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NATIONAL ASSEMBLY HANSARD 26 SEPTEMBER 2013 VOL. 40 NO. 5

PARLIAMENT OF ZIMBABWE

Thursday, 26^th September, 2013.

The National Assembly met at a Quarter-past Two O’clock p.m

PRAYERS

(MR. SPEAKER in the Chair)

ANNOUNCEMENTS BY MR. SPEAKER

SWITCHING OFF OF CELLPHONES

1. SPEAKER: May I once again remind hon. members to please switch off their cellphones before business commences.

INDUCTION SEMINAR

1. SPEAKER: The induction seminar for all Members of

Parliament scheduled for Monday, 30^th September and Tuesday, 1^st October, 2013 will be held at Pandhari Hotel. The programme for the days has been circulated to all Members of Parliament through their pigeon holes. The buses will leave Parliament Building at 0815 hours.

MOTION

DETERIORATION OF THE HEALTH DELIVERY SYSTEM IN

ZIMBABWE

1. LABODE: I move the motion standing in my name that this

House:-

ALARMED by the deteriorating nature of the health sector in

Zimbabwe which includes the health infrastructure and services;

CONCERNED by Government’s lack of adequate attention, time

and effort into averting the health crisis;

DEEPLY WORRIED by the expanding gap between the private

and public health delivery systems;

ALSO DEEPLY ALARMED by the reports from Harare Central

Hospital where mothers are delivering babies on the floor;

FURTHER CONCERNED by the shortage of basic services such

as water at Government institutions;

NOW THEREFORE resolves that the Portfolio Committee on

Health and Child Care conducts an inquiry into the health sector in Zimbabwe.

1. MATARUSE: I second.
2. LABODE: Mr. Speaker Sir, the challenges facing the health sector actually are either internal or external. By internal I mean within the Ministry of Health and Child Care, or outside the Ministry of Health and Child Care but not outside the country. One external factor that I thought I would discuss was that; a poor performing economy like ours is in no position to actually finance the health sector. More than 75% of the people in Zimbabwe are unemployed hence, they are not contributing to the revenue but constitutionally, they are entitled to free health. This means they are actually depleting the finances within the health sector.

If you boost your economy and there is enough revenue, it means the Government would actually be able to finance the health sector but as it stands now, you find that when the Ministry of Finance says they have allocated $2 million to Mpilo Hospital, what it translates to is that they have allocated $300 000 or something and the hospital has to look for monies elsewhere.

We resolve that in this regard, with immediate effect, Government ploughs money into all ailing companies to revive at least the 30 000 jobs that were lost in Bulawayo.  I know that in a lot of other places jobs were lost but this is the figure I have. If we revive those jobs, it means we have a workforce that can go to an institution and at least contribute towards the running of the institution and also contribute towards the taxes.  An injection of $2 billion in the manufacturing sector would oil the wheels in the Bulawayo companies.

Mr. Speaker Sir, the anchor of the health system in the Third World is a well performing district health system. A district health system ensures the A, B and C of public health is implemented. It can almost be said that the district health systems ensure the GOBIFF targets of UNICEF are achieved. GOBIFF is Growth Monitoring, Oral Rehydration Therapy, Breastfeeding, Immunization, Family Planning and Food.

A district health system is the epicenter of an effective national surveillance system. It also coordinates and monitors donors at a district level. An effective national surveillance system will pick epidemics as they come out. How does it work? You have radio systems at every rural health centre and if that radio is working and the nurse notices that last year they reported seven malaria cases that has now twenty-one, that alone is a trigger that there is an epidemic coming. That is what the system is supposed to be but as we stand today, all those radios are not working.

We resolve that as the epicenter, the district health system needs, with immediate effect, at least 4 x 4 twin cabs and 4 ambulances for every district within the next three months. The outreach teams must be increased. Some of you who are in the rural constituencies will know what an outreach team is. The outreach team leaves the district hospital to try and bridge the gap between facilities by going to meet communities within their homes for immunisation, family planning and other things. These teams are now stationery, they are not moving because there are no cars at district level.

A new radio system linking the rural health centre with the district hospital and the provincial hospital must be installed immediately.  District hospitals must be equipped to provide essential health services which include basic surgical interventions.  We also need to ensure drug availability of at least 80 percent at the rural health centres because as of now, there are no cars to move people from Siyabuwa to Binga Hospital.

Mr. Speaker Sir, equitable distribution of existing resources has remained the challenge for the Ministry of Health.  This problem has been debated since Adam was a foetus.  The problem emanates from the formula which the Minister of Health uses, the resources given to them by your ministries for onward distribution.  The formula uses variables like the provincial population, the number of all patients in attendance, the number of hospital admissions, vehicles and staff establishment.

This formula, as it stands, ensures that the poor remain poor because if

we have a lot of vehicles and a lot of people are coming to the institution, it simply means that somehow there is an economic activity happening there.  So, it would mean the poor places where people travel long distances have fewer attendances.  Their population is small and there are obstacles.

So, as a resolution, I am saying we include variables like poverty levels which we can get from the census as a way of distributing money and distances between facilities.  I am glad the Minister of Health yesterday said in the next five years, he is going to build one thousand rural clinics.  This will translate to about two hundred clinics being built every year and two clinics that will be built every month.  The distance between health facilities in places like Binga is between fifty and seventy kilometres.  That would mean between Siyabuwa and Binga, there will be about seven clinics built.

Mr. Speaker Sir, the whole sector is operating with a very demotivated workforce.  When a nurse who is earning US$400 monthly as gross is paying rent somewhere because she is a human being like us, has a maid to take care of her children, has a family to feed, ZESA and water bills to pay, has to travel to work and show up at the hospital with a spotless white uniform and a smile for the patient, that is a mission impossible.   The resolution is we need to review their salaries.

Mr. Speaker Sir, some fifteen years ago, when the Ministry was under Dr. Stamps, a fund called the Health Service Fund was introduced.  The fund was supposed to achieve two broad objectives.  That is to supplement the Government budget through user fees and to deter abusive use of health services.  It was common that people would have a headache and rush to a clinic because it was near you, when you could have gone and bought asprin somewhere and you would be okay.  Very unfortunately, that slowly but surely, the Government began to absolve its responsibility of ensuring that they finance and remain the caretaker of public services.  However, they decided that since there is a health service fund, health services cannot stop but how did that happen?

If you take, I am sorry Mr. Speaker Sir, I will keep using Binga.  If you go to Binga, in a month, they raise about $2 thousand from the Health Service Fund.  So if you do not give them their money, what will happen to them?  Then we move onto Nkayi, it is $5 thousand.  You go to Mpilo, maybe it will be $10 thousand and if you go to Parirenyatwa, it will be $100 thousand.  So, there are issues of inequity here.  The economic activity of a district determines how many people are willing or are able to pay for services.  So, Government needs to take their role and do it properly.

The resolution is to introduce the long awaited Public Health Insurance Scheme.  I know for sure that people have been sent to other countries to look at that possibility.  A Public Health Scheme means every Zimbabwean – it is like the NHS in England, you belong to some basic public health insurance which allows you to go to an institution and it works in a way where I would say because my income is high, I pay $40 and the next person pays $2 and other people do not pay, but everybody will be covered and can access health centres.

The Government must commit real money to the health sector.

