The Zambia Medical Association has said that it is alarmed with the rhetoric from Ministry of Health officials that appears to ask trained doctors to volunteer their hard-earned skills in government facilities, without salaries and with no clear roadmap to fair and reasonable employment.
The Association said it is further dismayed to hear the government’s proposal to engage the punitive approach of prioritizing for employment, those who agree to volunteer in government facilities, even over those who have been waiting for much longer.
Dr. Kaumba Tolopu, the Association Secretary-General says the move functionally strong-arms doctors into offering their services for free, and potentially paving the way for a system in which the government is not obliged to pay doctors for their work.
He said in a statement that Zambia currently has close to 700 medical doctors and dental surgeons who have been awaiting employment for almost two years now who have already spent 7 plus years in medical school and who in past years have been immediately absorbed into the civil service at managerial level.
Dr. Tolopu said the Association finds the expectation that these professionals should now be expected to work and risk their lives without the reasonable protection and privileges granted to members of the civil services to be unreasonable.
He said the Association does not accept the notion of subjecting its members to free labor especially now when the world is facing the biggest health crisis of this generation in addition to continuing heavy burden of infectious diseases such as malaria, TB and HIV.
Below is the full statement
ZAMBIA MEDICAL ASSOCIATION OPPOSES VOLUNTARY INTERNSHIP FOR DOCTORS
The Zambia Medical Association (ZMA) is a nonprofit-making professional body whose main goal is to champion the practice of medicine for the benefit of society through ethical practice, advocacy and research. ZMA is the official representative of medical doctors and dental surgeons in the country, and is committed to ensuring optimal conditions of service for its Membership as they diligently serve the Zambian people.
ZMA notes with alarm, the rhetoric from Ministry of Health officials that appears to ask trained doctors to volunteer their hard-earned skills in Government facilities, without salaries and with no clear roadmap to fair and reasonable employment. ZMA is further dismayed to hear Government’s proposal to engage the punitive approach of prioritizing for employment, those who agree to volunteer in Government facilities, even over doctors who have been waiting for much longer. This move functionally strong-arms doctors into offering their services for free, and potentially paves the way for a system in which Government is not obliged to pay doctors for their work.
Zambia currently has close to 700 medical doctors and dental surgeons who have been awaiting employment for almost two years. These are fully qualified professionals, who have already spent 7+ years in medical school, and who in past years have been immediately absorbed into the Government as civil servants at managerial level. ZMA finds the expectation that these cadres should now be expected to work and risk their lives without the reasonable protections and privileges granted to members of the civil service to be egregious and unreasonable.
As ZMA, we do not accept the notion that Government cannot appropriately staff its own health service. The world is facing the biggest health crisis of this generation. Zambia is no exception, and in addition, faces the continuing heavy burdens of infectious diseases such as malaria, TB and HIV; an ongoing maternal health crisis, and gross understaffing at almost every health facility in the country.
According to the World Health Organization, the desirable doctor-patient ratio is 1 doctor for every 1000 patients. Zambia currently reports a ratio of 1 doctor for every 12,000 patients, well below the WHO recommendation for a country working towards the attainment of universal health coverage and access to quality health care for all by 2030; a goal in line with the Sustainable Development Goals (SDG) agenda and with Zambia’s own national strategic health plans.
Doctors are a precious resource, and the Government must immediately recognize them as such. ZMA calls upon the Ministry of Health and his Excellency President Hakainde Hichilema to absorb all doctors into the civil service with immediate effect, and with remuneration at the appropriate level. The current health crisis must not be used as an opportunity to exploit those working at the front lines.
Doctors, like all hardworking Zambians, have obligations, needs and family responsibilities. We are not exempt from the high cost of living. Nonetheless, doctors have made huge sacrifices in order to serve the nation, and continue to do so in the line of duty. Many doctors have indeed already been volunteering through the various COVID waves, at great personal cost, and with no promise of compensation for that contribution, save for the nation’s gratitude, which they cannot use to feed themselves or fill fuel their tanks. The labour of medical doctors is not free, and cannot be treated as such.
ZMA prides itself on a track record of well-meaning and inclusive consultations to promote equity and welfare of its members and society at large. ZMA will continue to hold consultative deliberations that promote fairness, and urges all stakeholders to take advantage of ZMA’s open door policy to advance deliberations. As we continue to engage government, ZMA urges our members to desist from bowing to exploitation attempts.
ZMA simultaneously appeals to the leadership of this great country to expedite the process of promotions and recruitment of healthcare professionals, to address the huge human resource deficit in healthcare delivery, motivate this critically-needed cadre, and put the nation on the fast track to development.
Dr. Kaumba Roy Tolopu
ZAMBIA MEDICAL ASSOCIATION