Specialised treatment abroad will remain a thorny economic and moral issue under the neo-liberal economic system Zambia inherited in 1991. Specialised treatment abroad serves as a safety valve for those influential in society to access first world health services without the pressure to strengthen the country’s health system. It is therefore one of the mechanisms perpetuating class inequity whilst taking away the incentive to radically transform the Zambian health system.
The same parliamentarians surprised by the irrational nature of our specialised treatment abroad have in the past given approval to annual budgets that undermined the Zambian health system. They have not stood by the health workers in their daily struggle for a better living wage and better health facilities. They have not been decisive in tackling the inequity of specialised treatment abroad. In other words, just like the executive, the Zambian legislature has failed the Zambian masses over the past 25 to 30 years!
We have a macabre situation in our country where the health workforce, including the likes of Ministry of Health Permanent Secretary, Dr. Mwaba and his colleagues, have been agitating for improved funding and some resemblance of 21st century health services, while our politicians are uncaring and at times mockingly throw away the recommendations of these technocrats. The technocrats are apparently closer to the suffering of the Zambian masses whereas the politicians are blinded by vanity and sheer greed – they see the pain and anguish of the sick in society, but their schizophrenic existence makes them blind and uncaring!
However, Dr. Mwaba’s statements to the parliamentarians are misplaced. He was invited to speak in his capacity as a Permanent Secretary and not as a clinician. Under that capacity, he is obligated to strictly adhere to the financial rules and regulations and the requisite fiscal discipline. Misallocation and misapplication of public resources is not a cavalier’s offence; it is a serious offence and some levels of remorsefulness have to be exhibited. We understand the moral dilemma he faces in decision making over specialised treatment abroad. However, the class bias in deciding as to who has access to treatment abroad is quite obvious. Are the lives of poor Zambians dying without health care in our rural areas not equally important? How long has Choma Hospital, for example gone without a functioning x-ray machine? Has the Ministry of Health shown the required urgency and diverted funding from any account to attend to this need? Why then the overriding priority to specialised treatment abroad?
Coming to the economics of treatment abroad; the figures do not make sense indeed. This country spends less than US$60 per capita on health; but will spend US$330,000 on a single patient abroad! Three quarters of the cases requiring treatment abroad could be handled in Zambia with moderate investments in the diagnostic infrastructure. This would reduce the total cost of treatment to only 30%.
The numbers of those seeking specialised treatment abroad was moderated for a couple years with the setting up of the Cancer Centre at the UTH in Lusaka. But of late we see these numbers increasing, especially in urology, trauma and cardiology. South Africa, India and Europe have become preferred destinations where the government and private Zambian individuals have to spend this country’s hard earned dollars to save lives. For each individual family venturing for specialised treatment abroad, the cost implications are immense. Such middle class families are being driven into huge debts and despair. That is why we, as a socialist party, strongly advocate for a socialised health system with prioritised investment in public health and specialised treatment within our country. Anything short of that is a betrayal to our national cause and the spirit of equity.