Connect with us

Slider

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

Published

on

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.

Advertisement

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.

 

Advertisement

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.

Advertisement

 

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.

 

Advertisement

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.

Advertisement

 

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.

 

Advertisement

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

Advertisement

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.

Advertisement

 

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

 

Advertisement

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.

Advertisement

 

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.

 

Advertisement

“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.

Advertisement

 

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.

 

Advertisement

“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

Advertisement

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.

Advertisement

 

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.

 

Advertisement

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.

Advertisement

 

“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.

 

Advertisement

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.

Advertisement

 

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

 

Advertisement

The cost of the journey

These journeys to Zambia come with challenges.

 

Advertisement

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.

Advertisement

 

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.

 

Advertisement

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.

Advertisement

 

“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.

 

Advertisement

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.

Advertisement

 

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

 

Advertisement

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

Advertisement
Continue Reading
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

In the community

Hwange police seek public’s help in locating missing teen

Published

on

BY STAFF REPORTER 

The Hwange police are urgently seeking the public’s assistance in locating 16-year-old Latoya Lisa Munkuli, who went missing on May 7, this month.

Advertisement

Latoya, a dark-complexioned female juvenile, was last seen leaving her residence in Hwange around 4 pm.

She was wearing a distinctive outfit consisting of green trousers and a white T-shirt, and carried a black satchel. She stands approximately 1.6 meters tall.

Inspector Glory Banda of the Hwange police is leading the investigation and urges anyone with information about Latoya’s whereabouts to come forward.

Advertisement

If you have any information about Latoya’s disappearance, please contact Inspector Banda on 0785961747 or 0771256607.

Advertisement
Continue Reading

National

Coal train in flames: NRZ locomotive damaged in fire incident

Published

on

BY WANDILE TSHUMA 

A National Railways of Zimbabwe (NRZ) locomotive suffered significant damage after catching fire while transporting export coal to Zambi. The incident occurred between Kalala and Matetsi sidings, resulting in the explosion of the locomotive’s fuel tanks.

Advertisement

According to the NRZ press statement on Monday, “A National Railways of Zimbabwe locomotive suffered some damages after it caught fire this afternoon while transporting export coal to Zambia.” Fortunately, the crew members on board managed to escape unharmed.

The NRZ responded swiftly to the incident, dispatching a rescue train with crews to the site. The team successfully extinguished the fire, preventing further damage. However, the locomotive itself sustained considerable damage.

The cause of the fire is yet to be determined, with investigations currently underway. “Investigations are already underway to establish the cause of the fire and the amount of damage to the locomotive,” the NRZ statement read.

Advertisement

Continue Reading

In the community

Human-wildlife conflict claims 18 lives in Zimbabwe’s first quarter

Published

on

BY NOKUTHABA DLAMINI 

The Zimbabwe Parks and Wildlife Management Authority (ZimParks) has reported a disturbing trend of human-wildlife conflict in the country’s first quarter of 2025. According to the authority, 18 people have lost their lives, and 32 others have been injured in encounters with wildlife.

Advertisement

ZimParks spokesperson Tinashe Farawo revealed that the authority received 579 cases of human-wildlife conflict, which they managed to respond to promptly. The incidents have also resulted in significant livestock losses, with at least 53 cattle and 85 goats killed by wildlife.

The districts most affected by these incidents include Binga, Hwange, Kariba, Chiredzi, Hurungwe, Nyaminyami, and Mbire. ZimParks has been working tirelessly to raise awareness about wildlife behaviors and effective preventive measures in these areas.

In response to the crisis, ZimParks has translocated 129 animals back into protected areas and eliminated 158 animals deemed problematic.

Advertisement

“We encourage communities to continue reporting incidents to ZimParks Problem Animal Control numbers and local leadership, such as Councillors, Traditional Leaders, and Rural District Council Authorities, to ensure that we preserve lives,” Farawo urged.

The significant increase in livestock losses, with cattle deaths rising from 18 to 53 and goat deaths from 21 to 85 compared to the same period in 2024, highlights the growing challenge of human-wildlife conflict in Zimbabwe.

ZimParks’ efforts to mitigate the conflict include community initiatives to educate people on managing wildlife encounters effectively.

Advertisement

 

Advertisement
Continue Reading

Trending

Copyright © 2022 VicFallsLive. All rights reserved, powered by Advantage