Zimbabwean doctors鈥� difficult call: Do they have to strike to serve?
| Harare, Zimbabwe
Clepantine Magara started working as a doctor to make other people鈥檚 lives easier. And he stopped working as a doctor when the work made his own nearly impossible.
For months Dr. Magara had watched as his salary halved in value, and then halved again, as inflation in Zimbabwe charged into the triple digits.
So in early September, he joined hundreds of other junior doctors working in public hospitals in Zimbabwe and went on strike.
Why We Wrote This
Two years ago this month, longtime leader Robert Mugabe was pushed out of power, sparking fervent hopes for change. Today鈥檚 strike is dangerous, for doctors and patients alike 鈥� but shows a refusal to let go of that hope.
鈥淵es, it鈥檚 a calling, but without [the salary] it takes to do what you have to do, [that calling] is nothing,鈥� says Dr. Magara, standing at the main entrance to Parirenyatwa Hospital, the country鈥檚 largest.
The doctors鈥� predicament looks a lot like their country鈥檚. Inflation in Zimbabwe recently topped 300%, higher than any country in the world except Venezuela. The country is facing shortages of hard currency, fuel, medicine, and basic foods like bread. Meanwhile hope for political change, which had been recharged by the resignation of Robert Mugabe in November 2017, has gone flat.
But in that climate, Zimbabwe鈥檚 young doctors are testing a risky proposition: that change might still be possible if you ask for it loudly enough.
Their strike began in early September, when runaway inflation pushed the value of junior doctors鈥� wages to about $100 per month. The doctors 鈥� who are second-year interns听鈥� say they didn鈥檛 have the savings to subsidize the cost of working. Many were also deeply frustrated by widespread shortages of medicines and other basic supplies like needles, rubber gloves, and running water.
鈥淚t鈥檚 not only about the low salaries,鈥� says Tapiwa Chagonda, an associate professor of sociology at the University of Johannesburg who studies how Zimbabwean workers survive in times of economic crisis. It鈥檚 also a matter of dignity for both doctors and patients. 鈥淭hey鈥檝e signed up to the Hippocratic oath鈥� to do no harm. 鈥淏ut there鈥檚 no working equipment, there aren鈥檛 basic drugs. In those conditions, how do you even begin to assist your patients?鈥� he says.
Heavy consequences
On a recent Saturday outside Parirenyatwa 鈥� which was named for the first black Zimbabwean to qualify as a medical doctor听鈥� the parking lots were empty and still. Without its junior doctors, the hospital was running on a skeleton staff. Nurses and a few doctors tended to emergency cases. But most arrivals had to be turned away, or find their own way to receive treatment in the hospital鈥檚 ghostly wards.
Last month, Tendai Liwombo was one of them. When she found herself suddenly doubled over in pain one morning, her husband Prince Masawi rushed her to Parirenyatwa.
A nurse suspected she had an ectopic pregnancy, a life-threatening condition.听From there, Ms. Liwombo spent hours bouncing between public and private hospitals across the city as her husband searched frantically 鈥� first for a facility with a working ultrasound machine, and then for a private anesthesiologist for the surgery.
When he found one, Mr. Masawi says, the man demanded $450, many times his monthly salary as a security guard. Frantic that he would lose his wife, Mr. Maswai thrust his cellphone into the man鈥檚 hand, begging him to take it as payment. At last, the doctor agreed to a payment of $50.
鈥淭he government should do something [to end the strike],鈥� Ms. Liwombo says. She says she sympathizes with the doctors, whom she knows are living in the same harsh situation as she is, and doesn鈥檛 believe it is their responsibility to go back to work in these conditions.听A month after her surgery, she is still in intense pain, and fears what will happen if she needs further medical care. 鈥淧eople are dying. Any further delay to my situation and it could have been a different story today.鈥澨�
Stories like these deeply trouble Dr. Magara, who says he dreamed of becoming a doctor since childhood 鈥渢o save lives and to play a humanitarian role in society.鈥� He knows his strike puts his patients鈥� lives on the line. But he reached a point, he says, where he could not afford to continue showing up to work.
The strike itself has also been dangerous. In September, Peter Magombeyi, one of the strike鈥檚 leaders, was abducted and tortured. Many suspect government involvement, though the government wanting to destabilize Zimbabwe.
Promises of change
The strike, indeed, is a consequence of the country鈥檚 messy political transition.
When Emmerson Mnangagwa became president in November 2017 after ousting Mr. Mugabe, who had ruled the country since 1980, he vowed Zimbabwe was now 鈥渙pen for business.鈥� On visits to foreign countries, and at the Davos World Economic Forum, he promised investors and donors a new dawn after decades of oppression and financial mismanagement under Mr. Mugabe.
Instead, his government violently put down protests, using the army to break up demonstrations and shooting live ammunition at protesters. This did little to win the confidence of the governments and companies Mr. Mnangagwa hoped to woo, and the country鈥檚 already-weak economy continued to backslide. Earlier this year, the country uncoupled its currency from the U.S. dollar, and inflation skyrocketed. The economy is now at its worst point since 2008, when annual inflation .
As the value of their salaries dwindled, young doctors like Dr. Magara began hustling for other sources of revenue. Some became farmers. Others begged money off parents and relatives abroad to pay rent. Still others began seeing patients in private clinics, where they could charge enough to make up for their lost wages.听
鈥淚 had 100% confidence in Mnangagwa鈥檚 government when he took over in 2017, but it dwindled over time,鈥� says Dr. Magara, who is currently living on money from family members.
Although the strike has so far failed to achieve its aims, it has听drawn renewed international attention to Zimbabwe鈥檚 economic collapse. In late September, a global health听summit听in Boston named Zimbabwean first lady Auxillia Mnangagwa an 鈥渉onorary ambassador鈥� who would听collaborate on听听But a swift outcry,听including from several former U.S. diplomats, quickly led the organization听听from Ms. Mnangagwa.听The honor, the diplomats wrote,听gave tacit support to 鈥渁n increasingly corrupt and abusive administration in which tolerance for dissent is nonexistent and democratic rights are violently denied.鈥�听
Dr. Magara continues to hope听the government will eventually come around to the doctors鈥� demands, which include a 400% raise and salaries pegged to the dollar. Strikers have rejected the government鈥檚 offer to boost salaries by 60%, and there is little indication they would offer more. More than 400 doctors have been , and the deputy minister of information has tweeted that the 鈥渕oney mongering鈥� strikers听.
鈥淭his is sad for me and my colleagues,鈥� says Dr. Magara. 鈥淭here is a possibility that I might choose to jump off the bus and do something else [professionally]. But I have my patients at heart.鈥�
