Mathew 12:33 says make a tree good and its fruit will be good, or make a tree bad and its fruit will be bad, for a tree is recognized by its fruit.
Let me start by thanking you for your media. It is very informative and very interactive giving chance to get wider opinions on issues affecting the people of Zambia. It is one of the very few media currently developmental and putting the government in check.
What have precipitated my writing are the good articles by Given Mutinta and Joshua Nkama ‘What can be done about the deplorable health conditions…”(30.01.12). What we need is an overhaul of the Ministry of Health and control of funds disappearing and realigning services based on peoples health needs.
Central Board of health re-visited: CBOH is the way forward. It worked because monies from public and donor funds had specific functions targeting at activities at grass root. The MOH was for policy only. The Perm Sec had no chance to loot the monies. Thus dr Miti and his connections destroyed CBOH. As you may see now the current Perm Secs looted e.g. Dr Bulaya- funded elections, Dr Miti-Kapoko saga, Mwaba funds for by-elections, the K9.1 billion and funding general the last presidential elections.
Staffing: More medical and nursing schools have opened in Zambia, thus we hope over the next 10 years staffing can improve though attrition remains high. There is ‘no funding’ for highly specialised training in our Ministry so we may not have many specialists as desired. Many doctors have rushed into management positions(because of poverty) worsening the artificial shortage. Count doctors at Ndeke house. The total is more than any provincial hospital. Worse still, very few doctors in provincial and district hospitals do actual clinical work. They sit in office and attend meetings. Also, specialised senior doctors in Zambia have poorer conditions of service compared to junior doctors heading district and provincial hospitals. More Clinical officers training schools are required though there is no career progression(forget about medical licentiate), thus most of them eventually leave medicine. This a very critical cadre to health provision but grossly underpaid.
Financing of MOH: Ministry of health remains among the most well funded ministries in the country. Some donors are aware that billions of Kwacha left the MOH to fund election campaign e.g. mobile clinic funds. Some donors may not be comfortable with the current Perm Sec. as he is on record to have been involved in ‘disappearance’ of K1.8 billion Federal funds for health research and evidence was circulated among donors. User fees could be a reliable source of funds for health services in form of health schemes for specificied different levels of health care, but this has been politicised.
Local research: Literally all health institutions nationwide have piled enough information awaiting to be analysed to provide government with information on peoples health needs. Local research are usually not in budget of MOH. Lucrative donor funded research have specific objectives and donor interests e.g HIV and ARVs. The Perm Sec may guide on who will conduct or head such research. Between him and his childhood friend kasonka-UTH ED are heading, about five of donor-funded researches. Interestingly, while Kasonka specialised in issues dealing with child birth, he heads researches in adult nutrition and ARVs.
Gross corruption/Nepotism: The current Perm Sec (Dr Peter Mwaba), has appointed, and has surrounded himself with former classmates or loyalist, and who are not the most seniors of doctors, thus may suggest other motives for appointments e.g Dr. Kasonka (Director-UTH, Mwabas classmate/friend), Dr Chikoya (Deputy director-UTH- Mwabas classmate/friend), Dr Chilengwe- Director in charge of mobile clinics-Mwabas Classmate/friend. Dr Kachimba-Director-Mwanawasa hospital- Mwabas classmate/friend to mention a few. Maybe it is coincidence or serendipity, God save us. Only a clique aligned to him benefit from certain services e.g. traveling abroad (remember the trip to Namibia to go and visit ailing KK?)and consultancies. The medical fraternity, we are told, is dissapointed due to the PS lack of respect for professionalism and no respect for hierarchy. Mathew 7: 16 ‘says by their fruits ye shall know them. Do men gather grapes of thorns, or figs of thistles?’ AMEN
Thus re-visiting CBOH, reorganising MOH and having accountable expenditures, health services close to peoples needs, health schemes, basic-satisfaction of and placement-on-credit of health workers are among possible way forward.
Ndeke house Yearners of change