By Fred M’membe

We urgently need to employ more than the 700 doctors

The Zambia Medical Association says “Zambia currently has close to 700 medical doctors and dental surgeons who have been awaiting employment for almost two years”.

For a country with so few, and desperately in need of, doctors this is difficult to understand and accept.
Today Zambia’s physicians density stands at 1.19 physicians/1,000 population (2018) – (Source: CIA World Factbook – This page was last updated on September 18, 2021).

The physician density gives the number of medical doctors (physicians), including generalist and specialist medical practitioners, per 1,000 of the population. Medical doctors are defined as doctors that study, diagnose, treat, and prevent illness, disease, injury, and other physical and mental impairments in humans through the application of modern medicine. They also plan, supervise, and evaluate care and treatment plans by other health care providers. The World Health Organization estimates that fewer than 2.3 health workers (physicians, nurses, and midwives only) per 1,000 would be insufficient to achieve coverage of primary healthcare needs.

Physicians density in Zambia was 0.091 as of 2016. It was 0.163 in 2012, 0.052 in 2006 (Source: World Health Organization’s Global Health Workforce Statistics, OECD, supplemented by country data).

WHO estimates that at least 2.5 medical staff (physicians, nurses and midwives) per 1,000 people are needed to provide adequate coverage with primary care interventions (WHO, World Health Report 2006).

It’s scandalous that a country with such a low physician density cannot prioritise the employment of 700 doctors. But it has money to urgently employ district commissioners and other political personnel.

The country needs far more doctors than the 700 we are failing to employ. We actually urgently need to hire more expatriate doctors to meet the minimum number required to give our people the minimum acceptable standard of health care.

With a physician density of 1.19 per 1,000 population it means that the great majority of our people are born and die without ever seeing or being touched by a doctor. When such people talk of a doctor they are actually talking about a clinical officer or male nurse – since a female nurse is referred to as a “sister”.

And because of this very low physician density we are everyday unnecessarily losing our women in childbirth. Today Zambia, with a maternal mortality of 591 deaths per 100,000 live births, is among countries with the highest maternal mortality rates in the world partly due to lack of doctors. Five per cent of our expecting mothers need Caesarean operation, especially with a very high number of teenage pregnancies. But a Cesarean operation can only be conducted by a qualified physician, and not a clinical officer or nurse. Many of our health centres, clinics and hospitals don’t have doctors to carry these desperately needed Cesarean operations.
Clearly, we urgently need to employ more than the 700 doctors we are failing to employ.

Life is sacred. One cannot claim to uphold the principle of the sanctity of life if provision has not been made for even minimal healthcare for every person.

This is a priority we cannot ignore if we wish to be a caring and compassionate nation. It must be recognized that, if this problem is to be tackled, it will demand the allocation of more state resources to health.

The Socialist Party is making its modesty contribution by training a few medical doctors. Right now it has 17 young Zambians from poor backgrounds studying medicine abroad. And this year it is sponsoring another 30.

By Hon Yotam Mtayachalo

First and foremost it is a fact that state utilities have been the major players in the electricity sub-sector in Africa although some countries are also pondering changing their business models in line with global trends.

Therefore plans to restructure the Zambia Electricity Supply Corporation ( ZESCO) LTD by the Industrial Development Corporation (IDC) which may eventually lead to the unbundling of the power utility looks good at face value however there is a need to be extra cautious as electricity drives the engine of economic development and as such in my view the process should not be rushed but should be a product of consensus-building among key stakeholders to avoid repeating the mistakes of privatization which looked very good on paper in initial stages but the post-privatization era was not a success story to write home about as its scars are still visible especially on the Copperbelt.

I remember during our time in the union the National Energy Sector and Allied Worker’s Union (NESAWU) took a strong stance against privatization and unbundling which was being spearheaded by the IMF and the world bank and as such we strongly opposed plans by the then MMD government to either privatize or unbundle the power utility based on the experiences we gathered from other countries such as Uganda which was the pioneer country in sub-Saharan Africa to unbundle it’s power utility but we instead supported commercialization benchmarks as an alternative business model and the same were endorsed by the world bank and for the first time in many years ZESCO declared dividends to the government.

Although Uganda has registered some success in terms of improved revenue collections, connections and investments just to mention but a few the same has not been replicated in countries like the Ivory Coast while currently, South Africa is also debating whether to unbundle its state power utility ESKOM or not

While unbundling of the Zambia Electricity Supply Corporation (ZESCO) LTD MAY lead to improved efficiency, revenue collection, and promoting investment opportunities however the same will come at a great cost to a Zambian consumer as the cost of electricity shall go up because of the anticipated increase in overhead costs.