The health sector is not like the education sector where if you budget on projected revenues and if they do not come, you can postpone building the school or even postpone writing the exam for that matter.  If you give a health sector the projected revenue and there is an outbreak, the money is wanted there and whether you have made it or not, it is wanted.  So, we need real money and not money you think you may get or may not get from diamonds.

I propose also, that we continue using the user fees.  I know the user fees raise a lot of issues because we implemented them without a good safety net.  The safety net which was put in the user fees was that you go to the Social Welfare and obtain a letter that you are now unemployed and get free treatment.  Sometimes those instances deter people when they arrive at institutions and are chased away.  The ministry needs to set up a good safety net.

Our Ministry also needs to encourage triple “Ps”.  I recently visited

Gweru Hospital and I was amazed by what they have done together with

Unki.  Unki is building the infrastructure and if you go to Mpilo also, the

CBZ has bought ambulances for Mpilo and the World Vision has repaired the boilers which were broken done.  So, the Ministry needs to work on triple ‘Ps’. I do not want to say our but on their own, they cannot make it.

Mr. Speaker Sir, the state of the hospital infrastructure and equipment is deplorable.  In general, most boilers in Zimbabwe have broken down.  Theatres and laundry machines have also broken down.  I will give an example of Mpilo, we have four theatres and we are operating one.  They have stopped taking cold cases and they only do emergencies.  That is very frustrating for a specialist who went to school to conduct some surgical operations and they will find themselves in a hospital which only takes emergencies.  The resolution is that the

Government must transfer all buildings from the Public Works to the Ministry of Health.  The Ministry of Health is in a position to raise funds from outside Government, to bring in partners to help repair or maintain some of these buildings.  Central Hospitals should be allowed to contract our maintenance services to the private sector.  That can only happen if these buildings have been transferred from the Public Works.  We need to recruit a handy-man for each hospital.  This could be a trial in central hospitals first before it is moved to the district hospitals.

What I am about to propose now is that since this is my first time in Parliament, but I am seeing an opportunity where Parliament can monitor the activity of some of the issues that we are told.  For me it is a performance indicator that Minister Parirenyatwa said he will build one thousand rural health centres.  It means that the Portfolio Committee on

Health can use that as an indicator of monitoring the performance of the Minister.  I remember yesterday Minister Muchena also talked about the cadetship and that becomes an indicator.  I think we need now, together with the Research Department of Parliament, to start using them to monitor some of these activities.  Even to do district visits because if the Government is serious about building about one thousand rural health centres, it means by December there will be about fifteen of them in

Binga.  So, Binga will get a big chunk of these as well as Beitbridge.  So, we need to see those things happening with immediate effect.  I thank you Mr. Speaker Sir.

1. SPEAKER:  Hon. member, do not apologise for being you, I think you have done well. May I apologise to Hon. G. Moyo and Hon. S. Nkomo for the administrative breaches that took place within the office in terms of their motion.  I want to assure you that next Tuesday, your motions will be accepted.
2. MATARUSE:  Thank you for affording me this time to

update this august House on the status of health care services in this country.  The objective of health services is to safeguard the health and livelihoods of the community and therefore the primary health care approach that was internationally adopted by WHO member countries should be prevailing in all nations.  For the benefit of this House, I will define this pivotal element and main component of health delivery services.  Primary health care is that health service that is made affordable, accessible and available to the community through prevention of diseases, promotion of nutrition among pregnant mothers and under five children, immunization, rehabilitation, oral health, prevention of local and endemic diseases, sanitation and wholesome water supply.

Now Mr. Speaker Sir, I would like to highlight the status quo in terms of health delivery in the country:

1. Health infrastructure:- People are walking long distances to access health services and the available facilities are not well maintained and equipped.  For example, most of the facilities that provide comprehensive health do not have adequate medical equipment.
2. Prevention of diseases: - The emergence of new diseases is a challenge to the nation. We need to be prepared for diseases such as H1N1 and the AIDS pandemic.  We also have challenges in terms of infant mortality due to preventable diseases such as diarrhoea.   The current situation in the country is conducive for the spread of diarrhoeal disease because of overflow of sewage in urban settlements and unavailability of sanitary facilities in rural areas.  Water rationing is also a problem in the urban areas and sometimes residents go for weeks without water in their taps.  Typhoid is almost becoming endemic in Harare and other towns because of the current situation.

Immunisation coverage is not adequate in order to prevent diseases among children under five years.  Rota virus vaccine is long overdue as this may also reduce our infant mortality in the country.  The outreach services are no longer in place and this alone reduces our immunization coverage.

Emergency preparedness in terms of disease epidemics is something to be looked at as we are indispensable to such phenomena.  The shortage of midwives is also a problem in the country and if addressed, will reduce maternal mortality.  The increase of home deliveries need to be  reduced through health promotion among communities and as alluded to before, through provision of more midwives and provision of 24/7; a tall facility.

Availing ARVs to those deserving will mitigate HIV and AIDS related problems.  Decentralisation of diagnosis HIV/AIDS and OI/ART  services is the only way out given that the local health staffs are capacitated.

3. Availability of drugs medical equipment: - It is my conviction Mr. Speaker Sir that most of the health facilities are running without adequate drugs. We are relying on donated drugs without anything from the fiscus.  Drugs for conditions such as asthma, mental conditions, hypertension and diabetes are out of stock most of the time and people cannot do without these drugs.  Some of the health facilities are running without adequate medical equipment such as sphygmomanometers and scales, thus disenabling the health facility’s functions.  Equipment that is supposed to be in an ICU is not available in districts, thereby overburdening the central hospitals.
4. The gap between public health and private health services: The quality of care between these two is widening and the majority of our people cannot afford the private health care service.  The service at the public facilities leaves a lot to be desired and is characterised by overcrowding and shortage of trained personnel.
5. Health staff: Speaker Sir, I am sure we all agree that we have been experiencing the flight of health professionals to neighbouring countries and this has also affected our health delivery service.   We have a shortage of doctors, nurses and specialists just to mention a few.  Currently, we have nurses and other health professionals on the streets who are awaiting employment and there is need to unfreeze posts so that we improve on health service delivery.  There are no adequate doctors in district hospitals and in some local authorities.

Specialist services are centralised; a situation which is not conducive.  We need to safe guard the community in general and avoid unnecessary deaths among the communities by availing services to the public.  There is no economic development without a proper public health system.  Let us all be focused towards integrating health services in our scope of thinking at all levels.

The health staff that is currently employed is being overworked and poorly rewarded.  Their morale is down and they cannot spend adequate time with patients thereby compromising the quality of service.  Employees who are not motivated develop negative attitudes that will eventually develop into a culture that will be irreversible.  Without proper and adequate medical equipment, employees become disabled in service delivery.  Poor remuneration in terms of salaries, night duty allowances, risk allowances, housing allowances and even transport allowance will reduce their morale at work.  I read their presentation for next year and nurses are asking for US$600 as salary.  I feel that if that is awarded to them, maybe it may improve the relationship betweenthe patients and the hospital staff.  Overally, I am sure if you take into consideration what I have said and what Dr. Labode has said, we have noticed that the health care delivery system in our country has actually gone down.  I request the august House to at least form a Committee which will thoroughly investigate and give a proper recommendation so that we revive the health care system in Zimbabwe.  I thank you Mr. Speaker.

