Harare, Zimbabwe – Wound to Mucharambi The uncle was only lunch when he got up, then collapsed. “(He) started to bleed from the nose,” she says, “and died on the spot.”
Regarding his family, he had no health problems. While they were fighting to give meaning to the news, the hospital of Chitungwiziza – where his body had been taken to a morgue – told them that a medical -legal post -mortem would be necessary.
The Zimbabwean law obliges post-mortems for sudden or unexplained deaths, and public hospitals offer them free of charge. But there are only five skilled pathologists in Zimbabwe serving a population of nearly 17 million people. The wait could extend for days. And every day, the funeral has been delayed would increase at the cost of the accommodation of mourning people, as certain traditions require.
A police officer parked at the hospital offered them a bypass solution. Instead of a forensic post-mortem, they could make it a general-an option when no unfair game is suspected and faster because it does not require a specialist. But even that, he warned, could take days. He offered acid the process for costs of US $ 30. Desperate to bury their beloved, they paid.
“We could not afford time,” explains Mucharambei. “We did it because we had no choice.”
A country in free fall
Post-mortem bribes are just one element of a health-and state-free fall system. Hospitals in the country are plagued by chronic under-funding and obsolete infrastructure and mass emigration of health professionals to pay better abroad. The government estimates that the country needs more than 1.6 billion US dollars to make its health sector recover.
Sub-paled and overloaded health workers have relying on informal payments as a means of survival, explains Dr. Norman Matara, secretary general of Zimbabwe Hospital Doctors Association. “People try to survive. But over time, corruption is part of culture. ”
He says it is a common problem between hospital services, from the moment a patient is admitted. New mothers, for example, face the extortion for birth cards intended to be free. A study in 2021 of Transparency International Zimbabwe interviewed more than 1,000 people in Zimbabwe and found that 74% had been invited to pay a bridge pot while trying to access health services.
In March, a demonstration of nurses at the central hospital in Sally Mugabe – the country’s largest benchmark hospital – revealed how disastrous the situation is. He was the last of a long history of strikes by health workers, who have repeatedly protested a bad salary and deteriorated working conditions. But their actions are often welcomed with intimidation. In June 2022, the government responded to a strike by adopting a law prohibiting health officers from hitting more than 72 hours, with sanctions that can go up to six months in prison for participants and organizers.
A problem made
The pathology services are particularly tense, says Matara. The few specialists available are grouped in large hospitals, which creates operating opportunities.
Few medical students choose the career and those who face a difficult battle. The training programs are underfunded, mentoring is rare and working conditions in public hospitals are lamentable.
But this is partly a manufactured problem, explains Memory, nurse of the central hospital of Sally Mugabe, who asked to use her second first name for fear of losing her job. Memory worked at the hospital’s morgue almost 20 years.
“There is not really a backlog, but a false is created by police officers, doctors and mortuary staff to put pressure on families to pay,” she said.
These services are supposed to be easily available, she adds. A Cuban doctor performs medico-legal post-mortes on Mondays, Wednesdays and Fridays, while the generals are carried out daily. But families are often informed that there are delays. Sometimes they are asked to pay $ 50 of us to jump entirely, even when required by law, or US $ 100 to speed up the process, says Memory.
“It is a program to control money to the detriment of people in mourning,” she says.
Global Press Journal contacted the Sally Mugabe Central Hospital for a response to these allegations. They refused to comment.
Tendai Terrence Mautsi, public relations manager at Parirenyatwa Hospital, the largest public hospital in Zimbabwe, says that there are occasional delays with the medical-legal post-mortem cases, mainly due to the demand. The hospital, he said, replied by increasing the two to three forensic post-mortem days. They also reduced the average waiting time up to two weeks to only three days. To respond to the national shortage, Mautsi says that the hospital has teamed up with Cuban doctors to fill the skills deficit.
He recognizes that corruption has tormented the process. But, he says, that is part of a much more important detangling, and everyone has become an accomplice.
“Sometimes you can’t find evidence,” he says. “When you want to investigate, the patient is an accomplice. The service provider is also an accomplice. “
In the end, corruption harms people in need, explains Tafadzwa Chikumbu, executive director of Transparency International Zimbabwe. “For those who cannot afford to pay (a brown pot), it means being left unattended,” he says, who erodes the integrity of public institutions.
The solution, he says, is to do an ethical conduct – including fair hiring and the provision of honest services – the standard.
A concealment?
Post-mortem corruption means that some families never discover what has happened to their beloved. When Emily Muchabai’s brother was found dead in the industrial zone of Harare, his family was desperate for answers. The circumstances of his death were not clear, and the family hoped that a post-mortem at the Parirenyatwa hospital would offer a closure.
According to the standard procedure, a doctor or the pathologist must explain the results to the family, says Matara. There should also be a written report. But he was a police officer who gave the results, verbally, to the Muchabaiwa family. There was no official report.
“(He) told us that my brother had died of tuberculosis and a cold in the lungs, but he had trouble explaining the medical conditions. Before all that, my brother had no signs of illness, “she said.
The family was suspect. Muchabai says that they believe that death involved an unfair game and that the process was compromised. It would cost the family family to delay the funeral, so they buried their brother, who left a young son.
“We had no choice,” she says, her voice trembling. “The post-mortem failed us. Corruption has failed us. “