Declaration of Incapacitation of Senior Hospital Doctors

On the 9th and 23rd of September 2019, we wrote to you raising specific concerns relating to our declining capacity to provide timely, acceptable and affordable health care of appropriate quality to the nation. We followed this up by engaging the Permanent Secretary in the Ministry of Health and Child Care to no avail. No efforts have been taken to address any of our concerns, giving the impression that there is no interest on the part of the Government to address those concerns. In this regards, we need not remind you of the State’s obligations in terms of sections 65 and 76 of the Constitution of Zimbabwe as well as Article 12 of the International Covenant on Economics, Social and Cultural Rights as read with Article 12 (a) to (d) of General Comment No. 14 of 2000.

These peremptory requirements for the attainment of the right to health do not exist in Zimbabwe on account of the following:

a) Inability to provide acceptable healthcare of appropriate quality

  1. Health service delivery requires a full complement of medical professionals such as consultants, senior registrars, junior doctors, nurses and other allied health professionals. At present, due to their incapacitation, nurses and other allied health professionals are coming to work for 2-3 days per week, as per ministry directive, while junior doctors are completely incapacitated. This creates unbearable pressure on the senior hospital doctors in terms of the work load. It is for this reason that we scale down our operation to the provision of only emergency hospital services.
  2. Our hospitals do not have adequate stocks of essential medicines and sundries particularly in critical areas such as Casualty, Maternity, Neonatal Units, High Dependency and Intensive Care Units as well as theatres.
  3. Medical equipment and machinery keep breaking down. Diagnostic services, especially laboratory and radiological, are erratic and not in keeping with the requirements for patient care. There are perennial stock-outs of reagents.

Without a full complement of medical personnel necessary for the management of a patient’s health, and without the necessary tools of trade such as essential and critical drugs, machinery and other essentials, we cannot conscientiously pretend to be offering acceptable and quality healthcare when all that we are doing is to walk with patients to a certain slow death due to a failing health care system. We are incapacitated and cannot continue working like this.

b) Financial Incapacitation

In terms of section 65(1) of the Constitution of Zimbabwe, we have a right to fair and safe labor practices and standards and to be paid a fair and reasonable wage.

Our conditions of service are appalling and disgraceful to say the least. Our remuneration is not in line with comparative remuneration trends regionally. South African senior hospital doctors are paid an average of ZAR80 000 – ZAR120 000 per month. In our situation senior medical doctors are paid a basic salary of less than RTGS500.00 while consultants receive a basic salary of RTGS1010.00. This is a pittance which does not take into account the rising cost of living which sees the entire salary of a senior medical doctor as barely adequate to fuel up a small vehicle to get the same doctor to and from work. As it stands, our remuneration is neither commensurate with our skills and services and also out of touch with our lived realities in terms of the costs of basic goods and services. We are thus incapacitated from continuing to come to work as our remuneration has been eroded by the ever-rising cost of living.

We have a right to be able to practice our profession in a manner that allows us to fulfil our professional responsibilities to patients and society. We have a right to be able to practice ethically and in an environment that allows us to practice legally and in accordance with professional standards. Equally, we have the right to advocate for ourselves, to receive fair compensation for our services, to perform our duties in safe working environment and to negotiate our working conditions and compensation levels. As a profession, we have been patiently negotiation our conditions of service with the Employer for years. Unfortunately, the Employer has not been forthcoming.

In the circumstances, and on account of your failure to address or at least respond to our concerns as summarized above, we are left with no option but to openly declare our incapacitation. It is with a heavy heart we hereby inform you that with effect from Thursday 03 October 2019 at 0800hrs, we shall not be able to continue reporting for duty until the causes of our incapacitation have been addressed by you.

Source: Senior Hospital Doctors Association (SHDA)