*MS. CHIMENE:  Thank you Mr. Speaker.  I stand up to add my voice concerning the health delivery system in the country.  I am so happy that the hon. member who moved the motion is seeing what is going on in our country.

Firstly, I want to show her that we are so pleased with the motion.  We thought that they were not seeing that things are not functioning well and that they are using the right terms that things are deteriorating.  Yes, things have started deteriorating and I want to congratulate her for speaking the truth. I would also want to say to this House, that a long time ago, when we got sick, we were ferried by ambulances to the hospitals until to the time when ambulances were not being repaired.  The reason why ambulances were not being attended to is the reason why all things started going down.  That started around the year 2000 to

2008. –[HON. MEMBERS: Inaudible interjections]-

I am so excited again, when I hear that they refer to the times of Dr. Stamps, when things were moving smoothly.  I thought she was going to give reference to the time of Dr. Madzore when he was the one in charge of the Ministry of Health and Child Welfare.  When the then

Minister of Finance, Biti was supposed to fund the Ministry of Health …  MR. CHIBAYA: On a point of order Mr. Speaker!  I just want to remind my fellow hon. member that you do not refer to a fellow Member of Parliament as Biti, you say Honourable.

1. SPEAKER:  Order.  There is no point of order. It is just a point of correction.  Thank you.

*MS. CHIMENE:  Thank you Mr. Speaker because I did not

know that he had won.  I did not know that.

1. SPEAKER: Order, the hon. member holding the floor by

implication was advised that Hon. Biti is Honourable, therefore, he is a Member of Parliament.  Thank you.

*MS. CHIMENE:  Thank you Mr. Speaker. What I was saying is that when Hon. Biti was then the Minister of Finance and he used to give money to the Minister of Health, at that time, nothing of that nature was taking place.  So, you have helped us by showing us what you could not do.  So, we are going to take-over from where you left. –[HON.

MEMBERS:  Inaudible interjections]-

Mr. Speaker Sir, can I be protected?

1. SPEAKER: Order, can Hon. Khupe please stop pointing at another hon. member.

*MS. CHIMENE:  I am so excited Mr. Speaker that the Hon.

Minister of Health and Child Care, yesterday really explained to this House that whatever was not done when we did not have that Ministry, he is going to look into it. –[HON. MEMBERS: Inaudible interjections]-

I am so thankful Mr. Speaker that because of this motion which was put forward, it will really help us as the people in Government to look into this matter seriously where others failed.  I thank you Mr.

Speaker. – [HON.MEMBERS: Inaudible interjections]-

1. CHIMANIKIRE: Thank you Mr. Speaker. Allow me

firstly to congratulate you on being elected as Speaker for the National Assembly.  Contrary to public media that we boycotted your election, we did not, takanga tiri kutora ma I.D.s next door. – [HON.MEMBERS:

Inaudible interjections] - Am I still protected Mr. Speaker?

1. SPEAKER: Can the hon. member proceed please?
2. CHIMANIKIRE: Thank you Mr. Speaker. Mr. Speaker, since the late 1990s, contrary to what Hon. Mandy Chimene was referring to, the year 2000, since the late 1990s, we had a crisis in the health sector.  Junior doctors and nurses went on strike and this is a fact.  They were protesting against their conditions of service, the poor environment under which they were operating.   

         Mr. Speaker, to pretend that our health system has not been deteriorating in the last two decades is anything other than burying our heads in the sand like an ostrich.  The motion is very constructive for any focused Member of Parliament and the attitude that has been adopted by the last speaker is regrettable.

Mr. Speaker, we have a country where the President has to go outside the country to receive medical treatment.  What is wrong Minister?  Two or three of our heroes that are at Heroes Acres, I will not mention names out of respect – got to receive treatment in Egypt and in South Africa before they passed on because our own system is not adequate to cater for us as Zimbabweans.

So, the proposal that is being brought in this motion is a very serious proposal that should be taken by every member in this House and not to make jokes out of it in order to score points – that is not what we were elected for.

Mr. Speaker, let me point out that in terms of facts, the total number of hospitals and clinics in Soweto surpasses the total number of hospitals and clinics in Zimbabwe.  That, is a challenge that we have to face and go along with policies that will ensure that we increase the number of facilities in this country to cater for our population.  I am surprised … - [DR. J. M. GUMBO: Inaudible interjections] -

When we look at our situation, we should be encouraging.  I heard the last speaker refer to the intention by the Minister of Health to build over one thousand clinics.  May I remind this House that four thousand people died of Cholera when the current Minister of Health was Minister of Health then.

On issues of recommendations, that we would like to see achieved through this motion, we would like the House to encourage that companies should establish workplace clinics – if they can afford and encourage them to ensure that employees and members of their immediate families are catered for at such clinics.

Secondly,… -[DR. J. M. GUMBO: Inaudible interjections] – Aaah ndinofunga kupfuura iwewe.

1. SPEAKER: Order, order. Can that exchange please stop.
2. CHIMANIKIRE: The other issue that we would like to encourage the Committee to pursue when it is set up is to ensure competent remuneration. There should be no generalisation between the general civil servant and health staff - the two should be separated because health staff are a special category.

Mr. Speaker, we need the Committee to also examine the issue of putting into place policies that attract our personnel in the diaspora through adequate provision of housing, transport and other benefits that will ensure that we attract those experienced persons now working in the diaspora.  For example, when I visited the State of Virginia about four years ago, the six junior Doctors who came from Zimbabwe are now surgeons.  They are working in the United States yet we need them back home.

Policies should be put in place to ensure that elderly people and retirees receive free medical treatment – that area is still gray in our country.  Others are receiving but the majority do not or they are ignorant of such a provision but thank goodness now our Constitution provides for that.

Finally, I would like to conclude by encouraging the Committee to also look at services being rendered by the City Councils throughout the country - so that about 50% of Council budgets are allocated to health services and facilities.

*MR. CHINOTIMBA:  Mr. Speaker, I would like to thank the hon. member who moved this motion concerning the health delivery system.  Truly, our health delivery system is in a sorry state but there are issues which when they have been talked about, we label them as political.  I think, we should understand each other that what has been said has nothing to do with MDC or ZANU PF.

Health is for everybody, we will be viewed as people that do not think as Members of Parliament.  When people have spoken then we oppose the good that has been said.  We should unite in this House and go out and speak against sanctions …-[HON. MEMBERS: Hear, hear] –

may I please be protected Mr. Speaker.

Mr. Speaker, this will really help us as hon. members to come up with ways to help our country - as ZANU PF Members of Parliament publicly condemning sanctions and also MDC Members of Parliament publicly condemning sanctions.  From there, we will become respectable Members of Parliament.  By so doing, it does not give a good picture of where we are coming from.

I was shocked when the hon. Member of Parliament said it was her first time yet she was so articulate as if she was in the previous Parliament.  But, those that were in the previous Parliament are the ones that are making noise and yet they failed to articulate issues like she just did.  I am excited about the hon. member’s speech and can only add the fact that it is not only drugs but also water.  You will find that there is no drinking water in the rural areas.  People are ferrying water from open wells and boreholes that they share with animals and because of this health hazard, there is Cholera.

The situation can be tackled by us as Members of Parliament so that we can advocate for the Ministry of Health to be allocated more money without jeering at each other so that the Ministry of Local Government should be allocated money without jeering. The same applies to District Development Fund and Transport so that our boreholes are sunk. The ministry which was once led by Hon. SipepaNkomo should be allocated funds and when we do such things, it will improve our health delivery system.

