation has been built around it.

“Exploitation does not start on arrival [in the UK],” said Hillary Musarurwa, a Zimbabwe-born social scientist in England.

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“It starts during the application process [in Zimbabwe].”

One route to the UK is by completing a Red Cross care worker certification programme.

“It’s like cow barns, Red Cross academies are filled to seams with UK-hopeful care-work trainees.

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“It’s ex-teachers and geologists desperate to retrain for UK care work,” said Joseph Zuze*, a trainee nurse at Mutare Hospital, who plans to emigrate to the UK when he graduates.

‘Huge web of corruption’

The Certificate of Sponsorship (COS) is highly coveted, which has led to it being exploited by middlemen, according to locals.

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Zuze said his wife had been scammed by “agents” who charged US$380 to put her on the training waitlist, despite the official Red Cross certification costing just US$300.

These agents are not in any way employed, endorsed or contracted by Red Cross Zimbabwe and there is no evidence Red Cross Zimbabwe is aware of them.

Closed WhatsApp groups, seen by the Telegraph, show that so-called agents then ask care workers to pay up to £5,000 if they want to be linked with UK-based care agencies.

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“This has created another huge web of corruption; care agencies in the UK, run by Zimbabwe nationals, [are] gifting the COS to their relatives and friends first and anyone else [faces] hefty fees that reach £4,000,” said  Zuze

Another Zimbabwe-born nurse working for the NHS in North London added that she knew someone in the UK “charging £7,000”.

This clearly contradicts British law, according to Taffi Nyawanza, head of immigration at Mezzle Law in Birmingham who is well-known in Zimbabwe’s UK diaspora community.

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“UK law is clear. A recruitment agency cannot charge a fee for ‘placing’ an employee.

“The person who ‘assigns’ or prepares and allocates the [COS] must not be related to the prospective employee. [If] this is the case, the relationship must be fully disclosed to the Home Office,” he said.

However regulation of these agencies is weak, and the Department of Health and Social Care (DHSC) suggested that – although it is unacceptable that some overseas-based agencies are charging fees to place candidates with jobs in Britain – their hands are tied because the actors are not under UK jurisdiction.

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“We understand repayment clauses may be used by some organisations to recoup upfront costs if internationally recruited staff do not meet the terms of their contract,” a spokesperson said.

“The vast majority of care workers are employed by private sector providers who ultimately set their pay, terms and conditions independent of central government. However, we would be concerned if repayment costs were disproportionate or punitive”.

Experts said the schemes have taken advantage of chronic staffing issues across the UK’s social and health care systems – the NHS alone is currently trying to fill 40,000 nursing positions – which has triggered a surge in international recruitment.

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This week, the DHSC signed a deal with Nepal for 100 nurses to work at Hampshire Hospital NHS Foundation Trust, under a pilot scheme that could pave the way for thousands more Nelapese nurses to come to Britain.

But the ethics of the move are “debatable at best”, according to Sir Andrew Goddard, president of the Royal College of Physicians, as Nepal is on an international recruitment red list – operated by the World Health Organization (WHO) – to prevent developed countries from actively recruiting from regions with a lack of health workers or an undeveloped health system.

“That the UK should have [to] do special deals with other countries to support its own NHS workforce is in itself a marker of how workforce planning for the NHS has failed,” Sir Andrew told the Telegraph.

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“That we are taking from a country that has substantially lower numbers of healthcare workers than many countries have is something we should have serious reservations about.”

NHS England has also been accused of “emptying” Zimbabwe of health workers – although the country is not on the red list, experts have warned of a “critical shortage” of staff.

In 2020, the UK issued 1,059 skilled visas to Zimbabweans, a figure which jumped to 5,549 in 2022, placing the southern African country among the UK’s top five skilled visa grantees.

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Yet the recruitment drive has drained Zimbabwe so badly that Bulawayo municipality, in the southwest, recently complained that 13 nurses out of its skeleton staff have moved to the UK since January.

That’s despite a vast difference in the number of health professionals per population.

In 2018, there were 1.9 nurses and midwives per 1,000 people in Zimbabwe, compared to the UK’s 8.2 nurses and midwives per 1,000.

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But extreme poverty is stalking Zimbabwe, and nurses – who are paid just US$79 a month and expected to juggle a high patient load – are seeking a better life.

Inflation has shot to 479 percent this year alone, according to Steve Hanke, director of the Troubled Currencies project at the Cato Institute.