Even assuming that ZESCO is unbundled as being proposed by the IDC we expect possibly three companies to be born out of such a process namely; generation, transmission and distribution thereby lengthening the electricity supply chain and as such these companies will have their independent management structures and board of directors to manage these firms and this, of course, will come at a great cost to Zambian electricity consumers.

Further in 2005, the Mwanawasa government made a bold decision to integrate Kariba North Bank Corporation (KNBC) into ZESCO, and in fact, the union supported the move because it was made in the national interest because before the move, ZESCO used to buy power from KNBC which was never the case after the two companies were amalgamated therefore the question to ask ourselves is did the integration of KNBC into ZESCO bear positive results or not?

It is my considered view that the challenges facing ZESCO today are well-known facts and the cure lies in depoliticizing the firm and as such, I don’t think unbundling is an answer to the current challenges the company is facing as the only cure is divorcing politics from the company and thus the only sure way the company can run as a business entity and ensuring that the best human capital is appointed to management positions to run the firm efficiently and profitably.

Furthermore, during the UNIP government, ZESCO was one of the best run power utilities in Africa that even engineers from some European electricity utilities used to come and learn something from Zambia but over the years the company has been run down because of political interference as the company does not run as a business entity and above all appointments to the position of managing director and directors respectively are no longer done on merit as it used to be during KK’s reign because during the UNIP government it was not easy for someone to rise to the position of managing director and director as one had to have a proven record of competency and experience and rising through management structures but the system changed after the fall of the UNIP government in 1991.

Fellow countrymen and women you don’t need to be a rocket scientist to tell that nowadays it depends on who you know in government to be appointed to top management positions at ZESCO and this should not be the case where appointments are largely driven by political, tribal and regional considerations which is retrogressive more importantly in this day and age.

I keep wondering why the position of managing director and directors at ZESCO and other state-owned enterprises are not advertised in line with corporate good governance principles so that well-deserving Zambians regardless of their political, tribal, and regional affiliations applies for these jobs so that the best brains are appointed to top management positions in order for the firm to run efficiently and profitably.

Moreover, it is sad that every time there is a new head of state at state house or change of government there is a new managing director and directors at ZESCO and as the results, the staff turn over is too high and in such a scenario it is extremely very difficult for the company to effectively implement it’s business plans because of lack of continuity and in fact, already more than 30 highly trained management staff have been retired in the national interest or fired at the power firm following the ascendance of the new dawn government to power and most of these casualties have nothing to do with politics but fired based on rumour mongering which is synonymous with parastatal politics and surely where is the money going to come from to pay severance packages when the company has a backlog of more than 40000 unconnected customers who have paid capital contributions in full, cry my beloved country Zambia?

By and large, the end result is that the company has continued and will continue to lose highly qualified and experienced electrical engineers if this culture of hunting does not end because these men and women we trained at great cost to taxpayers money are now providing dedicated service in the diaspora and indeed it is true that a prophet is not respected in his own country which is a very retrogressive way of thinking.

It is in light of the foregoing that we need to put our heads together as to whether ZESCO is ready for unbundling taking into account the experiences in Uganda, Nigeria, and Ivory coast however the country should continue to invest in renewable and non-renewable sources of energy in order to meet current and future electricity demands.

Needless to say that Zambia is well-positioned in the region and is a member of the Southern African Power Pool(SAPP) it can become the net exporter of electricity in the sub-region and beyond therefore we must emulate countries like Ethiopia whose electricity state utility is building the Grand Renaissance Hydro-Electric Power Dam on the Blue Nile which will be the largest hydropower investment in Africa and upon completion, it will generate about 6450mw of electricity and as a country, we can also do it.

It is unfortunate that as a country there were no significant investments in the electricity generation sub-sector in the last more than 45 years apart from the then 900mw Kafue Gorge Hydro Power Station which was commissioned in 1977 and until now when the country has developed the 750mw Kafue Gorge Lower Power Project which is a single major investment in the power sector after so many years despite increasing population and economic activities, especially in the mining industry.

Lastly but not least I hope that the new dawn government will carry on the good works left behind by the PF government which includes the construction of electricity interconnectors to neighboring countries to enable the country to export electricity and accelerate the completion of the 750mw Kafue Gorge Lower Power Project which undoubtedly is a giant step in revolutionizing the electricity generation sub-sector in Zambia.

In addition, the new dawn government should also seriously consider investing in the 2400mw Batoka Gorge Hydro Power Project which is a joint venture between Zambia and Zimbabwe, the proposed 600mw hydropower project on Luapula river and many other pipeline investments while at the same time encouraging private sector participation in the electricity sub-sector such as Independent Power Producers (IPP’s) so that they can compete with the state power utility(ZESCO).

The author is a member of parliament for chama north and former General Secretary of the National Energy Sector and Allied Worker’s Union (NESAWU)