I really implore all hon. members to unite and we should not jeer at each other. If someone has spoken well let us give credit to that person but if it appears as if we are learning politics in the National Assembly that should be found outside. In here we should work. I am repeating

Mr. Speaker Sir, that all hon. members should not be concerned about when it started but should say we are coming out of this Parliament with one voice because this will affect all of us. We should go out and denounce the sanctions together as Members of Parliament.

*MRS. MAHOKA:  Let me start by congratulating you for being in that Chair. We are so thankful for the work which was done in this House. I would also want to thank all hon. members who are present for being elected by the people of Zimbabwe. The people of Zimbabwe are looking up to us for we were sent to represent them. So, all the people in this House have been given power by the people who elected them. As hon. members in this House we should be serious when we are in this House.

I would also want to thank the mover of the motion, it is a very good motion. I would like to thank you for your vision because people out there are in trouble. If we do not work together we will not get anywhere because for sure hospitals are far away. Things became worse because of sanctions. We need to get rid of sanctions which were imposed at the behest of our people. I think those who asked for sanctions should rot in jail. You actually see some people vindicating sanctions which destroy not only ZANU PF but even MDC-T people are dying because people are in trouble in this country because of what they know.

Even the hon. member who was there in the Ministry of Health, he found out that it was so difficult for him to work because of the

Inclusive Government which was not very clear. The people of Zimbabwe have elected people who are capable and also they elected a new Government of ZANU PF which is on fire. I think the motion which was moved by the hon. member – people out there are now looking up to us and they think things are now going to move because ZANU PF has taken its place.

We did not come here to play, even if you are from MDC-T, we are here so that we work together for the people of Zimbabwe have put their trust in us. We should work together because people who are dying are ours. For sure the nurses are in trouble but I think their troubles are coming to an end starting this month because this Government really knows what it is doing through the leadership of our President, Robert Gabriel Mugabe. This President was brought here by God. So, nurses no longer have problems because the Government is so good because it was put in place by the people. The Government which is there was put by the people and the people out there want to see action.

In the last five years there was no action because there was heckling and jeering. Nothing was being done because people came here to get rich. ZANU PF is made up of people who are hard workers. We own farms but some refused farms because they knew that sanctions were coming. Sanctions started when we did the Land Reform Programme. When we started fighting for our land that is when they started to put sanctions. It is not their problem, they did not know.

1. SPEAKER: Order! Can we respect the hon. member who is holding the floor. If you have anything to say against, you are free to take the floor.

*MRS MAHOFA:  I want this motion which was moved in this House to bear fruit because women are paying a lot of money which is hard to come by, especially in the rural areas. Let me say to the whole of

Zimbabwe or to the hon. members present that because of President Robert Mugabe we no longer have those problems.

We used to run this Government without diamonds or sanctions and it was so good but when MDC came, things started to go haywire. When sanctions were introduced, life became so difficult. Let me say that this issue of hospitals and our nurses being remunerated well, even the President mentioned it in his Speech. The nurses are going to get that money because they knew where to put their X by retaining the

President who knows what to do. So, if they bring more sanctions, the President who is there will continue. Even on our farms we used to farm with sanctions there because Gabriel is like an angel – you see, all hon. members are agreeing that Gabriel is an angel which was put down here on earth.

I am so excited Mr. Speaker for the hon. members who spoke about the health system in this country. All of us want good health.  I want to thank the President of this country for choosing Minister Parirenyatwa as the Minister of Health and Child Care because he is well versed in this ministry. I want to tell all the nurses that we are going to have state of the art hospitals through our President R. G. Mugabe.

Thank you.

+MR. MAHLANGU: I thank you Mr. Speaker Sir. I stand up to debate on the motion that was moved by Hon. Labode in connection with the health facilities in our country Zimbabwe. Mr. Speaker Sir, it pains us a lot, as Members of Parliament when we come to this august House to debate such an important issue and we start to laugh about the lives of people. I realise that my colleagues from ZANU PF, when they are debating, they create a platform to showcase that they won the elections.

We did not come here to tell each other that we won the elections.

Everyone who comes to this Parliament has won the elections. We are not supposed to be telling each other whether you managed to win the elections or not but to represent our people. Some of you who are hon. Members of Parliament did not win the elections, but you actually stole the elections. It is on record. Some of us, managed to win the elections because we were voted for by people. Some of you were given the votes and we know that.

Mr. Speaker Sir, I want to highlight that the issue that was highlighted by Dr. Labode is painful. When we talk about the health delivery system in Zimbabwe, we all know that since independence up to the time that MDC was formed, we already had a crisis in the health delivery system. One thing that amazes me is that when we talk about challenges in the health delivery system in Zimbabwe, we then start talking about sanctions. When did the sanctions come in Zimbabwe?

When did the problems that we have in Zimbabwe start?

When we want to talk about an issue and hide the main issue, there is no way we can solve the problems that we have in Zimbabwe as long as we are divided. Let us as Members of Parliament agree on the problems that we have and how we are going to solve them. I also have people in my constituency in Nkulumane who want a better life and also you as an MP, Hon. Mahoka, you have people who want a better life from your constituency. Hon. Chinotimba had very good points when he said that, at the end of the day, we should realise that we are all Zimbabweans. The challenges that are faced by the people from our communities are the same challenges that are being faced by the MP from MDC or from ZANU PF. If you come here and start talking about sanctions, especially the female MPs, maybe you were told a slogan to talk about sanctions but Parliament is not about talking  sanctions but debating issues.

Mr. Speaker Sir, let me come back to my debate. I come from

Bulawayo -[ HON. MEMBERS: Inaudible interjections]-

+MR. SPEAKER: Order. May you please give him a chance to

talk?

+MR. MAHLANGU: I thank you Mr. Speaker. I was saying I come from Bulawayo, as an MP from Nkulumane Constituency. We have Mpilo Hospital and Central Hospital in Bulawayo. They are called referral hospitals but to our surprise, you find that Mpilo Hospital is not referred to as a referral hospital. It is referred to as a district hospital. So in terms of allocation of the budget from the Ministry of Health, Mpilo Hospital is taken as a district hospital and it is not given the budget that it is supposed to be given. We realise that when we come to Harare for example, Parirenyatwa Hospital, when we compare the delivery system at Mpilo Hospital and Parirenyatwa Hospital, there is much difference.

Mpilo Hospital is not given enough budget like other big hospitals like

Parirenyatwa Hospital and Harare Central Hospital. It is disadvantaged.

One thing that I want to highlight to the Minister of Health is the issue that when the budget is allocated, Mpilo Hospital should be given enough budget because it is a big hospital that services almost everyone in Bulawayo. People are being short changed by that. I also want to touch on the issue of diseases that are a problem, like cancer. I think such diseases, the Government should take steps like what they have done with TB. When you suffer from TB disease, the Government is assisting. The Government should also assist anyone who is suffering from cancer. Also in hospitals, we have people who are elderly such as our grand-mothers and grand-fathers who are over 65 years who would be suffering from sugar diabetes, or BP. We realise that when they want any medication from hospitals, they do not get any medication. Even when they go to the pharmacies, still they are not able to get any assistance, because they will not be having enough money.

