Monthly Archives: September 2012

ZAMBIA: Minimum wage leads to steep food price rises

LUSAKA 27 September 2012 (IRIN) – The euphoria that greeted the government’s imposition of minimum wage increases has quickly soured, with prices of food and other essential commodities escalating as higher wage costs are passed onto consumers.

CLIMATE CHANGE: New urgency to rethink dam projects

JOHANNESBURG 26 September 2012 (IRIN) – The massive hydropower dams built on the Zambezi River, the largest river system in Southern Africa, not only supply power to major economies in the region but also help mitigate annual floods. But as electricity…

FOOD: Poor importing countries need help

JOHANNESBURG 18 September 2012 (IRIN) – High cereal prices have bloated countries’ food import bills in the past decade, partly because of export restrictions imposed by some governments that have squeezed supply. As cereal prices begin to again climb, a new study has called on the World Trade Organization (WTO) to take action to exempt poor countries from other nations’ export restrictions.

Zambia’s healthcare system in need of an MOT as road accidents increase | Sarika Bansal

With emergency care costly and hard to come by, people injured on Zambia’s roads often experience needless complications

On a sunny Wednesday afternoon, 16-year-old Vasco Mzanda limped into a district health centre in Zambia’s southern province, accompanied by his father, Listen. Three weeks earlier, Vasco had been riding his bicycle near his village when a car hit him, causing him to fly off the dirt road. When he stood up, he had trouble walking and could not put any weight on his left leg.

Vasco’s injuries were exacerbated by Zambia’s healthcare system. Listen immediately took his son to the nearby rural health post. But it did not have any diagnostic equipment, so Vasco was referred to the district health centre, 60km away. Having saved money for the 60,000 kwacha (£7.50) round-trip fare and paid for an X-ray once there, Listen learned that his son’s femur had been fractured; in the three weeks without care, the bone had partially “malunited”. The district hospital did not have the surgical equipment to fix it, so the attendant doctor told them to find their way to Livingstone general hospital, another 130km away.

There are more than 20,000 road traffic accidents every year in Zambia, resulting in an estimated 3,000 deaths and exponentially more injuries and disabilities. The country has less than 0.02% of the world’s registered vehicles, but almost 14 times the proportion of fatalities from road traffic accidents. Many injuries, like Vasco’s, are technically simple to treat. But without adequate emergency care, transportation or referral systems, many patients experience unnecessary complications. Some suffer from neglected physical trauma, some become permanently handicapped, and others die needlessly.

To date, road accidents and their accompanying surgical complications have received little attention in Zambia. Yet, with the number of roads and cars in Zambia growing, accidents are becoming an increasingly common part of Zambian life. In 2012 to date, nearly 6,000 people have either died or been injured in traffic accidents. This summer, for instance, 12 people died in a crash in eastern Zambia and another 11 in southern Zambia.

“Road traffic accidents raise a lot of concern to me as a surgeon,” said Emmanuel Makasa, the deputy director of emergency health services at the ministry of health. “If you don’t provide surgical services to manage the patients quickly and adequately, it means most people end up being handicapped. Most Zambians use their hands or have to walk to work. If they’re not managed properly and become handicapped, then they get deeper into poverty.”

There are several reasons why road traffic accidents take such a heavy toll in the country. Like Vasco and Listen, 60% of Zambians live in rural areas, where there are almost no options for emergency care. Patients usually have to make their own way to health centres, with the journey often expensive and time-consuming. Once they arrive, there is no guarantee the surgeon will have the equipment to diagnose and treat the injury – that is, if there is a surgeon in the first place. Zambia has a population of 13 million but just 44 surgeons, only six of whom work in rural areas. Patients must usually pay for treatment out of pocket, which can be prohibitively expensive.

“It’s depressing,” said Makasa. “You know what you have to do, you want to do something, but then you can’t do it, either because you don’t have the materials or because you have too many patients to see.”

To combat these inadequacies, some officials in the ministry of health, including Makasa, have formed a taskforce to reduce the toll of traffic accidents. They are trying to encourage the police to enforce laws on alcohol, seatbelts, and mobile phone usage more strictly. They are also trying to enhance “post-crash care” – specifically, by increasing the number of emergency vehicles and training police officers in first aid. Others in the ministry are working to increase the number of surgeons and “medical licentiate” officers to handle emergency cases.

