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Decent public health is one of the absolute essentials in almost every society and this means that there must be properly equipped and staffed clinics and hospitals across the country.

While post-independence Governments had been expanding the public health sector, progress had slowed dramatically by 2018 and growing problems of shortages of equipment and drugs, reduced maintenance and the like were making the public health sector highly vulnerable.

It was made a major priority of the Second Republic, and the Covid-19 pandemic provided a serious jolt that first saw a dramatic acceleration of the plans to upgrade public health, but which also made it clear that this was a community and national priority that could involve everyone, with the Government budget rising but backed by a lot of others now willing to step in and help.

The national public health budget has been rising fast as Zimbabwe embraces the Abuja Declaration that 15 percent of every African country’s national budget should be spent on health, and the budget grows as the economy grows.

That provides the solid foundation. There are many development partners, from UN Agencies and the Global Fund down, who are willing to help, but that help is far more readily given when the country is already committing a lot of its own resources and has ensured that there is first-class accounting and administration so there is neither waste nor corruption.

The Second Republic has fulfilled both conditions so wins twice, first from what it does itself and secondly from willing support. Private sector backing in Zimbabwe has also been more readily given because of the same Government commitment.

We need to remember that huge surge in support for the public health sector during Covid-19.

The resumption of open heart surgery at Parirenyatwa Group of Hospitals and other major advances in specialist care tend to grab the headlines, but these are only possible when the far less glamorous work had already been done in cleaning up hospitals, making sure all the necessary equipment and supplies are now in place and that adequate staff is available.

Yesterday President Mnangagwa commissioned the new magnetic resonance imaging centre at Parirenyatwa, seriously top-end equipment that is needed to fulfil the hospital’s role. But at the same time he took the opportunity to hand over a lot more of the mundane equipment that is needed far more often and in far more clinics and hospitals.

So there were the 77 dental chairs, the sort of basic unit that a dental surgeon needs and which can deployed in almost any hospital. There were those thousands of kits of basic test equipment, needed by every clinic as well as every ward in every hospital.

There was a large addition to the health vehicle fleet, from the latest batch of ambulances to add to the batches already now in commission, to the trucks needed to move equipment and drugs to all hospitals and clinics, the next batch of buses so staff can be transported to and from work, remembering that hospitals are open 24 hours a day, plus the general run of utility vehicles.

None of these additions, except the MRI, was not there before. But having the required numbers and ensuring that gaps in fleets are filled and that the new centres being opened can be equipped is important. The public health system is in far better shape now than at the start of the Second Republic and President Mnangagwa’s term, but upgrading and improvements must be continuous.

At the other end of the public health system from Parirenyatwa are the clinics, where most people are likely to start when they fall ill or need medical attention.

The serious cases can always be moved up the line, and that explains the need for a decent ambulance fleet, but the clinics themselves can sort out a lot of cases, such as many of the ailments and things like normal births.

They need to be equipped and staffed, of course, and improvements have been made there. But the clinics also need to be where the people live, and sometimes some communities face immense transport problems. So the network has to be expanded.

In rural areas this is now steady work in progress. The Second Republic’s commitment to the devolution agenda is now well known, at least in rural areas and some of the better run smaller towns, as rural district councils have new clinics as one of their priorities.

At the moment the simplest way of setting priorities of who goes next on the list seems to be assessing which community is most desperate and so most keen to be involved.

We carry a lot of reports of these new clinics, and in every case there is that paragraph that the community started collecting and making materials in a particular year, and so the rural district council was able to stretch its devolution money since the local materials and labour were already in place.

We need to remember that a rural clinic is not just a building. It involves staff housing, a patient shelter, a borehole, solar powered pumps and solar cells to power up the lights and some of the equipment.

While a lot of this comes from the Health Ministry, who back the community and council efforts, there are other donations with everyone generally satisfied that a really keen community that has had a lot of input will not only look after the clinic, but make sure everyone else does to. You do not hear of vandalism and theft at these places.

Urban areas, under their less effective urban councils, are still, with the odd exception, living on what the colonialists and the post-independence councils in the 1980s and 1990s did. Central Government has come in with improvements at the hospital end, and has built new clinics in the largest of those new suburbs that are now being regularised, since the people could not be abandoned, but the council infrastructure has not been expanded or even fully maintained. We still do not know where the urban authorities spend their devolution money.

The President has several mantras, and one is building one stone at a time. With public health services this is being done, but the work has been speeding up significantly especially as we move aware from emergency remedial work to upgrading and expanding.

Devolution and the provision of ambulances and other equipment is filling his second mantra of leaving no one and no place behind.

There is still a lot of work to be done, and probably there always will be as everyone wants the very best, but in public health we have moved a long way from the days of stopping the rot and then fixing what was broken and we have been moving to creating more and better.