Institute for War and Peace Reporting | Giving Voice, Driving Change

The High Price of Falling Ill

Even with medical insurance, few Zimbabweans can afford to pay the cost of a stay in hospital.
By Nonthando Bhebhe
Recent days have been living hell for my family as we try to raise money for my brother Sibanengi, who needs an urgent life-saving operation. Our family is frightened and perplexed by an inflation rate that has now reached a surreal annual rate of 1,043 per cent.

Price go up from day to day, and the grim joke here in Harare is that shop assistants have never been so busy, because their hands are aching from constantly adjusting price tags to keep pace with inflation.

I accompanied Sibanengi to a cardio-thoracic surgeon, to whom we first had to pay

500,000 Zimbabwean dollars, Z$, (about five US dollars) to cover any shortfall in our private medical insurance. Luckily, we thought, Sibanengi had at least taken out his own insurance, otherwise we would have had to pay eight million Z$– or 80 US dollars - for the consultation.

On April 1 this year, the consultation fees charged by general practitioners doubled overnight, from 2.9 to 5.8 million Z$, while consultants’ fees went from four to eight million Z$.

In a reassuring voice, the surgeon told us that Sibanengi needed an urgent operation – but then said it had to be done within two weeks, otherwise he might develop fatal complications. We listened as the doctor explained how he would not be able to function on one lung with a ruptured diaphragm.

Although the surgeon gave us two options, we obviously went for the operation. We would not let Sibanengi die at just 29 years of age. This was to be his second operation, exactly one year after an intervention which had proved unsuccessful.

At this point, we were not worried about the cost since Sibanengi had taken out his own medical insurance. For the earlier operation, his mother put him on her own medical insurance to cover the fees of 25 million Z$ for the doctors and anaesthetist, plus 22.5 million for a five-week stay in a private ward at a public hospital.

But now we have learned that inflation has eroded our insurance benefits. Of the total doctor’s bill of 258 million Z$ plus 181 million for the anaesthetist, we will have to make up shortfalls of 20 million and 110 million, respectively, that are not covered by our insurance.

As far as we can work out, basic doctors' fees have increased by more than 1,600 per cent just in the last 12 months.

Other charges have gone up accordingly – the Intensive Care Unit is charging 8.5 milion Z$ a day compared with 600,000 the last time Sibanengi was there, and his private ward will cost 46 million a week, ten times more than last year.

Even the poorest of the poor now have to pay a deposit of 23 million Z$ just to be admitted to a general ward – last year they would have paid 250,000.

To complicate matters, most surgeons are no longer performing surgery at public hospitals because the equipment there has broken down and essential drugs are in short supply. Our surgeon made it clear that for the major operation Sibanengi required, the Parirenyatwa and Harare Central state hospitals would not do. He also said the first operation probably failed because it was done at a public health institution.

"Parirenyatwa hospital does not have the capacity to handle such an operation. I cannot do it there. It will have to be either at St Anne's Hospital or Avenues Clinic," the surgeon told us, referring to two private hospitals.

As we desperately try to raise the 130 million insurance shortfall, we are too afraid to phone these private hospitals in case we find there are other costs we will have to pay.

At the time of writing, the Avenues Clinic, the country’s most prestigious private hospital, was charging cash-paying patients 870 million Z$ for five days in a ward and in intensive care. This represents an astonishing increase of nearly 11,000 per cent on the amount it was charging in February 2005.

Zimbabwe has endured catastrophic economic decline coupled with unimaginable inflation rates in recent years, but in the past few months the economy seems to have been cast adrift from whatever moorings it had left.

Things surely cannot go on as they are for much longer – the situation is completely out of hand. What kind of country is it where for the price of a single car battery, you could have bought more than a dozen new cars ten years ago?

As the joke has it, "Zimbabweans are the world's unhappiest millionaires."

Not many people living on an average monthly income of 10 million Z$ can afford the monstrous costs of healthcare. They are already battling to make ends meet, since the government’s own poverty indicators say a family of six needs some 40 million Z$ a month for basic survival.

To be accepted by a reputable and solvent medical insurance firm, an individual in my position with two young children needs to pay 15 to 17 million Z$ a month, on top of a down-payment of 100 million.

As one friend said to me recently, "People are just going to die at home. We can no longer afford hospitals, consultation fees for doctors, school fees, food.”

“I just don't know where we are going,” said my friend. “I pray every day that my kids don't get sick. What will I do with them when I am not on medical aid? Please God, help us, we are Your children and You can't watch us die.”

Yes, as my friend said, God help us all - and God help my brother, if I am not to lose him.

By the time you read this article, all the prices quoted here will have gone up.

Nonthando Bhebhe is the pseudonym of a journalist in Zimbabwe.