Zimbabwe and Guatemala are both in crippling hospital-funding crises. And in each case, the same culprits are responsible: corruption and lousy bureaucracies. In Zimbabwe, nurses from Harare Central Hospital demonstrated on Monday against CEO Peggy Zvavamwe’s use of $87,000 — raised by patients – to buy a Jeep Cherokee as her service vehicle. That money should have been used to buy medicines, as the hospital is one of many facing shortages of drugs, blood transfusions, and other supplies. But apparently a freeze was placed on all drug purchases in order to free up funding for the Jeep.
Surprised by the backlash, Zvavamwe insisted that the governmental procurement board had approved the purchase, and stated “We actually chose a cheaper car compared to others. It is not up to me to say how, but all central hospitals bought their own cars.” (And dispelling any doubts about who’s right and who’s wrong in this drama, security guards broke up the protest by beating the nurses with batons.)
In all of Zimbabwe, hospitals are facing severe shortages of drugs due to procurement delays by the National Pharmaceutical Company (NatPharm). For example, last week Mpilo Central Hospital’s CEO Leonard Mabandi said the situation of his facility was critical, with only 50% of its drug requirements and no telling how long they would last. Unable to provide adequate medicine, hospitals are now forced to give patients prescriptions for private pharmacies to supply, even though many patients can’t afford that option.
Last week NatPharm said that although the ongoing international tendering process was taking a long time, it is “much cheaper” than sourcing domestically. But even after an agreement is reached, funding it is the next hurdle, with no guarantees. According to NatPharm, drug supplies should arrive within two months after the Treasury released $800,000. But the company emphasized it is owed $24 million by the government (dating back to 2009), and if that debt were to be settled, the situation would significantly improve.
Similarly, Guatemala is facing one of its worst public health crises ever, due to an appalling lack of funds and government corruption eating away at hospitals. On Friday a doctor at Pedro de Bethancourt National Hospital said “It has been really bad because the hospital is virtually running on the materials that patients are providing us.”
Earlier this year, a corruption scandal known as “La Linea” (involving former President Otto Perez Molina and his Vice President Roxana Baldetti) resulted in a massive loss of government resources, some of which would have been sent to the health sector. Unfortunately, Guatemala’s spending on healthcare is already the lowest in Latin America — no more than 1.2% of GDP, whereas the average public investment in the region is 4-6%.
In November, Guatemala’s minister of health and social welfare Mariano Rayo said hospitals were in a “pathetic state” and blamed the health disaster on political corruption and the mismanagement of public funds. Rayo added that in recent years, the government has refused to increase the health ministry’s budget, even though cost of wages for health employees has increased 750 percent.
Subpar services in both countries due to “garden-variety” corruption and bureaucratic incompetence are disgraceful, but not surprising. Starving hospitals of funds, however, is in a whole different league — patients’ lives are at risk, so there needs to be immediate fixes and accountability.