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Sata: the health reformer

WHEN President Michael Sata assumed office on September 23, 2011, it was echoed across the country that the man of action had come to change Zambia’s landscape.
In the health sector action was immediately seen when he initiated construction of 650 health posts countrywide at the cost of US$55 million.
The health posts, aimed at catering for a 500 households in rural areas and 1,000 households in the urban areas.
In the same year 2011, President Sata ensured that five district hospitals in Lufwanyama, Chadiza, Chiengi, Nakonde and Shangombo were commissioned.
In addition, 30 district hospitals in various parts of the country were at different levels of construction as at December 2013 in Gwembe, Kazungula, Kalomo, Namwala, Choma, Lukulu, Mongos, Mulobezi, Lumwana, Chauhan, Lundazi, Nyimba and Chipata.
Other district hospitals under construction are in Chiengi, Kawambwa, Milenge, Mwense, Luangwa, Mpulungu, Mungwi, Chilubi, Nakonde, Mpika, Chama, Mkushi, Serenje, Lufwanyama, Masaiti and Chililabombwe.
Hospitals completed by December 31, 2013 included Lumwana in North-Western Province, Lufwanyama District Hospital on the Copperbelt, while Chiengi was completed in the first quarter of this year.
And by the end of this year, Government will embark on the construction of an additional eight district hospitals in Mafinga, Ikelenge, Nalolo, Limulunga, Vubwi, Mansa, Mufulira and Chilubi.
Furthermore, in an effort aimed at affording more Zambians access to specialised quality health care services, President Sata ensured that Government allocated K204 million to the Ministry of Health for the upgrading and modernisation of University Teaching Hospital (UTH), Ndola and Kitwe central hospitals.
The UTH modernisation project, whose works have already commenced, is a new one-stop centre and ultra-modern adult medical emergency unit (AMEU) at a cost of K70 million.
Construction of the emergency medical unit is being undertaken alongside that of a two-kilometre road network and construction of a double-deck car park.
This is aimed at improving the quality of health care and reducing referrals abroad.
Apart from the new construction works, President Sata’s Government has procured and installed modern and specialised medical equipment at the four hospitals.
Theatre equipment includes prosthetics and orthotics; physiotherapy equipment; paediatrics equipment; outpatient equipment; ophthamology equipment among others.
Under the leadership of President Sata, decentralisation of operations of Medical Stores Limited has been embarked on to ensure timely and efficient delivery of medicines and medical supplies across the country.
To this effect, Government decided to establish six regional hubs for medical stores Limited.
So far, two regional hubs are fully operational, one in Chipata and the other in Choma, while the Mongu hub will be operational before the end of this year.
And addressing the Fourth Session of the Eleventh National Assembly President Sata, said access to quality health services remains the cornerstone of Government’s health policy.
In line with this policy, the government swung into action increasing availability of health frontline staff, health infrastructure, drugs and other medical supplies and equipment.
To mitigate the shortage of skilled health personnel, Government has been rehabilitating and constructing training institutions.
To this effect, two new training institutions are under construction in Senanga and Lusaka at Levy Mwanawasa General Hospital.
In addition, 27 health training institutions countrywide are under rehabilitation and expansion. These works, when completed, will increase the health institution training capacity by 4,500 students bringing the total to 10,000.
This includes the 3,000 student capacity health training facility at Levy Mwanawasa General Hospital.
President Sata’s legacy of ‘Man of Action’ stems from the time he introduced health reforms when he was minister of health in 1994 under the Movement for Multi-party Democracy (MMD).
A story is told of how Sata had once travelled to a hospital clinic in Eastern Province at night disguised with a coat and a hat and joined other patients in the waiting room. There he noticed how the nurses lazed around and were rude to patients.
When he got up to approach the nurses, they shouted at him, telling him to get in line and wait his turn. Sata then took off his disguise and told off the staff, firing them there and then.
An author from Leiden University Leenstra Melle wrote in a dissertation ‘Beyond the façade: instrumentalisation of the Zambian health sector’ that some individuals within the health sector also retained positive memories of Sata’s time at the ministry.
For instance, a former senior ministry official, who had since moved to a faith-based organisation, said that Sata had been an experienced hand in government ‘and he gave us a glimpse of how things worked she wrote.
“At times he was unpredictable, but he introduced some good things. He really cleaned up the place. He introduced incentives for cadres, who really benefited. Doctors were picked up for work, nurses got good new uniforms. He didn’t rock the boat.
He wasn’t bureaucratic but a man of action, a practical man, who worked well with professionals who took the decisions”.
And former minister of finance in the MMD regime, Dr Katele Kalumba, who also served as deputy minister under Mr Sata in the ministry of health in 1994, said it was Mr Sata who introduced pre-payment schemes.
These increased financial protection for members of such schemes by reducing the need to pay for health services at the point of delivery.
Dr Kalumba also said President Sata was the Minister under who the 1995 Health Services Act was managed where health and central boards were introduced although later dissolved.
“It was a very good piece of health legislation which countries like South Africa, Lesotho among others drew from and implemented with success,” he said.
Dr Kalumba said President Sata also singularly appointed board members of district hospitals throughout the country. Through them, he obtained information of what was obtaining in the hospitals.
He said Mr Sata would randomly inspect hospitals and his concern for patients drove him to fire nurses whose attitude and work culture was not befitting, Dr Kalumba reminisced.
Dr Kalumba described late President Sata as a good politician who even if did not have any medical training was prepared to listen to medical advice to bring about reforms that would benefit patients.

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