One of the consequences of the suspension of funding to Zambia by the Global Fund to fight AIDS, Tuberculosis and Malaria, has been an increasing number of stock outages and drug rationing that has affected all hospitals nation-wide, Mwandi Mission included.
Stock outages at clinics and hospitals have been so far fairly short term, but Central Medical Stores have sometimes run out of stocks for a considerable period as they wait for emergency shipments to arrive. In cases of low stock levels, drugs are rationed.
Regular readers will remember in an earlier blog the covering of the allegations of corruption at the Zambian Ministry of Health (MoH) uncovered by an investigation by the auditor general. The audit found that the ministry could not account for more than US$7.2 million. The repercussions from this are still being felt.
Another audit undertaken by the Global Fund* reported on poor financial management at the MoH, Ministry of Finance, the Christian Health Association of Zambia (CHAZ) and the Zambian National AIDS Network. These bodies used to receive Global Fund monies directly for programme implementation and then pass funds on to other organisations called sub-recipients. The audit found that $10.7 million of Global Fund money was not passed on and, to date, none of it has been repaid. The alleged financial mismanagement includes the purchase of vehicles for personal use, inflated salaries - sometimes more than double the going–rate locally, and funds disbursed to sub-recipients who could not provide auditors with financial records.
The Global Fund only funds CHAZ directly now; the MoH no longer receives funds, its responsibility in this area has gone to the United Nations Development Programme (UNDP) in Zambia. Teething troubles with these new procedures have brought delays for us on the ground in receiving funding for our AIDS Relief Programme. We have also suffered two major stock-outs of antiretrovirals (ARVs) recently. Fortunately we had a Hospital vehicle in Lusaka at the time that waited for one of the drugs to arrive in the country. We are relying on UNICEF and USAID who are scrambled to bring in more expensive emergency supplies until the new bodies get their procurement procedures properly functioning. TB drugs have also been in short supply. A week’s supply of the children’s ARVs was borrowed from the District Hospital.
The knock-on effects from this was that we could only give a week’s supply which meant the children and parents having another walk in a week’s time to the Clinic to receive the rest of the month’s supply. This meant further unbudgeted transport costs for the rural poor with an increased risk of defaulting and subsequent resistance.
Those responsible for the misuse of funds are still not being held accountable. It will be up to local courts to prosecute those suspected of fraud or the misappropriation of funds. Civil Society and some NGOs are pressing for this. Patients and clients in this area rely on these funds to provide their medication; if there are no drugs available or they are in short supply they need to know why. They have a human right to universal and equitable access.
Linked to this we have four workers facing immediate redundancy. The Government has recently been recruiting mission workers and has put on their payroll some who were formerly paid by CHAZ through a grant from Government which came originally from outside donors. The Government is keeping that grant to pay workers directly. CHAZ workers who are under 45 years of age and in possession of a Grade 12 School leaving Certificate were eligible to apply. The grant to the Hospital to pay the CHAZ workers is being cut in proportion to the number of workers put on Government payroll and linked to the ‘on paper’ establishment. So we now have four over-aged or under-qualified workers with many years of good experience and loyal service who are about to be thrown on the scrap heap as surplus to requirement. The change-over was supposed to be done over time and using where possible natural wastage. The Hospital cannot at the moment generate enough independent income to pay them or pay their retrenchment package.
Like our clients and patients living with HIV and Aids, these four people are another set of victims of the world’s greed and injustice, their dignity in work destroyed. Wealth that has been given generously is not shared fairly but kept in the hands of a few and misused to promote inequality and injustice.
*The full report can be found by googling 'Global Funding Country Audit Zambia'
Friday, 18 March 2011
Friday, 11 March 2011
Tuesday, 8 March 2011
Half the sky?
Women hold up half the sky – Chinese Proverb. Pie in the sky more like! Of course they do, but it is still a glass ceiling!