However, many find themselves no better off when they reach the UK – a situation experts say is now too large to ignore.

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Rumours of agencies overcharging workers exploded publicly on Twitter in June, with leaked care-worker pay slips purportedly showing salaries of £2,255 drained by their employers under guises of administrative fees until just £604 was left.

Mr Moyo, who left the UK after a matter of months due to the conditions, said he was not alone in seeing his wages cut dramatically, or living in cramped conditions.

While in Britain, he was forced to pay £70 a week to share a house with eight others.

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“I’ll never return to the UK as a care worker,” he told the Telegraph, describing the schemes as a form of modern slavery.

“”But the experiences of those who were undocumented were even worse, he added.

“I met with guys who told me, ‘I have been [in the UK] since 1999 and don’t have papers, so I do care work, I work for an agency and [I’m] left with 300 pounds.

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“You just do what they ask you to do’,” Moyo said, referring to colleagues he met in Margate.

He added that some workers were so impoverished that they slept in the clients’ homes.

‘Slavery happening in front of our eyes’

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Though UK law allows employers to dock wages for “reasonable costs”, any employee must not be left with an income that is below the UK national living wage of £9.50 an hour, Nyawanza said.

These workers are also subject to zero-hours contracts, which means an employer does not guarantee the individual any hours of work, according to Tich Dauramanzi, a Zimbabwe-born engineer who ran a legitimate care staffing agency in Stoke-on-Trent until 2017.

“This is slavery happening in front of our eyes. I strongly believe we are going to have a court case very soon.

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“Most of these employers owe people more money than they can ever pay,” he said.

The DHSC told the Telegraph that it takes reports of illegal employment practices seriously, and that the Gangmaster and Labour Abuse Authority prosecutes lawbreakers, though it’s not the DHSC’s responsibility to penalise agencies.

The Home office has cracked down on similar practices in some Asian and East European recruitment companies in the past, with some success.

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But Zimbabwe-owned care agencies have a clever tactic up their sleeve, according to  Dauramanzi.

“They are recruiting a lot of young [Zimbabweans]. For some, this is the first time they have been employed.

“Most of them are gripped by the fear factor. They’re told ‘here’s your only chance to come to the UK,’” he said.

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Meanwhile, the UK’s strict immigration regime has also exacerbated exploitation, according to Justine Currell director at the anti-slavery charity, Unseen.

“The hostile environment is creating an ability for people to be [living] in exploitation, to be kept in exploitation, and to not to want to come to authorities for fear of repercussions,”  Currell said.

The hostile environment policy was introduced in 2012 by then-Home Secretary Theresa May, with the intention of making life in the UK difficult for those who cannot show the right paperwork.

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Such policies prevent people from accessing housing, healthcare, education, work, bank accounts, and benefits.

Though Unseen runs a help fund for victims to report anonymously, the reality is that “people feel they have no options but to continue working,”  Currell said.

“[It’s] very difficult [to] get info from individuals because there are no easy routes to get support. It’s quite tragic.” – The Telegraph

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Leaders commit to creating pathways for transformative education, skills development for children

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BY SIRAK GEBREHIWOT

Victoria Falls – A historic gathering of seven Southern African leaders, international representatives, over 7000 children and youth took place at Baobab Primary School in the resort town of Victoria Falls to commemorate regional World Children’s Day.

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The event, attended by dignitaries from across the southern Africa region, emphasized universal dedication to the rights and welfare of children, guided by the UN Convention on the Rights of the Child.

His Excellency President Emmerson Mnangagwa of Zimbabwe extending warm welcome to delegates, underlined the unity and shared goals of the Southern African Development Community (SADC). “Today is a powerful reminder of our collective duty to protect the rights of all children,” he affirmed.

President Mnangagwa’s speech underscored the importance of providing children with quality education and resilience against climate change, all while fostering their sense of identity and pride in their African heritage.

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The President expressed gratitude to regional counterparts, particularly President Duma Boko of Botswana, for participating in Zimbabwe’s festivities. In a gesture of regional solidarity, he acknowledged, “Though we hail from different nations, we share a common vision for a vibrant, educated, and united Africa.”

Mr. Edward Kallon, the UN Resident and Humanitarian Coordinator for Zimbabwe, echoed the President’s sentiments. He stressed the significance of this event as a platform to emphasize children’s rights, aligning with the Sustainable Development Goals.