Some of them might not even have the cash to buy such medication. Therefore the Government should also try to take part in helping the elderly people to get medication. In Zimbabwe the health delivery system is only affordable to a person who has money. Anyone in Zimbabwe should have an opportunity to live, not only those who have money. Someone has highlighted that if someone is not feeling well, he can actually go and get medication from foreign countries like South Africa but, it is not everyone who is able to do so.

The health service delivery system should be accessible to everyone in Zimbabwe, not only the people who have money. Also the issues about clinics, especially in rural areas, I was happy so much to hear the Minister highlighting that he will build more than 1 000 clinics, I hope he is going to be able to afford that. I also hope that the money that we get from the diamond in this country is going to assist the Minister to fulfill what he promised to do whilst he is running that ministry and in your campaigns during elections.

The other thing that we hope for is; we wish that people who work in our hospitals especially the nurses and the doctors, Hon. Mahoka highlighted that by the end of next month, the doctors and the nurses, will be getting good salaries. I do not know whether she is the one who is the Minister of Finance. However, I will be happy if that happens. I hope that they are going to be able to fulfill their wishes. I will go to my constituency and tell people that ZANU PF has promised that they will give you money at the end of next month to fulfill everything that you have said. The other problem that is a challenge to our hospital staff is that our nurse and doctors are not getting enough pay.  I hope the Government will give them a pay rise to boost the morale at the hospitals.  I also want to acknowledge the presence of Dr. Labode and everything that she said in the motion.  It is her first time in Parliament but very eloquent.  She is also the Shadow Minister of Health and Child Care in our party, she is doing well.

1. KEREKE:  I want to thank hon. member Dr Labode for moving a very pertinent motion and also want to say that we appreciate the differences in views.  It is the epitome of our democracy and the liberties of the speech.

The area I would like to contribute on in respect of the regulatory framework in the health sector, is that there is the parent statute, then we have a whole array of councils and associations which in my well considered view, are operating almost rudderless. You find a mere association and I will be specific, the association which looks at the pricing in the medical sector.  It is not founded in any piece of legislation, a mere association, but it sets prices that then affects the delivery and access to health services by Zimbabweans.

We want to encourage and perhaps further move that measures be taken to put such associations under the statutory instrument of the

Ministry of Health and Child Care so that there is greater accountability.  We also do have instances where the delivery of health services is done under the assumption that communicable diseases are more damaging to the species of humanity in Zimbabwe.  I want to say when one compares HIV/AIDS which is a communicable disease against such non communicable diseases like diabetes, kidney failure, cancer as the hon. member here eloquently put it, you would find that the machinery of Government is almost paying a blind eye.  Take for instance a patient who is ailing from kidney failure; this is what it means.  It means for life, if that person is to survive, every week, he needs to go for therapy three times.  Each time they go, they must part with between US$80 to

US$120.  If you multiply by three, averaging US$100, that is US$300 to US$360 every week for life.  The question we then pose and answer is; is it the intention of Government that if someone suffers from kidney failure, it then means they ought to be rich or they are condemned to death.

Such is the scenario in the health sector, the response framework, how Government responds.  There has been a tendency to overplay and orient resources towards communicable diseases.  We have the HIV/AIDS Fund, which is well funded.  Currently, you can almost survive getting medication worth US$10 a month for an HIV/AIDS patient, whereas if you suffer from kidney failure you need thousands.  There is no public intervention, there is no fund for kidney patients, yet they are the most desperate.

When you look at cancer treatment, the hon. member who spoke before me mentioned Mpilo Hospital.  We have two major centres of treating cancer. For a population of our size of plus or minus 12 million, never mind the age group, some kids are born with cancer, so it affects everyone.  If you look at our case, the majority live in the rural areas, the exposure and risk factor to cancer is affecting especially women, the toiling when they go out to gather firewood.  It is an established empirical fact that the rural folk are more likely to conduct skin pigment related cancer yet there is no complete formula or institutional framework to respond to the issue of cancer.  At Parirenyatwa, efforts have been made by previous Governments to put remedial machinery for the weekly and monthly treatments.  How many of our grandmothers, grandchildren, daughters and aunties out there can afford bus fare to come and queue for the one machine in the whole country.  The answer is the majority have got no access.  The motion is very pertinent, it is a serious motion which we must deliberate on and come up with tangible solutions so that inter-generationally, we will be recognised as having made a difference to our people.

There is the issue Mr. Speaker Sir, around the subject of sanctions of whether they affect the health sector or not.  I think the reality, I will use an example, in Chinhoyi, there is Chinhoyi District Hospital. It is one of the most well equipped hospitals but only ten percent of their equipment works.  The reason is that they sourced equipment from France, Germany and United Kingdom.  That equipment is not working because of the difficulties in securing the spare parts because of the dynamics of what other Governments say about supplying into Zimbabwe. I want to concur with Hon. Chinotimba to say let us sing from the same hymn to say those that supply  our medical sector, for whatever orientations they may have with their fellow governments, they need to do so.  Sanctions must not penalise us.

There was talk about the need for water, food security as it relates to the health sector.  I want to say in the pyramid of existence, the base really, before you can talk of food, is health.  You need to be healthy to be a farmer, to be sitting here, if we all had diarrhea, we will be queuing at the lavatories there, we would not be debating.  Health! Health! It is so apt that this motion has been moved during our formative stage of this session, so that we lay the foundation of a healthy nation.

I want to move on and to propose that over and above the noble suggestions that have been put across, we also involve the community in growing the facilities for the health sector in rural areas.  In Bikita West, we introduced a model for the benefit of hon. members, where we assist the community in getting say cement. It could come as a model through Government under the Constituency Development Fund (CDF). The local community is very willing and able to play a part through molding of bricks. We have artisans and builders who are ready, willing and able to invest their labour in the actual construction. We successfully constructed a maternity clinic at Marozva Clinic where the community played a leading role. So, whereas we say there are no resources, the community itself stands ready. It is given certain enhancements to create solutions. So, I would like to urge each one of the hon. Members here, if we say, in your constituency, over the tenure targeted, you come up with at least a clinic in every ward, I want to say Mr. Speaker, it is a very achievable target.

In fact the Hon. Minister’s target of a thousand clinics could very well be an understatement if a response framework to equip hon. Members with such resources to support with cement and you need very modest quantities which are affordable.

I want to touch on the issue of funding, Mr. Speaker Sir. It is very well to almost resign and say there is very little we can do because there is no money. When hunger strikes and difficulties tighten, there is need to introspect, look internally at what it is we can do as a people to deploy our own resources and to respond to our challenges. When you look at every employee in the country, by law, they are supposed to contribute to the National Social Security Authority (NSSA). NSSA has become a liquid elephant that almost tramples on the people. I will explain.

Workers contribute monthly, Mr. Speaker and if you do not contribute, it is a criminal offence. The question this House needs to ask and get transparent answers to is: Where does that money go to? I have a fair idea of where it is going to and I am going to speak, Mr. Speaker Sir. NSSA, on a monthly basis (and I am speaking in terms of Bolpak indicative figures not refined to perfection, but within the margin of reasonableness) gets plus or minus US$15 million, which is paid mandatorily by every person employed in Zimbabwe. Of that, about US$2 million is used monthly for their own operations. Naturally they need to pay salaries, their ZESA  bills, water, etc. That leaves from

US$15 million, US$13 million monthly.

