Victoria Falls, Zimbabwe – At 5pm, at the Victoria Falls border post, Margaret Tshuma – who has a 24-hour day pass to be in Zambia – is in a hurry to return home to Zimbabwe before dark.
This is not the first time that Tshuma, 53, has traveled from his rural home in the village of Diki, 120 kilometers away, to spend the day in Zambia. It has become a routine trip that she takes monthly to buy medicine for her husband who has scleritis – an inflammatory disease that affects the outer covering of the eye.
Prescribed medication is almost never found on pharmacy shelves in the Hwange district, where he lives. Of what exists, the high cost makes it unaffordable for many, she said.
“The same medicine is expensive at home. If we add the costs of transportation and medication, it is still cheaper to come to Zambia. Furthermore, most of the time, some of these medicines are not readily available, which puts the lives of patients at risk,” said Tshuma.
Buying the medicines in Zimbabwe costs Tshuma around $85 a month, while across the border, in Livingstone, she pays 320 kwacha ($13). Even with travel, it works in your favor as a round trip from Hwange to Livingstone costs $14.
Zimbabwe’s economy has been hit hard by decades of economic crises and rising inflation. Many basic products are not as easily available or affordable and Zimbabweans themselves have lost confidence in the local currency.
At the border, Tshuma follows a short queue, before officials check his luggage and documents without much fuss and stamp his 24-hour pass – a process that takes less than 10 minutes.
Speaking to Al Jazeera, Mike Muleya, a commuter bus operator who transports passengers to and from the border area, said a significant number of people make the daily journey from Hwange – a community of around 21,300 people – to shop medicines or visit hospitals in Zambia.
“On my first morning journey from Hwange, I take at least six to nine passengers heading to Victoria Falls to cross into Livingstone. We talked along the way and I found out that five to seven are doing medical trips,” he said.
“At night, on my last trip, I literally park close to the border, as they will call me to take them back to Hwange. In between, I’ll be carrying one or two, so it’s a big number [making the daily trip]as I am not alone in the transport business.”
Cost analysis
According to a 2023 report by local advocacy group Community Health Working Group, the majority of Zimbabweans do not have access to quality, affordable healthcare. The group called on the government to prioritize primary health care to achieve universal health coverage.
Poor Zimbabweans who rely on state healthcare struggle significantly more to obtain treatment than wealthier citizens who can turn to more expensive private services. In addition to difficulties in obtaining care, many complain of long queues at public hospitals – often requiring four to seven hours of waiting.
In Matetsi District 1, Hwange Rural, 20 km (12 miles) from Victoria Falls, Mercy Khumalo recounted the ordeal of taking her aunt to Zambia for treatment.
It was not an easy situation for the family, Khumalo said. Using their meager savings and money from selling a cow, they finally managed to earn enough to pay for an appointment with a specialist at a private hospital in Zimbabwe. But after doing a cost analysis, they chose to go to Zambia.
“We did local consultations and got some quotes from various experts. Tia was diagnosed with a brain tumor. Our neighbor told us that the treatment was affordable and a pure public service in Zambia. We saw that, with the money we had, it would have been spent in a month at a local private doctor; however, in Zambia, we will save a lot as we monitor the situation,” she explained.
“Foreigners are allowed to use the public healthcare system in Zambia and it is generally free as long as they have their passport and health records in order,” said Natasha Chola Mukuka, a public health doctor and medical student at Levy Medical University. Mwanawasa, in Lusaka. Zambia, he told Al Jazeera.
Although specialists and surgery cases come at a cost, patients in Zimbabwe told Al Jazeera they find it more affordable than at home.
5 Miles Hospital is still miles away
The province of Matabeleland North, where Victoria and Hwange Falls are located, is historically marginalized, despite being a tourist center that is also home to the largest coal mine and largest national parks. Locals lament the lack of tangible infrastructural development, including healthcare facilities.