On Saturday evening Ida received the following text from the Nursing Officer:
'Good afternoon, how are you and the family? I am asking for cleaning materials which you can spare. Women’s Day is on Tuesday and women will come and clean the hospital but up until yesterday I have not been issued with anything. Please, cleaning is on Monday morning at 0830h. I won’t be around, as I will be on the salary trip. If possible women are supposed to work on Monday, freeing men then, so that the women will be free on Tuesday for their activities. Contributions for Women’s Day is K50 000 Thanks.'
Not a lot of warning, but we managed to get a driver who was on an airport run to buy some mops, Windolene, and Surf on Sunday in Livingstone. On Monday morning we cut up some rags for cloths. Early in the cool of the morning regiments of women, Zambian Molly Weirs to a woman (sic), from various Church and other Associations clad in chitenges and headsquares and shouldering rakes and hoes marched onto the Hospital premises and immediately got down to much needed and appreciated business of tidying up the grounds, washing windows, mopping floors and cleaning beds and lockers.
There was none of the annoyance that women from more developed countries may have felt at undertaking such ‘demeaning and menial’ work but there was a pride in doing this women’s work for the common good. The fundamental divisions of labour apportioned to the two sexes here are not yet a great issue. Women still are expected to do most of the child care and tidying up after their menfolk.
Women’s Day on Tuesday will begin with a March from the outskirts of town to the Basic School. The theme: Equal Access to Education and Training: Science and Technology: Pathway to Decent Work for Women. A speech from the MP’s wife will open the programme . Next will be some ice-breaking activities followed by traditional dances, a drama, a tug-of- war and an educational talk for women and girls,. After lunch a netball tournament will be held, comprising of teams of teachers, hospital, OVC staff and women stallholders from the market.
The ideal girl in Zambia is passive and submissive, serving others and speaking only when spoken to. This is not to say that girls are especially maltreated they are loved and treated humanely within the family. It's just that cultural norms are different. It is not that she doesn't count, it's just that she counts less than her male relatives. This is reinforced at initiation ceremonies.
A problem in rural areas are young girls being 'married off' at an early age despite this being illegal. There is a local case at the moment of a 12 year old being pregnant. There are also a number who fall out from school because they get pregnant. This is allowed to happen because insufficient value is given to girls' education. Why waste your money, she's only going to get married and be a housewife anyway? Your boys'll - (actually their wives!) -look after you in your old age.
Much status for a woman comes from being a wife and mother. After the birth of your child you no longer publicly keep your childhood name but become someone's mother, i.e. Fiona is Bo-Ma Sepo (Mother of Sepo).
Girls of school age are often their Mother's right hand and are burdened with childcare and household chores and duties such as drawing water, fetching firewood, cooking, sweeping, washing clothes and gardening. Many have worked 2-3 hours before they turn up for school, so it is no wonder they are often late. They may have had to walk a considerable distance as well. When they get back it's not homework that is a priority but more housework. With HIV and Aids prevalent, they may be the head of the household or be living with an elderly granny so again a large load falls on the young shoulders.
Many parents, and sadly teachers (male and female), continue to have the expectation that girls will not do well. They, by their attitude, encourage the stereotypical behaviour: the male teachers through prejudice and their perception of what makes a good girl; the female teachers as well because they were brought up in the same way also tend to perpetuate the system. You find this typically in Maths & Science. Home Economics after Grade 7 is purely a girls' subject while the boys do woodwork! Unfortunately too, a number of male teachers also see their female students as fair game.
40% of Mwandi households are woman or child-headed. A lack of economic opportunity and any other alternative make many of these local women look to selling fish, beer brewing and unfortunately these activities often go hand in hand with casual prostitution. Education, training and decent work is certainly a must.
When you can see all this coming through culture and the education system, it is not surprising that you end up with rather a negative self-image and inferiority complex from the attitudes of parents, teachers and the wider community.
There are a number of organisations in Zambia attempting to address this issue, such as GEMS(Gender, English, Maths & Science) and FAWEZA (Forum for African Women Educationalists of Zambia).