Given that they are an insurance entity, they have claims where those who retired and got injured at work post claims. Those claims, Mr.

Speaker, are no more than USD$4, 5 million in a month at the most. This leaves a balance of US$10 million to US$11 million positives, unencumbered, loose and free cash and it is a vehicle for national savings.

When you look at the current money market, a market where you invest money uri musvo. Dziri mombe dzinonzi hadzisi kurima, NSSA, I stand to be corrected, has got between US$140 million to US$150 million invested “in the money market”. Yet they are behaving like a private company which has the discretion to put money in the pillow, snooze and decide someday yet the august House, when it formulated laws to create the juristic person in the mould of NSSA, it was so that the country has long term savings to meet long term infrastructural developmental requirements. I want to move a motion that US$150 million should be deliberated on by the House and that the House uses  legitimate means so that if the money if that money moves out of the money market, it is deployed in the health sector or even agriculture, the season is here – [HON MEMBERS: Hear, hear]. Agriculture is a key subset of health. Our Government, which has just been formed, has an urgent mandate to deliver to the people. We need fertilizers, we need inputs and if the Treasury issues a piece of paper, let us call it a health sector revival bond or an agricultural sector revival bond, issue it to NSSA and the cash comes this way. The next day we are spending to activate the livelihoods of our people. So I want this august House to be seized with the issue that the juristic creatures that emerged out of the laws the august House set must live to the expectations as per the letter and spirit of such laws.

NSSA needs to play a positive role. The target the Hon. Minister of Health has, there is the solution on how he can finance almost two clinics per constituency. It is there, the solution is there. As I said, perhaps it could be a matter for the relevant committees to then get the actual facts asked for through formal means so that greater accountability can be instilled.

The other issue, Mr. Speaker, affecting the health sector, is around the supply chain of medicinal drugs. When you walk into any average pharmacy, you will find that in general, the world over; generic drugs have become one of the cheapest basics in other countries, yet in our case, because the bulk of our generic drugs are imported from as afar field as India and other parts of the world. Locally the tendency and attitude of Government have been aloof towards activating the production of medical drugs locally, yet it is as important, a necessity as food. The same prominence we attach to food; promoting our farmers to plough, till the land and to produce enough food. I want to say, Mr. Speaker Sir, that same enthusiasm, noble strategic push be done in respect of the local production of medical drugs.

There was a time, and I will need to check on the current status of CAPS, which at one point closed for various reasons. Here is a country where we could not get the 4Cs which is a concoction meant for minor children who may have bronchitis, cough, high temperature and so forth.

Mothers would probably know better. But, we did not have 4Cs for months. We did not have a simple tablet to alleviate the unsettling effects of flu, we call them flumels, yes, that are manufactured by CAPS. The whole country went dry because as a country and Government we stayed aloof. The viability issues that unsettled CAPS were treated as a private sector affair or a shareholder’s affair that had to deal with their internal matters but as a country, we forgot to realise that this player is occupying a very vital space which is to produce essential basic drugs.

Most hospitals in the rural areas, the basic painkillers and other such devices for treatment, they depended on what was produced at CAPS. When it closed, the ripple effects touched almost the whole country. In support of the motion that has been moved, we really need to take a national geographical perspective to say, when we look at each province, what is the periodicity or the distribution channels. How often do supplies reach there?

In terms of local production, the quantities that are produced, what limitations do our local producers face as they produce medical drugs?

We then tailor-make so that when the Hon. Minister of Finance comes, as he will do to present the budget, we then must scrutinise that statement and see whether it resonates well with the thinking which I am persuading members to have, that we be convinced that the machinery of Government is responding to the definite glaring gaps in the health sector.

I could go on and on, let me end here Mr. Speaker Sir and challenge hon. members that here lies an area where we ought to be seen, not just on paper, but in reality to have meant a difference to our people. Political differences and heckling is healthy, it makes us strive as a people, but at the end of that heckling, we need to sober up, retreat and come up with agreed positions so that in our constituencies – actually it perpetuates our quality before the electorate if we deliver tangible results that they see. It is not just a matter of us discussing, we have to deliver what we have promised. I thank you.

ENG. MUDZURI: I really want to appreciate the motion by Dr.

Labode, seconded by Dr. Mataruse. We are a National Assembly. When we come here we are supposed to be talking about the nation, how far it has gone with the level of health failure. This country was inherited from the white men in 1980. Someone was saying they saw ambulances running. Ambulances were running. There were sanctions by 1980 in this country but I grew up seeing ambulances in rural hospitals. Today there are no ambulances in rural hospitals.

What I want to say here is that, we should not have “the blame the white syndrome”, when we are running a Government. It does not matter how you take power. Machiavelli says whatever you do, once you take power whether by a coup or by inheritance or whatever, your duty is to deliver the socio, political and economic goods to your community and here comes the most crucial good which is health. Government has a duty, irrespective of what condition, to deliver health services to the common person.

In my constituency, Warren Park, I have several hospitals, private and municipal hospitals, including the infectious diseases hospital,

Wilkins Hospital. There is also a rehabilitation centre which I do not think you know, St Giles – [AN HON. MEMBER: It is private.] – Aizve, it is private but there is no Government institution that deals with people who suffer strokes. It has become a common disease now and at elderly levels, there is no support system for all the people who are likely to suffer from stroke and other people who might not have anything.

The charges which people go through in terms of paying for their health once they suffer strokes are quite exorbitant compared to the income of the people. The Government cannot leave it to private people to rehabilitate people who become disabled by natural causes. We are saying we cannot afford to have a Parliament that bickers about 5-year ministerial positions when we have had 33 years of running a Government. 33-years of running a Government gives you a lot of experience. It gives you a lot of leeway to understand how you manage your economy or how you deliver to the local community.

Our biggest challenge is leveraging our natural resources which are mainly diamonds, gold and other things into the health sector. Have you addressed that? I understand Zimbabwe is now third or something as a diamond producing country but if you check the past four years they only delivered $43 million towards the fiscus.

I want to say, yes, we have hard minerals in this country and I said we are a third rated world producing country on diamonds. We need to leverage our production of those diamonds to ensure that our health and other services are delivered to our community. Diamonds have been sold. I think diamonds have been sold to quite a large extent. We have heard quantities, quantities which came out in this Parliament last time which show that quite large quantities of diamonds have been extracted and sold. What then ended being delivered to Government was $43 million.

Anyway, we have to seriously think about our country instead of just defending the indefensible. What I am saying here is that the money coming from diamonds is today, how many vehicles have we imported?

Luxury vehicles against all odds, we are talking of importing medicine. Are you telling us we are allowed to import vehicles more than medicines? Are you telling us that we are allowed vehicles more than pumping stations in city councils? Are we told that we are able to import vehicles more than building a dam to supply water in Harare just for health reasons? We are a failure if we do not introspect and look at ourselves as a nation and say whatever we are delivering, we are delivering for the purpose of a legacy that our children will inherit.

It is a shame that our President and I know that several Ministers ended up being treated in South Africa, Singapore and other countries when the common man is not being treated in Warren Park.  The common man is dying of sicknesses like typhoid.  These are dirty diseases that come out of the failure of a country to run in terms of taking its resources for the benefit of the common good.