The construction of 5 Miles Hospital – named for being 8km from Hwange city’s central business district – gave hope to residents and villagers. However, when it was nearing completion in 2018, construction was halted.
“The government started building some hospitals to demystify that the region is marginalized, but the structures remained like white elephants for decades,” said Fidelis Chima, coordinator of the Greater Whange Residents Trust.
“There is nothing to indicate that the hospital will be opened soon. We waited a long time. People in Hwange depend on the Hwange Colliery Company Hospital, but it is a private facility and very expensive. The government wanted 5 Miles Hospital to be a district hospital, covering both Hwange and Victoria Falls,” Chima added.
Matabeleland North has a record of poorly equipped hospitals. Existing facilities also lack essential medicines and sufficient trained staff, local residents say.
In Hwange district, five hospitals provide services to a population of around 125,800.
But according to Jowani Chuma, rural ward 12 councilor of Hwange Rural District, four wards are served by one hospital, St Marys – a missionary facility run jointly by the government and the Catholic Church, where patients receive a combination of services. free and paid.
Each district, or subdivision of a district, generally has between 2,000 and 7,000 people. Chuma considers it fortunate that some parts of the district have St Marys, as most districts do not have such a facility.
“St Mary’s is better because most rural clinics are run by hybrid staff, with one or two government registered nurses, while the rest are nursing assistants or village health workers. In the absence of the elder sister, one is left in the care of inexperienced staff,” said Chuma.
The electoral promise
During the campaign for the 2023 elections, the ruling ZANU-PF party said the Lupane Provincial Hospital in Matabeleland North – a large facility with 250 beds – would become the largest in the country upon completion and ease pressure on hospitals. reference in the southern region.
“The hospital will be the largest in all the provinces in the country,” said President Emerson Mnangagwa when addressing party supporters at a rally in Binga.
Binga villagers, however, who live in the Zambezi Valley, cross into Zambia every day using canoes in search of medicines and other basic goods. Unlike Victoria Falls, Binga and Zambia are separated by the Zambezi River and, in the absence of a bridge, boats become a means of transport.
The few functional hospitals from Lupane to Victoria Falls in Matabeleland North are either missionary or private, and both come at a cost to the patients who use them.
Despite the government allocating $47 million to build the Lupane hospital in 2023 – and the government promising the facility would be completed by the end of last year – the majority of patients in the province are still referred to St Luke’s , Catholic-run, for health services. , while critically ill patients are sent to Bulawayo.
To date, people still travel long distances to seek basic treatment. Meanwhile, Matabeleland North, home to around 827,600 people, remains the only province in the country without a provincial hospital.
Avoiding smuggling
With the daily influx of people across the Zambia-Zimbabwe border, immigration authorities are tightening requirements for people bringing medicines into Zimbabwe.
They now require a prescription from a doctor stamped by a medical center.
Previously, people crossed the country to buy medicines without a prescription, a situation authorities say is creating fertile ground for smuggling and the unregulated trade of medical medicines in Victoria Falls and Hwange.
“The border is busy on a normal day, most of the people crossing for services on the same day… some are tourists,” said a border security official who requested anonymity because he is not permitted to speak to the press.
“But most of them are Zambian sellers and individuals from Zimbabwe who go shopping, including medicines. It’s not much, but for medicines, we now require a stamped prescription and check purchased medicines to reduce smuggling,” he told Al Jazeera.
The immigration officer responsible for the border was not readily available when asked for comment.
As Margaret Tshuma heads from the border to her home in Diki village, she knows she will be back within a few weeks. But she also looks forward to the day when Hwange has a district hospital and the Lupane Provincial Hospital is complete.
“This will save lives as it will reduce distances to Bulawayo referral hospitals,” she said, adding that adequate facilities and steady supplies of affordable medicines closer to home “will be welcomed”.
“Otherwise,” she warned, “people will continue to locate medical facilities and medicines in Zambia if there are no prescription medicines on the shelves.”
This story originally appeared on Aljazeera.com read the full story