Mubita’s great-aunt, resting on her hoe met and greeted me on the way back from school. The maize crop will be a disaster this year with dry periods and rain at the wrong times.
We saw that on our visit to Kamusa Church on Transfiguration Sunday. It was harder to get to than normal now that inland flood water has started to spread. We were invited after the service for lunch. The people have little maize left from last year so the portion of buhobe that was served was much smaller than usual, the green vegetable was pumpkin leaves. There was sour-milk as dessert and warm milk to drink but no tea-leaves…
International Womens' Day, 8 March 2011
On Saturday evening Ida received the following text from the Nursing Officer:
'Good afternoon, how are you and the family? I am asking for cleaning materials which you can spare. Women’s Day is on Tuesday and women will come and clean the hospital but up until yesterday I have not been issued with anything. Please, cleaning is on Monday morning at 0830h. I won’t be around, as I will be on the salary trip. If possible women are supposed to work on Monday, freeing men then, so that the women will be free on Tuesday for their activities. Contributions for Women’s Day is K50 000 Thanks.'
Not a lot of warning, but we managed to get a driver who was on an airport run to buy some mops, Windolene, and Surf on Sunday in Livingstone. On Monday morning we cut up some rags for cloths. Early in the cool of the morning regiments of women, Zambian Molly Weirs to a woman (sic), from various Church and other Associations clad in chitenges and headsquares and shouldering rakes and hoes marched onto the Hospital premises and immediately got down to much needed and appreciated business of tidying up the grounds, washing windows, mopping floors and cleaning beds and lockers.
There was none of the annoyance that women from more developed countries may have felt at undertaking such ‘demeaning and menial’ work but there was a pride in doing this women’s work for the common good. The fundamental divisions of labour apportioned to the two sexes here are not yet a great issue. Women still are expected to do most of the child care and tidying up after their menfolk.
Women’s Day on Tuesday will begin with a March from the outskirts of town to the Basic School. The theme: Equal Access to Education and Training: Science and Technology: Pathway to Decent Work for Women. A speech from the MP’s wife will open the programme . Next will be some ice-breaking activities followed by traditional dances, a drama, a tug-of- war and an educational talk for women and girls,. After lunch a netball tournament will be held, comprising of teams of teachers, hospital, OVC staff and women stallholders from the market.
The ideal girl in Zambia is passive and submissive, serving others and speaking only when spoken to. This is not to say that girls are especially maltreated they are loved and treated humanely within the family. It's just that cultural norms are different. It is not that she doesn't count, it's just that she counts less than her male relatives. This is reinforced at initiation ceremonies.
A problem in rural areas are young girls being 'married off' at an early age despite this being illegal. There is a local case at the moment of a 12 year old being pregnant. There are also a number who fall out from school because they get pregnant. This is allowed to happen because insufficient value is given to girls' education. Why waste your money, she's only going to get married and be a housewife anyway? Your boys'll - (actually their wives!) -look after you in your old age.
Much status for a woman comes from being a wife and mother. After the birth of your child you no longer publicly keep your childhood name but become someone's mother, i.e. Fiona is Bo-Ma Sepo (Mother of Sepo).
Girls of school age are often their Mother's right hand and are burdened with childcare and household chores and duties such as drawing water, fetching firewood, cooking, sweeping, washing clothes and gardening. Many have worked 2-3 hours before they turn up for school, so it is no wonder they are often late. They may have had to walk a considerable distance as well. When they get back it's not homework that is a priority but more housework. With HIV and Aids prevalent, they may be the head of the household or be living with an elderly granny so again a large load falls on the young shoulders.
Many parents, and sadly teachers (male and female), continue to have the expectation that girls will not do well. They, by their attitude, encourage the stereotypical behaviour: the male teachers through prejudice and their perception of what makes a good girl; the female teachers as well because they were brought up in the same way also tend to perpetuate the system. You find this typically in Maths & Science. Home Economics after Grade 7 is purely a girls' subject while the boys do woodwork! Unfortunately too, a number of male teachers also see their female students as fair game.