“The UN2.0 and its quintet of change—embracing innovation, technology, and inclusivity—guides the United Nations renewed mission towards a brighter future for all children,” Mr. Kallon stated.

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He underscored the UN’s reinvigorated strategy, UN 2.0, aiming for transformational change with children at its core. Kallon called on all stakeholders to remain accountable to the children’s Call to Action, reinforcing the imperative to incorporate young voices in policymaking processes and national development programmes.

Education: A Pillar for Progress

UNICEF Regional Director, Ms. Etleva Kadilli, focused on the transformative power of education. She recognized strides made in various SADC countries that have prioritized digital learning, inclusive education, and curriculum reform. “These advancements illustrate that when governments and educators listen to children and act, significant progress can be achieved,” Ms. Kadilli underlined.
Kadilli acknowledged the persistent challenges facing sub-Saharan Africa, where educational disparities remain stark. She encouraged children present, stating, “Your voices are vital. When you speak, you not only shape your future but ours as well.”

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Collective Regional Pledge

His Excellency President Duma Boko of Botswana accepted the honor of hosting the next World Children’s Day commemoration. He pledged his administration’s dedication to addressing the needs and aspirations voiced by the children and youth. “We stand ready to work with you, empowering our children to lead with wisdom and courage,” President Boko assured.

Senior officials from Zambia, Namibia, Mozambique, Malawi, and South Africa echoed these commitments. They affirmed their governments’ resolve to enhance children’s access to quality education, healthcare, and social protection, reinforcing their rights as a priority.

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Empowering Through Culture and Heritage

The celebration also spotlighted the role of arts, culture, and heritage in building inclusive societies. President Mnangagwa stressed the importance of embracing cultural identity and utilizing natural resources to foster development and unity. “Let us, together, promote our unique cultural products and enhance our children’s understanding of their heritage,” President ED Mnangagwa encouraged.

Combating Emerging Threats

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Addressing contemporary challenges such as climate change and drugs and substance abuse, President Mnangagwa reaffirmed Zimbabwe’s commitment to combating these issues through strategic initiatives like the Presidential Borehole Drilling Scheme and the establishment of Child-Friendly Courts. “Our measures ensure that all children, particularly the vulnerable, have their rights upheld and their futures secured,” he stressed.

A Call to Action and Hope

Ms. Etona Ekole, UNICEF Representative for Zimbabwe said, “This World Children Day, I am incredibly proud to see children from Botswana, Namibia, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe raising their voices for change. Their Call-for-Action is a testament to the power of listening to children and investing in their future.

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The event underscored a unified call to invest in children as Southern Africa’s future leaders. With collaborative resolve, the leaders and stakeholders committed to translating discussions into concrete actions, guided by the insights and demands of the children and youth.

Facilitating a call to action from children and youth representatives across seven countries, Ms. Sithabile Mtigo, Speaker of the Junior Parliament of Zimbabwe, highlighted the critical role of young advocates throughout Africa. She declared, “We are the leaders of both the present and the future for Africa.”

The Regional World Children’s Day served as a reminder of the shared journey towards a future where every child’s rights and potential are realized, and every opportunity leveraged.

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The commitment made in Victoria Falls to “Educate and Skill the African Child for Posterity” is not only a theme but a driving mission as the African continent marches towards a brighter, more inclusive tomorrow.

SOURCE: Sirak Gebrehiwot is UN Partnerships and Development Finance Advisor at the UN Resident Coordinator’s Office in Zimbabwe

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Botswana’s president concedes defeat in election, ending ruling party’s 58 years in power

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BY STAFF REPORTER

Botswana’s President Mokgweetsi Masisi conceded defeat in the general election Friday, in a seismic moment of change for the county that ended the ruling party’s 58 years in power.

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Masisi’s concession came before final results were announced, with his Botswana Democratic Party trailing in fourth place in the parliamentary elections.

The main opposition Umbrella for Democratic Change held a strong lead in the partial results, making its candidate, Duma Boko, the favorite to become president of a southern African country that is one of the world’s biggest producers of mined diamonds.

Masisi said he had called Boko to inform him he was conceding defeat.

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“I concede the election,” Masisi said in an early-morning press conference two days after the election. “I am proud of our democratic processes. Although I wanted a second term, I will respectfully step aside and participate in a smooth transition process.”

“I look forward to attending the coming inauguration and cheering on my successor. He will enjoy my support.”