As Dr. Kereke said, you can go into political expedience but this is what has killed this country.  You would say, I stand by this, when you know you are not helping your community.  I want to applaud vaChinotimba where he says “let us work as a nation”.  A person who wants to see a difference in his country is not going to be just politically expedient at the expense of his people.  We must look at this seriously and see where our money is going.  If it is not going to our people, we must address it as a nation and as Parliament because we have a duty to oversee the work of Government.   When you have a duty to oversee the work of the Government, you must ensure that all the resources that come into the fiscus or that are supposed to be coming to the fiscus are delivered to the fiscus and everybody benefits, particularly in the health sector.

I want us to make a recommendation where there should be a deliberate fund to ensure that the elderly people who are above a certain age, which I think those above 70 years are assisted to get treatment.  Biblically, anyone above 70 is considered to have survived long enough to be accepted in heaven.  Those people must be treated freely everywhere and we must be able to pay for their private medication.  For instance, if they need rehabilitation, they must be paid for freely in hospitals like St. Giles.  We are also looking at children, we need free medication for children because there is no child who has filled a form to apply to be born and to be born from which parent.  There are

children who are disadvantaged, we need to have a deliberate effort to ensure that we have a resolution where Government takes part of these resources and put them towards enhancement of our children.

I also want to encourage that the curing of tobacco where you have transformed bans into clinics, please cure people and not tobacco.  I thank you Mr. Speaker Sir.

1. MLISWA:  Mr. Speaker Sir, congratulations are in order.  As Zimbabwe, we are certainly basking in the sun with so many countries with the resources that we have.  They are not endowed with the human capital we have in the health sector.  This is because of the nurses and the doctors that we have.  For your information, the Medical Faculty at the University of Zimbabwe (UZ) was or is number six in the world.  One of my medical doctors is white and has enrolled his daughter at the UZ.  He comes from a medical background where they are all doctors in their family.  They have gone to Cambridge and also to Oxford but have chosen the UZ Faculty of Medicine to be the place their daughter practices medicine.

We must commend our people for having kept the standards high despite the tough times our nurses – [HON. MEMBERS: Hear, hear] – our nurses are always smiling.  I say so because I am born of a nurse of forty years.  My mother is a nurse trained at UTH in Zambia and worked at Parirenyatwa Hospital.  In our time of being sick, we hardly went to see a medical doctor because the experience that my mother had was good enough to treat us.  The doctors who were coming in from the UZ would ask my mother because of her experience on what medication should be given to the patient.

We are talking of a long term in which a thousand clinics are going to be built but there is a short term strategy which must be employed because people are sick and they are dying.  The outreach programme where mobile clinics are going must be revisited.  This is important because from the Constituency where I come from, Hurungwe West, no one has money to go to a clinic or a hospital.  These clinics and hospitals have no doctors who can assist them.  That outreach programme assists in getting to the people and being able to assist them.  We have to respect our elderly at the end of the day.

What are we doing as a nation when we expect an elderly person to jump on to a kombi to get to the hospital?  Is it not time, as a nation that we also advocate for the hospital and clinics to go to the people?  This will certainly alleviate some of the problems in the short term.  A lot of what has been discussed by Hon. Members of Parliament certainly is good for the long term but in the short term, Mr. Speaker Sir, this must be looked into.  The issue of cervical cancer has become a very topical issue and I think it is important that we get specialists in areas of cancer to visit the rural areas where people need help and be treated.  We do not have the right machinery to treat them when they are sick.

The Hon. Member of Parliament Dr. Kereke alluded to the fact that it costs at least US$300 a week for dialysis treatment for anybody.  Prevention is better than cure.  By that, I am advocating for short-term strategy to be employed by the Minister before clinics are built and those mobile clinics which used to visit the areas, continues doing so using the human capital which Zimbabwe has.

Mr. Speaker Sir, may I take this opportunity to heartily pay tribute to the doctors and nurses of this nation for such a wonderful job.  I thank you Sir.  [HON. MEMBERS: Hear, hear].

MRS. CHIRISA:  Thank you Mr. Speaker Sir.  I would like to say thank you to all the other hon. members who have contributed to the motion.  We all agree that the public health system is the largest provider of the health care services and complimented by Mission Hospitals and some Non-Governmental Organisations.  In recent years this has declined due to economic decline and political instability and reduction of health care budgets.  This has affected health care service at all levels.

I also want to take the House a little bit …

1. SPEAKER: Order, will Hon. Mliswa please switch off your microphone. Thank you.

MRS. CHIRISA:  In the early 80s, we had a smooth running health care service and we used to have a slogan ‘free health for all’.  This slogan, as we went towards the late 80s and early 90s it was no longer said or sung by the children and mothers.  Why? Because corruption had crept in and resources had started to disappear.  What comes to mind is the Paweni saga, social services, the Willowgate scandal and you name them.  This affected the poorest of the poor and with a 40% drop in health care coverage.  Chronic malnutrition limits the life prospects of more than one third of the country’s children.

As a country Mr. Speaker Sir, we experience a heavy burden of diseases dominated by preventable diseases such as HIV infection and AIDS, malaria, tuberculosis and other vaccine preventable diseases, diarrhoea disease and health issues affecting pregnant women and children. Health also is a basic need for the population and if there is a nutrition budget or a nutrition diet in the home, a lot of these diseases will be preventable.  I remember the communal farmers used to contribute to the good health of the nation and we expected wonders when Zimbabwean black farmers started utilising the farms; but unfortunately, we do not see anything coming out of those farms.  It is a pity Mr. Speaker Sir.

There is a shortage of skilled professionals and health care like Dr Labode has said.  This also has contributed to the poor condition of service.  The eroded infrastructure, ill equipped hospitals like my colleagues have also mentioned.  I would like us to know that access to health is also contributory to the nation’s health population.

Health care services are now demanding user fees.  These are applied ad hoc and vary from provider to provider.  This also acts as a barrier to basic health services.  I remember, as the then Zimbabwe’s Deputy Prime Minister, Hon. Thokozani Khupe; mentioning in her analysis of the status of women and children’s rights in Zimbabwe – she made a call for reducing disparities and improving equity.  As the world turns to 2015 when all countries will be evaluated against their progress on the Millennium Development Goals (MDGs).  She went further to say that it is increasingly clear that women and children are central to the achievement of the major MDGs.  She also said that Governments’ successes are measured, not just by improvement in the political and economic situation but by how successful we have been in helping our women and children.

Mr. Speaker Sir, we are approaching the rainy season and this comes with different types of diseases.  We are saying, something must be done in terms of preventing cholera.  They always say prevention is better than cure.  Budiriro is one of the most affected areas in terms of statistics from the last rainy season.  I am appealing to the Ministry of Health to start doing something because this is linked to water and energy.  Some of these things we can prevent as a nation if we are serious but there is a lot of corruption that has crept in.  People do not care much about the nation.  They care much about lining their pockets and feeding their families and forgetting that they are in the august House.

In conclusion, I would like to say that the Ministry of Health has a willing partner, WHO, which is an international organisation.  WHO has advocated for improved access to oral rehydration for treating moderate dehydration, which is a symptom of cholera.  This could help quickly reduce sickness and deaths.  I thank you Mr. Speaker.

1. ANASTANCIA NDHLOVU: Thank you Mr. Speaker Sir. I

would like to start by thanking the hon. member for moving this motion which is a very critical motion as it contributes to the country achieving the developmental goals which are set before us among many other reasons.