40% of Mwandi households are woman or child-headed. A lack of economic opportunity and any other alternative make many of these local women look to selling fish, beer brewing and unfortunately these activities often go hand in hand with casual prostitution. Education, training and decent work is certainly a must.
When you can see all this coming through culture and the education system, it is not surprising that you end up with rather a negative self-image and inferiority complex from the attitudes of parents, teachers and the wider community.
There are a number of organisations in Zambia attempting to address this issue, such as GEMS(Gender, English, Maths & Science) and FAWEZA (Forum for African Women Educationalists of Zambia).
Mubita’s great-aunt, resting on her hoe met and greeted me on the way back from school. The maize crop will be a disaster this year with dry periods and rain at the wrong times.
We saw that on our visit to Kamusa Church on Transfiguration Sunday. It was harder to get to than normal now that inland flood water has started to spread. We were invited after the service for lunch. The people have little maize left from last year so the portion of buhobe that was served was much smaller than usual, the green vegetable was pumpkin leaves. There was sour-milk as dessert and warm milk to drink but no tea-leaves…
International Womens' Day, 8 March 2011
Friday, 4 March 2011
A Fairly Civil Disorder
I was in Livingstone again yesterday visiting the bank. I was paying the next instalment on the new High School furniture and in the interests of economy I went in by bus.
I was surprised to see on alighting from the bus, police in riot gear squatting on the backs of pick-ups and patrolling up and down the main streets. Had the turmoil in the Middle East now reached Zambia, I wondered?………. Not quite.
At 0930h there was still a tense atmosphere in town, and the noisy altercation was being observed from a distance by engrossed spectators, offering commentary on the proceedings despite the occasional whiff of teargas wafting through the air; a vain attempt by the police to disperse bus conductors, drivers and taxi operators who had blocked town centre roads in protest against a rumoured rise, in various fees and fines by the police and Road Transport and Safety Agency (RTSA).
As I passed the Post Office the Police were somewhat prematurely and optimistically starting to remove stones and other street debris that had been used by the protesters to block the roads in the town centre. The Livingstone Police, unlike their Mongu colleagues, thankfully only fired tear gas at the mini bus and taxi drivers. This resulted in retaliation by the protesters with rocks being thrown and rolled to block the road, and a tirade of insults and catcalls launched at the Police, prompting bystanders to scatter and take temporary shelter in less exposed areas. Things were now getting serious; even business at the Zimbabwe Market in the town centre came to a standstill.
Meanwhile officials at the RTSA office denied knowledge of any hikes in fees, saying the agency was still charging ‘old prices’. The police then asked the drivers who had gathered along the main street, Mosi-Oa-Tunya Road, to disperse and go back to work as this was an illegal assembly but that the Government would address their concerns.
It was a blessing that that common sense prevailed in the end and no-one to my knowledge was beaten by truncheons nor was any police officer hit by stones. Irene and Dorothy both have relatives who are women police officers in Livingstone.
A by-stander informed me, as we crossed the road together, on the way back from the Finance Bank, that the main gripe was the cost of renewing PSV licence, the fees were to be increased to K1 million (GBP140 or US$220) from the previous charge of about K200,000 (US$45 GBP30). There were also loud complaints from two taxi drivers behind us that the Livingstone Police allegedly pursue and fine motorists unnecessarily to help supplement their low pay. No other city in Zambia it is said is subjected to the same number of ephemeral roadblocks mounted by the Livingstone Police within the city limits.
Taxi drivers the world over are an opinionated and independent-minded group of people. Zambians are no different. Most drivers that we have met are decent and honest family men, very willing to help and trying very hard to scrape a living in order to feed, clothe, house and educate their family. The drivers are not usually the owners of their vehicle and competition for trade is stiff, so life is not easy. They are also expected to raise a minimum amount each day for the owner. The proposed rises were unreasonable and would have been almost impossible to meet. Some street wit suggested because it is election year and because of all the trouble caused, it looked like RTSA (a Government Agency) was ‘decampaigning’ the MMD, the ruling party!
