The resulting power outages lasted for at least three hours on Thursday, affecting communication services in the busy capital and forcing dimly lit shops, including clothing retail outlets selling school uniforms, to operate without being able to issue receipts.

The lowest-paid ZESA employee, said the unions, earned about US$91 a month, hardly enough to rent a single room in a modest suburb. Many skilled staffers have opted to migrate in search of better salaries. Last month, the Consumer Council of Zimbabwe reported that the cost of living, including non-food items like transport and rent, amounted to just over US$800 a month for an average family of six.

Junior doctors, who earn about US$223 a month, were demanding a monthly salary of around US$19,000. Most people are struggling to survive in an economy characterised by hyperinflation, unemployment of more than 70 percent and biting shortages of foreign currency, basic commodities, fuel and electricity, as well as a shrinking industrial base.

Nurses have been overwhelmed by the numbers of people seeking assistance at the Harare and Parirenyatwa hospitals in the capital, and the Mpilo and United hospitals in Bulawayo, Zimbabwe’s second city, which are the country’s four main referral centres and used by most people because they are more affordable than private institutions.

A notice in one casualty reception area announced the junior doctors‘ the strike and said only emergencies would be attended to.

Bridget Sadza, 34, a housewife, was hit by a haulage truck in the small town of Chivhu in Mashonaland East Province on Christmas Eve and sustained a broken arm, which nurses said might need to be amputated.

„I was transferred from Chivhu hospital to Harare because of the seriousness of my injury but, up to now, no doctor has visited me. The young nurses here tell me that if I don’t get attention soon, the injury might turn septic,“ Sadza told IRIN in a barely audible voice.

She said the single expatriate doctor on duty at the hospital could not attend to her because he had a backlog of sick people. Unable to afford the US$798 needed for admission to a private health facility, Sadza had to wait her turn at Harare Hospital.

Her brother, who is employed as an engineer in neighbouring Botswana and had to travel to Zimbabwe to assist her, said the only way to avoid amputation of her arm was to take her to a hospital outside the country. „Under normal circumstances, treating my sister’s arm would not have been a big issue. The health sector in Zimbabwe is now in a mess. It is because of poverty; the poverty of a people living in a badly performing economy.“

For almost a decade, Zimbabwe has suffered a debilitating brain drain of health and other skilled personnel who have migrated to other countries for better salaries and working conditions. The Health Services Board released statistics in late 2006 showing that major referral centres were operating without key medical staff.

Of a required 145 senior doctors, only 36 were available in the country, while only 72 instead of the necessary 189 specialist consultants were left in Zimbabwe. The board said there was a deficit of up to 89 percent of state-certified medical laboratory technicians and a 44 percent shortfall of state-certified nurses, while there were 19 percent too few sisters-in-charge for supervising nurses at major health centres.

As the economy fell into decline after the fast-track land reform programme that saw around 4,000 white commercial farmers being removed from their farms to make way for thousands of landless blacks, the United Kingdom gave 2,346 work permits to Zimbabwean nurses in 2002 alone, making Zimbabwe the UK’s fourth largest supplier of nurses after the Philippines, India and South Africa.

One of the striking doctors, speaking anonymously, said although they sympathised with the patients, withholding their services was the best way to push the government to improve their working conditions.

„We don’t wish to harm the patients because that is against the principles of our profession. It is unfortunate that the government, every year, does not want to heed our grievances until we go on strike,“ the doctor told IRIN. „We are living like paupers, and most of the time we are stuck in transport queues on our way to work.“

The Zimbabwe Medical Association (ZIMA) described the industrial action by doctors as „sad“, and urged the government to find a lasting solution to the plight of medical practitioners.

„Doctors strike every year … [over] the same grievances. There is a need for a medium- to long-term strategy to resolve this recurrent problem, because whenever doctors withdraw their services, the consequences are undesirable and services are disrupted,“ ZIMA secretary-general Dr Tapiwa Bwakura told IRIN. „Doctors, nurses, laboratory technicians and pharmacists are already thin on the ground due to a massive brain drain, and the sooner we resolve our problems, the better.“

Bwakura said Zimbabwe had been receiving doctors from Cuba and the Democratic Republic of Congo to fill in the gaps left by those departing for greener pastures, but the government needed to improve conditions to help retain local professionals who were familiar with the country. The expatriate doctors usually faced communication problems because they could not speak indigenous languages, while their English, the main official language, was basic.

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