I was looking at the motion and I said this is a motion which adds value to why we are here.  I agree with the mover of the motion that of course, health care in our country has deteriorated due to a number of reasons mainly in the past ten years, when the economy was not performing for reasons which mainly include the obvious one of sanctions.

Mr. Speaker Sir, I do not agree with the mover with regards to the assertion that there is a lack of adequate attention, time and effort into averting the health crisis by the Government; because in his opening remarks, President Mugabe made it very clear that his Government is committed to making sure that social services are improved including health care and that must be applauded.  It is very sad that the gap between the private and public health delivery system continues to widen as a result of the challenges that the public health sector is facing.  For example; most of the public health institutions do not have specialist equipment.  The equipment that is there is not working for reasons said by previous speakers.  I am not going to labour much on that but I am going to make some suggestions on how I think we can address public health care.

Government needs to procure and service specialist equipment; for example, it is very expensive for one to get a scan done, yet a scan in some instances will be the deciding factor on how the specialists can work on the patient. Effects of lack of such systems are mostly felt by the women and children.  As a result, we need to take this motion seriously so that we are able to address infant and maternal mortality as a nation.  We need to be united and urge Government to do what it did with HIV AIDS when it was first discovered.  In almost all schools, children were taught about the dangers of HIV and AIDS.  The same should be done with regards to non communicable diseases including issues to do with obesity which is one of the major causes of hypertension, sugar diabetes among many other non communicable

diseases.

Mr. Speaker Sir, Government should also set up rehabilitation centres for victims of accidents, strokes and so on; such as St. Giles which the hon. member said was in his Constituency when he was debating. It costs Mr. Speaker Sir, $600 a week for one to be treated at St. Giles here in Harare.  It is the best rehabilitation centre in the country but it is a private institution.  So, I urge Government to set up such institutions probably, one per province so that the people who are victims of accidents, strokes or even children who are born with disabilities can have access to such facilities.

Mr. Speaker Sir, reports that at Harare Central Hospital, mothers are delivering babies on the floor are very disturbing.  It is indeed unacceptable and needs to be addressed forthwith.  It is an insult to the dignity of women and we cannot afford to have such things happening.

But, I want to believe that, with His Excellency’s commitment made in his speech during the opening of this Session, these things will be addressed.

Water and energy shortages Mr. Speaker Sir, need to be addressed at all health institutions.  People who are on oxygen life support can lose lives when there are energy shortages.  We all know that vaccines and medicines need to be kept in refrigerators for them to maintain what is called a cold chain so that they are not affected by heat.  Temperatures should not exceed eight degrees Mr. Speaker Sir.  So, where there are power shortages, these medicines cannot be used because they will be a danger to the patients.  So, it is very critical that energy issues are addressed as well as water so that we have a sound health delivery system.

Mr. Speaker Sir, I want to also urge Government to ensure that the doctor/patient ratio is addressed, not only at district hospitals in the towns, but including the referral hospitals within our rural areas so that our people’s lives are saved.  As we speak, the doctor/patient ratio is very pathetic.  Mr. Speaker Sir, just as the whole civil service was affected, the men and women working in the health sector are among those mostly affected by the poor conditions of service.  It is therefore imperative that Government, as it seeks to improve conditions for civil servants, those in the health sector, which is an essential service, are also considered.

There are shortages of human capital at hospitals, yet we have a number of qualified nurses who have graduated in the past two or so years who have not been absorbed into the system.  That also needs to be addressed.  Of course, as we bemoan the situation of the health sector, I want to congratulate Government for the progress made with regards to reducing the HIV prevalence rate towards achieving zero new deaths and zero new infections.

I want to applaud the Ministry of health for the progress made in

Masvingo Province where out of 186 pregnant mothers who were put on treatment to prevent mother to child transmission, 182 babies were born HIV negative.  So, those efforts should be applauded and should continue.  I also want to congratulate Government for reports that we saw in the media a few weeks back that pregnant mothers now have a B+ option.  This means that, for a pregnant mother who is positive, they are not only going to get treatment to prevent mother to child transmission, but the mother herself is going to be immediately put on treatment.  That ensures that we have zero new infections, the baby is born HIV free and also zero deaths.  The mother will have a prolonged lifespan.  This must happen because previously the mothers would not come back for treatment.  Once they delivered their babies, some of them would not come back.  So, I want to thank the mover of the motion and the hon. Members who have debated before me and say that we need to continue moving in this spirit and deliver to the electorate who have put so much confidence in us.

Mr. Speaker Sir, I want to thank you for affording me this opportunity and say that we must do the things that we came here for.

Scoring points does not add any value to the electorate.  Singing or playing to the gallery is a let down on the electorate.  Thank you Mr.

Speaker Sir.

I want to also at this point congratulate Dr. Parirenyatwa and his Deputy, Dr. Chimedza.  I want to believe that they are going to be able to deliver and make sure that the health sector in this country is one of the best in the region and of course, long live President Mugabe and his Government.  I thank you.

1. MATANGIRA: Thank you Mr. Speaker. My name is

Matangira Remigius.  My Constituency is Bindura South.  Mr. Speaker Sir, I would like to congratulate you also on your election as the Speaker of the National Assembly.

Secondly, I would also like to thank the mover of the motion on health but, I wish now actually to maybe express my dissatisfaction on the way we are handling business in the august House.  Our people are earnestly waiting for whatever we are going to be delivering in the

House to benefit them.  But, to my surprise, it would look very much

like I said in the past Parliamentary sittings, nothing seems to have come out except heckling and arguments.  My wish is, may be, I would want to express it in the vernacular.

Sonke siyakwazi ukuthi sivelaphi.  We all know where we are coming from and we know where we are going.

Zimbabwe came because of those gallant sons and daughters who died for the independence of this country.  Kungela mehluko ukuthi namhlanje umuntu ukuphi –there is no difference where someone is coming from today.  Rusununguko rwakauya nekudeuka kweropa.  Huyai tive tinoita respect ourselves because we are representing those who chose us as God permitted.  Leaders do come from the Most High; you do not make your leadership from your pocket.   It is unheard of.

1. SPEAKER: Order, may I remind the hon. member to use one language and not three for recording purposes. Proceed.
2. MATANGIRA: Thank you Mr. Speaker, ndiri kukumbira kuti, I speak both Ndebele and Shona…
3. SPEAKER: Order, can you follow the Chair’s instruction.

Thank you.

  *MR. MATANGIRA: Democracy states that even where cattle

herding is concerned – there is democracy.

Part of speech not recorded due to technical fault.

         We said that we should build our own clinics, a single clinic at Rutope where a ground-breaking ceremony was held.  There will be another one at Manhenga and the community at Nyava will start constructing their own next month.  Today, we wonder what has to be done.  Let us unite, let there be a sense of common purpose that will lead to the development of the country and translate to a better livelihood for the people.

Mr. Speaker Sir, thank you for affording me this opportunity.

THE MINISTER OF STATE FOR MATABELELAND

SOUTH PROVINCE (MR. A. NCUBE):  I move that the debate do now adjourn.

Motion put and agreed to.

Debate to resume: Tuesday, 1^st October, 2013.

On the motion of THE MINISTER OF STATE FOR

MATABELELAND SOUTH PROVINCE (MR. A. NCUBE), the

House adjourned at Twenty-eight Minutes to Five o’clock p.m. until Tuesday, 1^st October, 2013.