THE Government is working on plans to introduce district hospitals in Bulawayo and Harare as part of measures to reduce congestion at central hospitals, an official has said.
Speaking recently to the State media at Mpilo Central Hospital on the sidelines of a memorial service for 21 people who died in the Tsholotsho road accident last week, Permanent Secretary in the Ministry of Health and Childcare Dr Gerald Gwinji told Sunday News that they were facing challenges with patients being referred from a clinic straight to a central hospital instead of being attended midway.
“We have a referral system that exists, it is still strong but needs to be reinforced and enforced. It is very difficult to turn away someone when they pitch up here. It will raise complaints that Mpilo is turning away patients so it’s a process that will be arrested by putting middle level facilities in urban centres as you know there are no district hospitals in both Harare and Bulawayo,” he said.
He said a system where people were referred from a clinic to a central hospital was not workable and should not be allowed to continue. Dr Gwinji said the hospitals were enhanced district sized hospitals where they have a small team of specialists and the super team would be found at central hospitals.
“That is the structure that we want now. We are putting in place district hospitals and a level of specialist care so that most of the cases are dealt with there and just a few come to the central hospitals. We have actually started on a pilot project in Harare where we have identified two sites for the hospitals. One will be in Harare South and the other in Budiriro,” he added.
He said when it came to moving patients from primary care they would go straight to tertiary care because there was no facility to assist them in-between.
“We used to have clinics which acted like district hospitals but there were complaints from patients who thought that they had gone to a high level hospital after they fail to get specialist treatment. We were just trying to get rid of the congestion at the central hospitals,” he said.
The permanent secretary said central hospitals were now treating common flu and colds using a specialist physician which means that flu was now costing much more than it would when using a nurse at a primary care level institution.
He said the ministry could only enforce the referral system if they first strengthen the urban centres.
The chief executive officer for Mpilo Central Hospital, Mr Leonard Mabhandi, said the institution was overwhelmed with referrals from clinics such that specialists and other staff are now dealing with minor cases instead of concentrating on their core business of treating serious and complex cases.
Mr Mabhandi said Mpilo was absorbing a lot of people from referrals from areas surrounding Bulawayo and this was putting a lot of pressure on the institution which has been starved of resources for a number of years. He said the hospital has been failing to cope with the large volumes of people and hoped that the Government would move in to assist the institution by capacitating the district hospitals.
Dr Nyasha Masuka, the provincial medical director for Matabeleland North said the Tsholotsho disaster could have been handled better if facilities were equipped.
“We have the infrastructure, look at Tsholotsho District Hospital, it is big enough but the number and skill mix of doctors who should constitute a team at a district hospital is just not there. In a district hospital, doctors should be able to do minor surgeries, fix certain fractures so that patients are not sent to a central hospital,” he said.
He however, said although district hospitals do not have Intensive Care Units, they should be able to deal with most cases.
“Like in this disaster if the district hospital had a full complement of six doctors supported by specialists on a regular basis they could have helped the situation.”
Dr Masuka said bad road network was also as a setback in the Tsholotsho disaster as the bumpy roads could worsen the situation. He said it was only fortunate that ambulances were made available.