As regards Livingstone City Council charges, apparently taxi drivers were paying K2,000 (45c or 30p) per day while mini-bus drivers were still paying K5,000 per day with large long distance coaches paying K80,000 per trip. These charges have not increased for some time.
It all seemingly ended later in the morning with the Southern Province Permanent Secretary Gladys Kristafor asking the Ministry of Home Affairs to direct the police and RTSA to revert to old fees charged to motorists.
Business was back to normal as we left Livingstone on 1430h bus to Mwandi.
*Decampaigning – a Zambian English neologism meaning to campaign against political opponents.
I was surprised to see on alighting from the bus, police in riot gear squatting on the backs of pick-ups and patrolling up and down the main streets. Had the turmoil in the Middle East now reached Zambia, I wondered?………. Not quite.
At 0930h there was still a tense atmosphere in town, and the noisy altercation was being observed from a distance by engrossed spectators, offering commentary on the proceedings despite the occasional whiff of teargas wafting through the air; a vain attempt by the police to disperse bus conductors, drivers and taxi operators who had blocked town centre roads in protest against a rumoured rise, in various fees and fines by the police and Road Transport and Safety Agency (RTSA).
As I passed the Post Office the Police were somewhat prematurely and optimistically starting to remove stones and other street debris that had been used by the protesters to block the roads in the town centre. The Livingstone Police, unlike their Mongu colleagues, thankfully only fired tear gas at the mini bus and taxi drivers. This resulted in retaliation by the protesters with rocks being thrown and rolled to block the road, and a tirade of insults and catcalls launched at the Police, prompting bystanders to scatter and take temporary shelter in less exposed areas. Things were now getting serious; even business at the Zimbabwe Market in the town centre came to a standstill.
Meanwhile officials at the RTSA office denied knowledge of any hikes in fees, saying the agency was still charging ‘old prices’. The police then asked the drivers who had gathered along the main street, Mosi-Oa-Tunya Road, to disperse and go back to work as this was an illegal assembly but that the Government would address their concerns.
It was a blessing that that common sense prevailed in the end and no-one to my knowledge was beaten by truncheons nor was any police officer hit by stones. Irene and Dorothy both have relatives who are women police officers in Livingstone.
A by-stander informed me, as we crossed the road together, on the way back from the Finance Bank, that the main gripe was the cost of renewing PSV licence, the fees were to be increased to K1 million (GBP140 or US$220) from the previous charge of about K200,000 (US$45 GBP30). There were also loud complaints from two taxi drivers behind us that the Livingstone Police allegedly pursue and fine motorists unnecessarily to help supplement their low pay. No other city in Zambia it is said is subjected to the same number of ephemeral roadblocks mounted by the Livingstone Police within the city limits.
Taxi drivers the world over are an opinionated and independent-minded group of people. Zambians are no different. Most drivers that we have met are decent and honest family men, very willing to help and trying very hard to scrape a living in order to feed, clothe, house and educate their family. The drivers are not usually the owners of their vehicle and competition for trade is stiff, so life is not easy. They are also expected to raise a minimum amount each day for the owner. The proposed rises were unreasonable and would have been almost impossible to meet. Some street wit suggested because it is election year and because of all the trouble caused, it looked like RTSA (a Government Agency) was ‘decampaigning’ the MMD, the ruling party!
As regards Livingstone City Council charges, apparently taxi drivers were paying K2,000 (45c or 30p) per day while mini-bus drivers were still paying K5,000 per day with large long distance coaches paying K80,000 per trip. These charges have not increased for some time.
It all seemingly ended later in the morning with the Southern Province Permanent Secretary Gladys Kristafor asking the Ministry of Home Affairs to direct the police and RTSA to revert to old fees charged to motorists.
Business was back to normal as we left Livingstone on 1430h bus to Mwandi.
*Decampaigning – a Zambian English neologism meaning to campaign against political opponents.
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