Harare, Zimbabwe – A few days after giving birth to her youngest daughter in May 2024, Shirley famous Mkono, a 34 -year -old mother, went to her local clinic to ask for help for persistent headaches. The nursing staff feared that she could not have uncontrolled hypertension, remembers Mkono as she rocks her daughter, now aged one year.
“The dealing nurse informed me that my blood pressure was extremely high and that I could collapse at any time,” she said.
After a few minutes, Mkono agreed to call a private ambulance for US $ 30. Despite this, she waited for four hours painful to get help to come.
“If the clinic had an ambulance in sight, it could not have taken so long,” she said. “I could have died.”
Only four public ambulances serve more than 2.4 million people in Harare, well below the 32 ambulances that the city says it needs; It would take a fleet of 48 to align Harare in accordance with an ambulance international guidelines for 50,000 people.
In February, the Municipal Council introduced a monthly debit of emergency services of US $ 1 per household to finance additional ambulances for the council clinics, collected within the framework of the monthly electricity bill. However, the poor council history in the management of public funds have made residents and skeptical surveillance groups that the money collected will be deployed with transparency and responsibility.
The local authority has been struggling with the financing of health care for a long time, explains Reuben Akili, director of the combination of the Harare Residents Association. Akili says that the emergency direct debit will only be effective if it is collected and spent locally to prevent funds from being diverted.
“There must be a mechanism in place which guarantees that money is closed to buy ambulances in places where this money has been collected,” he said.
Mkono, who lives in the suburbs of Glen View, is doubtful that the sample will serve his goal.
“There is a lot of corruption to local authorities. We pay for waste collection about $ 8 per month, but they do not wear waste. I remember that I saw a waste truck in my region in October of last year after the mayor visited our region, “she said.
The embezzlement is a persistent problem in local councils, as pointed out in an analysis in 2024 of the local authorities led by the parliamentary support for southern Africa and a coalition of local non -governmental organizations. The embezzlement of funds from critical services such as health care and sanitation has contributed to a cycle of mistrust and disillusionment, where citizens hesitate to pay public spending that do not really improve local services.
“If the clinic had an ambulance in sight, it could not have taken so much time. I could have died. “
Akili says that the scarcity of public ambulance services has led people who can afford to use private taxis, which can cost US $ 10 at US $ 20.
In May 2024, President Emmerson Mnangagwa set up an investigation into the Harare Municipal Council led by the opposition following corruption and poor financial management reports. The survey revealed that the municipal council has misused more than 1 million US dollars, the leaders spending more than $ 125,000 per year on vacation even if the city does not provide adequate services.
Mkono wonders why local authorities add another levy from residents who are already paying user fees when they request medical care in the council clinics.
“They should buy ambulances with this money,” she said.
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In A Written Update to Residents On Recently introduced levies, which also include in US $ 1 Streetlight Levy and Us $ 1 Water Levy, Precious Shumba, Director of Harare Residents’ Trust, Says The New Fees Were Never Predented and Discusd During The Annual Budget the City Council Held Across Harare in September 2024. Without an accurate, Transparent and Functional Billing System in Place, Shumba Writes, The Levies “Add to A Long List of Revenue Streams that has the potential to be mistreated by the cartels that direct the affairs of the city of Harare.”
Caroline Machelivenyika accompanied her 17 -year -old pregnant daughter at the local clinic in December of last year. When they arrived, her daughter was referred to a hospital because she was a minor, but Machelivenika learned that she would need US $ 70 to get a private ambulance to take them; The city’s ambulances were not available.
“I only had US $ 50 on me; I explained my situation, and after an hour, a private ambulance arrived, ”she recalls.
Transfers of pregnant women and traffic collisions constitute most of the emergency incidents that require ambulance services in the city.
Like many other residents, Machelivenyika has doubts about whether funds collected by the levy will really buy ambulances.
“We have lost confidence in local authorities because the necessities we pay are not adequately provided. For example, we only get water three times a week, but we pay these services each month, “explains the mother of four children.
But she says that the unpaid invoices of residents are also an important reason why the local authority is struggling to provide adequate services.
“They are supposed to hang on to the water for houses with unpaid bills, but when council workers come, people pay for bribes at $ 5 and they leave. Others are not even moved because they do not have access to water daily and do not care even if their water meters are disconnected by the council, “she says.
Stanley Gama, business communications manager for the Harare municipal council, did not respond to several requests for comments.
Only a third of African countries have emergency medical services and most of them require patients to pay costs.
Arriving at the hospital, Mkono was treated and sent home within 30 minutes. She obtained a prescription for a month of medication to take at home, and her condition quickly resolved.
The ambulances arrived quickly when there was a need, recalls the mother of Machivenyika, Esther Machelivenyika, 75.
“I remember that in 1995, when my husband fell ill at home, we called an ambulance and he did not take an hour to spend and he was immediately taken to the hospital,” she said, checking peanuts.
In the 1980s, Zimbabwe had a solid ambulance system with well -trained staff, including a public service in Harare. But decades of economic instability have left the emergency services unable to maintain or obtain modern equipment.
Now Esther Machelivenyika says that a patient must pay species in advance to get help.
“You can die while negotiating payment,” she says.
Even if people pay the emergency direct debit, she has no hope of change in the situation because of what she considers a culture of greed in the public service.
“They now consider money to be more important than a person’s health,” she said. “Even in health establishments, you have to pay a bridge pot to get a good nursing service.”