By ZimDoctorsfor Human Rights
The world continues to battle the COVID-19 pandemic, with the number of reported deaths globally standing at 154 350 (WHO, 18 April 2020) from a total of over 2 million confirmed infections. Zimbabwe, also continues to witness new cases with a total of 24 cases reported to the health ministry as at 17 April 2020. Three Zimbabweans have lost their lives after suffering from severe cases of COVID-19. In this report, we acknowledge the work by the COVID-19 Inter-Ministerial Ad hoc Taskforce in the identification and assessment of COVID-19 designated facilities and engagement of key stakeholders in the response to this pandemic.
The Zimbabwe Association of Doctors for Human Rights (ZADHR) is actively monitoring the response to this pandemic in Zimbabwe. The following are the key highlights in this current monitoring period.
The 21-day lockdown period declared by the government is coming to an end. ZADHR views the lockdown as a missed opportunity where extensive screening and testing could have been done with a particular focus on increased case detection, isolation and management of confirmed cases. ZADHR also notes with concern that the State has not managed to expand the health infrastructure to levels that are commensurate to the existential threat posed by COVID 19. We have less than 10 ICU beds countrywide in public COVID-19 facilities and our hospitalization capacity is still less than a thousand beds. Despite the success witnessed in curbing importation of cases into the country through ports of entry, we have continued to witness incidences of local transmission. These indicators all suggest that the time is not yet ripe to lift the nationwide lockdown. We advise for cautious and evidence-based decision making by the central government on whether or not to lift the lockdown. Any extension of the lockdown must be predicated on extensive screening and testing, and urgent rehabilitation of the existing service delivery infrastructure to increase preparedness for any massive upsurge in cases of COVID-19.
Screening and Testing Facilities
ZADHR welcomes the expansion of testing services in the past few days which to date has increased the number of total tests to 2493 (MoHCC, COVID-19 UPDATE, 17 April 2020). However, the figure remains low. A diagnostic facility has been set up at National Tuberculosis Reference Laboratory (NTBRL) at Mpilo Hospital in Bulawayo. Additionally, a rapid test kit for screening has been availed. Although less sensitive and requiring further confirmatory PCR tests, the introduction of this rapid kit allows more people to be screened daily, rapid turnaround of results and focused confirmatory PCR tests. ZADHR also welcomes and commends the move to utilise the over 130 gene expert machines across the country as this will increase access to screening and testing facilities, and reduce the turnaround time for tests. We therefore challenge the health authorities to increase the number of daily tests and conduct more intensive community screening and testing. Priority should also be given to enhancing screening of health professionals as per the High Court order.
2. Protective Personal Equipment (PPE)
The shortages of PPE continue to expose frontline health workers to COVID19 infection. Health workers in both public and private facilities have been exposed in the routine discharge of their duties. On 13 April 2020, ZADHR won a court challenge which compelled the State to provide PPEs to health workers. ZADHR will be closely liaising with health institutions and representatives of health workers to check for compliance of the court order and where necessary seek further legal recourse to ensure enforcement of the ruling.
3. Covid-19 Designated Facilities
ZADHR notes the increased expansion of COVD-19 designated facilities throughout the country and calls for their urgent capacitation. We also note, citizens initiatives to contribute in the capacitation of these facilities. Of note is the #Iam4Byo initiative in Bulawayo designed to get Ekuseleni and Thorngroove ready.• Local Council ClinicsWe note that the central Government has taken over the management of council clinics in efforts to expand facilities that can respond to COVID-19. However, we urge them to avoid disrupting the existing care for other medical conditions. The clinics form the backbone of our primary health care system and provide essential services such as Anti-Retroviral Therapy, family planning, immunization services and care for communicable and non-communicable diseases.
4. Private Practitioners and Community Engagement
ZADHR strongly advises the Ministry of Health and Child Care that there is need for transparency in the national response to COVID-19. We are deeply concerned by the actions a private practitioner who allegedly posted on social media that his facility is attending to private patients. We are discouraged by the unwillingness by the Permanent Secretary in the MOHCC to clarify this issue despite a formal email communication to her. We reiterate that all institutions providing care to COVID-19 patients must be made public and accessible to all Zimbabweans.
All cases must be collated, tabulated, reported centrally and available to medical practitioners, and epidemiologists with results and updates being given out in a more informative and transparent manner. Information should easily be digestible to the general public. Press briefings for information dissemination, and responding to questions and concerns are vital to curbing rumour, conjecture and the spreading of misleading if not dangerous information. ZADHR is considering legal action to have this matter clarified to guarantee the public and stakeholders on the state of affairs.
ZADHR is also deeply worried by the failure to rebuke myths and misconceptions peddled by a popular religious leader on COVID-19. The MOHCC must set the record straight that COVID-19 has no cure to date and all Zimbabweans must take preventative actions as advised by government and WHO. 5. Rights, Dignity and Confidentiality ZADHR has witnessed several cases of individuals being subjected to inhumane and degrading treatment for violating lockdown measures. During the lockdown period, ZADHR has attended to 31 cases of people allegedly assaulted by security officers enforcing the lockdown in various parts of the countries. Most of these people presented with moderate soft tissue injuries after being beaten with baton sticks.
ZADHR reiterates that, those violating the regulations must still be treated with dignity and subjected to the due process of law. We also note with concern, the unethical transmission and publication of COVID-19 results before patients are informed and consenting to their details being made public. The media is also encouraged to verify and if possible, avoid disseminating messages that foster stigmatization of COVID-19 patients.
Happy 40th Independence Anniversary Zimbabwe