Paidamoyo Chipunza Senior Health reporter
Wilkins Hospital says it did all it could to save the life of Zororo Makamba, given the resources at its disposal.
The hospital said before admission into the isolation facility, it took oxygen tanks to his house twice, against standard procedure, which was administered per mask.
Oxygen is normally delivered through a nasal cannula at low concentration levels, but a mask delivers high concentration levels.
While in admission, the hospital said its staff worked flat out together with Makamba’s two private doctors to try and manage his condition. In fact, the first nurse who attended to Makamba upon arrival at the hospital is said to be unwell and presently in isolation.
The local authority is awaiting her test results. This comes amid revelations that all referral and private hospitals in the city had refused to take in Makamba for intensive care, which could have seen him put on a ventilator.
Sadly, Makamba became the first victim to die of coronavirus in the country and the second to test positive of the same. In Covid-19 response, ventilators are used to manage the breathing function of patients. The current set up in the healthcare delivery system is that ventilators are found at referral institutions where serious cases are referred to from a primary healthcare facility.
Wilkins together with Beatrice Road Infectious Diseases Hospitals are under Harare City Council and act as primary healthcare facilities. Ordinarily, any complications requiring special services such as ventilators are referred to central hospitals for further management.
“All central hospitals refused to take him, even private hospitals refused, arguing that it was an infectious case hence should be attended to at the isolation centre.
“This was despite the fact that Wilkins is administered by Harare City Council and have not received any financial resources from central government to upgrade the facility to an ideal isolation centre. As part of our upgrading, we have reserved seven ICU beds with provision for ventilators and we are still resource mobilising to get equipment for those beds.
“Out of the US$6,7 million, which we requested for Covid -19 response, we were only given $100 000, which is yet to reflect in our account. We were given an unfunded mandate. By declaring the outbreak a national emergency, we expected financial assistance to upgrade the facility to an ideal isolation centre. Now its appearing as if Covid-19 is a Harare City Council responsibility.
“All central hospitals are now referring all cases here, including some which do not even meet the screening criteria, thereby overburdening our staff, which are already demotivated by the negative comments coming from clients. All facilities should be doing assessments before referring cases here.
“Already, staff has started coming up with excuses not to come to work,” said Harare City Council director for health services Dr Prosper Chonzi.
Asked why Makamba was put in an ordinary ward with no adequate facilities to take care of his condition, Dr Chonzi said at the time he was admitted, the wing which was previously reserved for coronavirus cases was undergoing renovations, facilitated by the Chinese Government and the hospital had to improvise. Refurbishments are expected to be completed by weekend.
“Not all Covid-19 patients require ventilators, a majority will recover without them. It is unfortunate, we started with one of the worse cases which required a ventilator.
“However, in our preparedness plan, we had budgeted for seven ventilators for the ICU beds and as said before, we are yet to get funding to fully equip these rooms,” said Dr Chonzi.
Dr Chonzi said Covid-19 national response required “all hands on deck” instead of shifting all the burden to the local authority administered facility. “There is need to invest more in this isolation facility. We need to make sure that serious cases go somewhere else. Our frontline workers are demotivated, they need risk allowances and they think someone in management has taken their money when in actual fact nothing has come down to us.”
A quick tour of the facility showed that indeed the wing, which many authorities assessed for preparedness previously, was under renovations. This makes management of any serious cases difficult under current circumstances. Floors, walls, handwashing basins, waste are all being spruced up.
There are also rooms with sockets for ventilators, but are not yet ready for use.
The Herald also witnessed a dozen people waiting to be screened. Although no exact figures could be provided immediately, authorities at the hospital said nearly 200 people were screened between Tuesday and Wednesday.
Responding to the funding gap, Health and Child Care Minister Dr Obadiah Moyo yesterday said Government was in the process of mobilising more resources for response.
He said the response plan has since been revised upwards to US$100 million.
Dr Moyo said no funding has so far been disbursed but Government has also committed local resources towards Covid-19, which would be disbursed as soon as possible.
In terms of the country’s capacity to manage worst cases, Dr Moyo said Government has sourced ventilators, which will soon be handed over to Wilkins as it completes its refurbishments over the coming weekend.
He said more centres will also be established countrywide. He said Government will also continue to train more health workers to build their capacity to deal with Covid-19.