unitex@rubbs.fidonet.org (unitex) (09/23/89)
MOZAMBIQUE: Party Congress Highlights Health Gains and Losses
Maputo, September 21, 1989 (AIA/Subha Ghai) -- Mozambique's
successful post-independence health delivery system has been
targetted by the South African sponsored war of
destabilisation. This is according to Frelimo's Central
Committee report, read by President Chissano at the Party's
Fifth Congress during the last week in July.
The report highlights some of these tragedies:
* Health professionals figure high on the hit list of the
MNR armed bandits who, between 1983 and 1988, murdered 40,
abducted 41 and looted the possessions of 669 workers in
this sector.
* In the same period bandits destroyed 193 primary-health
care units (17 percent of the total number of units) and
forced 654 health posts and centres to close through
looting. This meant 847 health centres had to stop
functioning.
* In 1982, 42 percent of all the country's 120 or so
districts had a health technician with diagnostic and
therapeutic capacity. By 1987, the figure had fallen to 18
percent. In 1982 there were 385 doctors in the country, of
whom 29 percent were Mozambican. In 1987, the number had
dropped to 327, but 37 percent of these were Mozambican.
* Directly as a result of South Africa's war of attrition
about 200,000 children have been orphaned, lost or
abandoned. Many of them are emotionally and physically
traumatised.
* An estimated 170,000 people are handicapped or mutilated.
* In a population of about 15 million people, approximately
5,6 million or 40 percent of the total has been affected by
the war. Hunger and malnutrition have increased. Diseases
such as measles, cholera and tuberculosis are more widespread
and difficult to control, let alone treat. The child
mortality rate is one of the highest in the world, not to
mention the more than one million people who have died since
1980.
Yet in spite of the war and underdevelopment, Mozambique has
also made some modest gains.
Between 1983 and 1988 the Faculty of Medicine at the Eduardo
Mondlane University trained 72 doctors. More than 5,000
health professionals were trained between 1982 and 1988
including more than 2,100 nurses, 370 technicians and health
workers and 825 midwives and child care nurses.
The Central Committee report states that some 42 percent of
pregnant women had ante-natal care in 1988 while 29 percent
of deliveries took place in institutions. The percentage of
monitoring consultations for children up to four years rose
from 17 percent in 1983 to 23 percent in 1988. Family
planning increased from 20,800 to 97,712, covering women
between the ages of 15 to 49 years. This represents an
increase of 22 percent over five years while still accounting
for only 0,65 percent of the total population.
Yet the IMF sponsored structural adjustment programme,
popularly known by its Portuguese acronym PRE, has seriously
affected the health services. Patients now have to pay for
various services which were previously free, and the cost of
medicines has increased substantially. This has reduced the
number of people using the health services. In 1987 only
three percent of state spending was on the National Health
System.
The report also mentions other problems in the health sector.
These include "lack of discipline, negligence, theft of
medicines and hospital equipment and slowness in attending
to the public." At the same time the report acknowledges
that "some of the causes of discontent among health
personnel are related to wage issues, overworking on shifts
and deficient logistical support while on duty."
A worker classified as "servant" at the Maputo Central
Hospital has an endless job description including cleaning
the facilities, bathing and dressing patients, assisting in
all levels of treatment, moving patients around the spacious
grounds and so on.
Yet this "servant" only receives 16,000 meticais (Mt) a month
which at today's exchange rate of 643,95 Mt to the Canadian
dollar amounts to CDN $24.84 per month. Of the 16,000 Mt,
2,000 go towards his/her pension fund. It is impossible for
an urban family of at least seven people to live on this
wage.
The suspicions of many that Frelimo's 5th Congress would
legitimise the privitisation of health care remained
unfounded. While the report creates more openings for the
development of the private sector, in the area of health it
has stated a flat, "No". Instead, the report criticises
health personnel who have been using hospital facilities to
"provide private health care".
The Central Committee report states: "In the actual
conditions of our country, the liberalisation of medical
practice would not increase the quality of health care, even
though it could improve the quality of services provided to
some people; and it would render useless the effort and
sacrifices of many cadres and doctors who dedicate themselves
to the creation of a national health system."
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* Origin: AlterNet, Node1 (Opus 1:163/113)
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