In addition, some Zambian doctors have taken it upon themselves to train medical staff on emergency trauma. “We don’t have a trauma centre in all of Zambia,” said Mzaza Nthele, a surgeon at Livingstone general hospital. Motivated partially by the number of “unnecessary” emergency cases that entered his hospital doors, Nthele regularly travels to district health centres in the southern province – like the one where I met Vasco – to train attendant doctors. Making post-crash care more localised, he believes, is the best way to ensure patients are treated properly.

“Road traffic accidents are the type of thing that shouldn’t make someone incapacitated,” said Makasa. “We need a comprehensive approach to address them properly.”

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SOUTHERN AFRICA: Increasing hostility towards Chinese traders

JOHANNESBURG/BLANTYRE/MASERU/LUSAKA 07 September 2012 (IRIN) – In the last decade, Asian migrants have fanned out through southern Africa, opening shops in small towns and rural backwaters. While consumers in countries facing increasing economic hardsh…

DfID urged to take direct investor role in Zambia’s booming economy

Commons report calls for more financial backing for country’s growing business sector, and an end to maize subsidies

The UK’s development finance arm, the CDC, could play a significant role in boosting Zambia’s economy and ending the country’s reliance on overseas aid, a UK parliamentary committee said on Thursday.

But the House of Commons international development committee criticised Zambia’s record on public expenditure, particularly its subsidy scheme for maize, which amounts to 8% of its budget and far exceeds the UK’s bilateral aid programme. The money could be better spent on education, said its report on the southern African state.

The committee said CDC investments through partners and directly into Zambian businesses would be good for the country and more appropriate than grants from the Department for International Development (DfID).

By the end of 2011 the CDC, which is owned by DfID, had eight investments totalling £5.2m through funds in Zambia. However, following reform of the body last year – designed to move it away from third-party investments through fund managers to more direct investments in “riskier” projects in poorer countries – the committee said the CDC clearly had a “major role” to play in Zambia. It recommended the institution work more closely with DfID.

“We see a major role for the organisation in initially co-investing and subsequently directly investing in Zambian businesses,” said the report. “This will generally be more appropriate than DfID providing grants for private businesses.”

Zambia has experienced huge economic growth over the past decade. According to World Bank classifications, Zambia is now considered a lower middle-income country. Countries in this category have per capita gross national incomes of between $1,006 and $3,975 a year.

The country is also less dependent on overseas aid. The average annual ratio of overseas development assistance disbursements to GDP fell from an average of 22% between 1990 and 2005 to 5.6% in 2010. The UK is a major donor, spending £54.7m on programmes in 2010/11, a sum expected to increase to £63m by 2014/15.

However, despite this growth, the country is still ranked 164 out of 187 in the 2011 UN Human Development Index and is off-track to meet many of the millennium development goals (MDGs) by 2015, including MDG1 to halve poverty and MDG5 to reduce maternal mortality rates, which remain high.

In a wide-ranging report on DfID programmes in Zambia, the committee welcomed the department’s increased spending on reproductive and maternal and newborn health, and urged it to encourage the Zambian government to allow people other than health professionals to be trained to give out contraception, particularly implants and injections.

But, along with cuts to the public sector wage bill, the report called for an end to maize subsidies, which MPs said was “one of the biggest issues that the Zambian government has to confront”.

Record maize harvests in 2010 meant the government was forced to spend $280m on 840,000 metric tons of maize, making a $140m loss. The problem was repeated in 2011.

The committee urged the government to phase out the subsidy, although it acknowledged such a move would be fiercely opposed. The money saved from the subsidy cut could be spent on free secondary and tertiary education, said MPs. Education in Zambia is free until the age of 14.

The chairman of the committee, Malcolm Bruce, said: “The Zambian economy has grown significantly over the last 10 years, but the country is still one of the poorest in the world and will not meet many of the millennium development goals without a renewed focus on maternal mortality, secondary education and rural poverty.” 

He added: “The economy is improving in Zambia but, if the country is to succeed in creating a modern economy, more needs to be done to improve secondary education.”

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