Masisi’s BDP dominated politics in Botswana for nearly six decades, since independence from Britain in 1966. The nation of just 2.5 million people will now be governed by another party for the first time in its democratic history.

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SOURCE:AP

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Zambia offers health care to Zimbabweans — but for how long?

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Illustration Credit: Wynona Mutisi for Global Press Journal

BY GAMUCHIRAI MASIYIWA

Summary: Zambia is as generous with patients from neighboring Zimbabwe as it is with its own citizens. That could mean problems for both countries.

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This story was originally published by Global Press Journal.

MASHONALAND WEST, ZIMBABWE — When Dube was diagnosed with gallstones in 2013, the public hospital in Zimbabwe recommended surgery costing close to 4,000 United States dollars. She couldn’t afford that.

 

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A friend suggested she go to Zambia, about 150 kilometers (94 miles) to the north. There, the friend said, treatment would be cheaper.

 

Over the past decade, Dube has gone to Zambia multiple times for medical treatment. Her most recent trip was in June. Treatment is cheaper there, she says, but the level of care is also far better than what she would get at home. Dube asked that Global Press Journal use her totem name, a symbolic representation of ancestral lineage, out of concern about Zimbabwe’s Patriotic Bill, which discourages criticism of the government.

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In the 1980s, Zimbabwe had one of the best health care systems in sub-Saharan Africa. But over the years, this glory has faded. An ongoing economic crisis spanning over two decades has left the health care system scrambling to meet the needs of its population. Skilled health care workers have left in droves, drawn to opportunities abroad. More than 4,000 health care workers left Zimbabwe in 2021 and 2022 alone, according to government statistics. By late 2022, Zimbabwe had about 1,700 doctors and about 17,200 nurses to serve a population of 15 million people.

 

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Just as health care workers are leaving the country, so are patients.

 

Over the past decade, Zimbabweans have spent more than 4 billion US dollars on cross-border medical migration. Annually, more than 200,000 Zimbabweans spend around 400 million US dollars on specialized medical treatment abroad. India, China, Singapore and South Africa are the main destinations.

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But an increasingly popular choice is neighboring Zambia. In April alone, the International Organization for Migration surveyed over 260 people migrating from Zimbabwe to Zambia. When asked why they were traveling, 42% stated that it was to access better services — health being the top priority.

 

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Precise data is hard to come by, but anecdotal evidence from sources who spoke to Global Press Journal, including border officials, points to a growing trend, raising questions about Zambia’s ability to manage the influx, and the future of health care in Zimbabwe.

 

The choice of Zambia

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Zambia and Zimbabwe allocated nearly the same amount of money to their health sectors in 2024, even though Zambia is home to 4 million more people. With that budget, it’s an unlikely alternative to the Zimbabwean healthcare system. And in Africa, it’s South Africa and Kenya that are top destinations for medical tourism.

 

But the border with Zambia isn’t far for many Zimbabweans, making the cost of travel low and the process of crossing the border usually straightforward. A person needs either a passport or a pass issued at the border for just 1 US dollar, says Morgen Moyo, assistant regional immigration officer at the Chirunduborder post.

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Even without documentation, immigration officials will at times let those seeking health care pass through. “Zambians prioritize life,” Moyo says.

 

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It’s not only about convenience. Zambia offers free primary health services, including basic treatment, preventative care, vaccinations and maternal health care services, according to the 2022-2026 Zambia National Health Strategic Plan.

 

While these free services are not available to foreigners long-term, they can access them in emergencies within the first 24 to 48 hours in the country, says Dr. Kennedy Lishimpi, permanent secretary of administration for the Zambian Ministry of Health. Foreigners are expected to pay for Zambian health care after that timeframe.

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In practice, though, Zambian health workers rarely charge foreigners, according to a 2019 study paid for by the US Agency for International Development, known as USAID.

 

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“You wouldn’t want to see somebody from Zimbabwe, for instance, getting to Zambia and not accessing a service and then they end up dying. That is not good. Similarly, we expect that our sister countries do the same to our citizens when they are there,” Lishimpi says.

 

Dr. Mwanza, a Zambian doctor who chose to use only his last name for fear of retribution, says availability of surgical and specialist services in Zambia drives medical migration. In Zimbabwe, these services are rarely available outside of the large provincial and central hospitals. In 2019, for example, about 10% of district hospitals could provide basic surgeries, compared to 83% of provincial and central hospitals, according to a Zimbabwe health ministry assessment.

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When Mary Chipfuvamiti’s son broke his arm in June, she says she chose a hospital in Zambia — about 93 kilometers (nearly 58 miles) from her home — over local options. She suspected the local hospital’s X-ray machine wouldn’t be working, and they would likely refer her to a private facility where an X-ray would cost her 40 US dollars.

 

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“I only had 30 dollars on me,” she says. In Zambia, the total cost came to about 12.50 US dollars.

 

A case for Zimbabwe

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Things haven’t always been like this in Zimbabwe. Before the country’s economy took a downturn, it offered free health services in the 1980s to low-income earners. About 90% of the population fell in that bracket.

 

In the early 1990s, the government introduced user fees in public health facilities as part of the austerity measures imposed on the government by the International Monetary Fund to reduce government expenditures. Currently, free health services are offered only to pregnant and lactating mothers, children under age 5 and adults over 60.

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The economic crisis continues to strain what remains of the health care system. Hospitals struggle with obsolete infrastructure. Shortages of medicines and supplies in public health facilities are the norm.

 

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And although Zimbabwe and Zambia have similar health budgets, Zimbabwe’s treasury sometimes delays funds disbursement, says Norman Matara, secretary general for the Zimbabwe Association of Doctors for Human Rights.

 

That was the case in 2021, when the health ministry by September had used just 46% of its budget allocation for the fiscal year due to late disbursement of funds, according to a 2024 situational report by the Zimbabwe Coalition on Debt and Development, a nongovernmental organization that advocates for socioeconomic justice.

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“There is a mismatch between the money that is put on the budget and what is being received by the health institutions,” Matara says. Reasons include hyperinflation and currency rate fluctuations, he adds.

 

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Comparing health services across countries is unfair, says Donald Mujiri, a Zimbabwe health ministry spokesperson. “Each country has its set standards and pricing.”

 

He doesn’t think this migration of patients reflects poorly on Zimbabwe’s health care system. “We have all the services in the country, and they are adequate to serve the people,” he says, adding that people are free to seek health care where they want.

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Mujiri did not address questions regarding the late disbursement of funds.

 

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The cost of the journey

These journeys to Zambia come with challenges.

 

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Dube recalled her trips along the bumpy Harare-ChirunduHighway that connects the two countries, when every bump caused piercing pain.

 

In 2019, six years after her initial treatment in Zambia, she began experiencing severe pain. She went to a hospital in Harare for treatment, but a few months later the pain resurfaced. By that time, there was a health care strike at home, forcing her back to Zambia for treatment. Then in 2023, Zambian doctors discovered metal clips from her earlier surgery in Zimbabwe were piercing her liver. She returned to Zambia in January this year for corrective surgery, and again in June.

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Health care experts warn that such journeys can be especially risky for patients who undergo surgery. If a surgery is performed in Zambia and there is no proper follow-up, there can be complications if doctors in Zimbabwe are unaware of previous procedures or tests, says Mukanya, a health expert working in a Zimbabwean hospital who chose to use his totem, fearing that speaking to the media would cost him his job.

 

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In the case of misdiagnosis or malpractice in a foreign country, it’s difficult to get recourse. “In most cases you are powerless because you don’t know the [reporting] process and approaching a lawyer may require money,” he says.

 

Medical migration also comes at a cost to Zambia. The influx of patients complicates health planning, leading to shortages of essential medications and making it difficult to allocate resources effectively, according to USAID. The agency’s report recommends the Zambian government create a fee-for-service system to discourage foreigners from seeking free health care, but doctors in Zambia don’t seem to agree.

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“Most health care providers interviewed stated that they would continue to provide services free of charge should a foreign patient be unable to pay,” according to the USAID report.

 

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Lishimpi, the Zambia health ministry official, had no comment on the report’s concerns.

 

Dube, who is recuperating at home, is uncertain about the solutions. But she thinks the Zimbabwean government needs to prioritize fixing her country’s health care system. “I don’t know how best we can help our hospitals, but if there was any other way, I think they should consider the health sector more than anything else because we are talking of human life,” she says.

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Gamuchirai Masiyiwa is a Global Press Journal reporter based in Harare, Zimbabwe.

 

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Global Press is an award-winning international news publication with more than 40 independent news bureaus across Africa, Asia and Latin America.

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