Zim playing part to resolve a global care crisis

Harare – When the National University of Science and Technology (NUST) introduced a short, three-month course in health care in August this year, Josephine Phiri screamed in excitement, as she immediately saw this as her long-sought pathway to “greener pastures” abroad.

That was before she had even applied, let alone been admitted into the course by the university, which joins other organisations such as the Red Cross and St John’s Ambulance Services to offer the highly sought-after course.

Her excitement turned into ecstasy when Phiri, 21 and head of four orphaned siblings, was admitted for the newly introduced course by NUST.

Requiring just three ‘O’ Level passes, the course is one of a few with less stringent academic entry requirements offered by a university.

By the end of the course, which has modules consisting of Basic Concepts in Health Care, First Aid, Home Nursing, Maternal and Child Health, students like Josephine would have acquired; “Knowledge, skills and competencies to feed, bath and groom patients thereby contributing enormously to their sense of normalcy and wellbeing.”

“I am hoping to secure my move to the UK as soon as I am done with my studies,” she said.

The short duration of study is meant to churn out health care graduates to meet unprecedented rising demand for care givers at home and abroad.

According to a recent report by the United Nations Institute for Research and Development (UNRISD), dubbed Crises of Inequality, an increasing number of persons in the world are in need of care.

“The care crisis has emerged as a result of several developments. First, the number of persons in the world in need of care is growing. In 2015, 2.1 billion people in the world were in need of care, and that number is expected to reach 2.3 billion by 2030.

“At the same time, the pool of available caregivers is shrinking. This is related to a number of factors, including increased participation of women in the labour market as a result of shifting gender norms and advances in women’s rights (creating increased demand for care as women navigate employment and care responsibilities) and the reduced role of extended family members in caretaking as a result of migration, urbanization and shifts in family structure,” the report said.

“The Covid-19 pandemic has demonstrated the essential value of care work, both paid and unpaid, as well as intersectional inequalities associated with the sector relating to gender, class, race/ethnicity or caste, informality and migrant status.”

The UNRISD report defines care work as a society-wide service performed by a variety of actors that is essential for the maintenance of social, economic, political and cultural institutions, and for continued existence.

Destination UK
According to a report published in June this year by the Health Foundation think tank, the British health system is facing a shortage of 93 000 employees.

Like other developed countries, Britain has a long tradition of recruiting staff from developing countries to meet the needs of its health service.

The Zimbabwean labour market has become a major source of replenishing the UK’s health system, as trained care givers, doctors and nurses trek to the UK.

According to StatisticsUK, in 2020, the UK issued 1059 skilled visas to Zimbabweans, a figure which jumped to 5 549 in 2022, placing the southern African country among the UK’s top five skilled visa grantees.

The hiring trend is expected to continue in the coming years, driven by the Covid-19 pandemic and a dramatic drop in nurses recruited from Eastern Europe as a result of Britain’s withdrawal from the European Union.

Zimbabwe’s Health Services Board Chairman Dr Paulinus Sikhosana said by December 2021, the Southern African country had lost around 2 910 health workers to various parts of the world.

“As at November 4 (this year), we had already lost up to 1538 health workers,” he said in an interview.

Closing the gap
While Zimbabwe has emerged as one of the leading suppliers of health care personnel, particularly to the UK market, the government has also put in place measures to protect its healthcare system and guarantee provision of services, including care services.

To stem the migration tide, the Zimbabwe government has introduced several strategies including increasing monetary and non-monetary benefits for health workers.

The Zimbabwe government has occasionally been reviewing upwards health sector-specific allowances on top of non-monetary benefits, which include institutional accommodation, in a bid to cushion the workers.

Some of the allowances reviewed include on-call allowances, which apply to Doctors and Laboratory Scientists, night duty, stand-by / callout allowances, which apply to nurses, nurse aides and general hands in theatre.

“We are aware that there are countries that are recruiting from Zimbabwe. We want to keep our staff that is why we are working so hard to retain them but with the right to movement and association, people will want to move,” Dr Sikhosana said.

While people trek to foreign lands in search of paying care jobs, another phenomenon regarding care work has also emerged.

The issue is that of unpaid care and domestic work (UCDW).

Unpaid care and domestic work refers to all non-market unpaid activities carried out in households-including both direct care of persons, such as children or the elderly, and indirect care such as cooking, cleaning or fetching water.

According to the UNRISD report, globally, women and girls perform the highest number of hours of unpaid care and domestic work, particularly in low-income countries where females are responsible for a disproportionate amount of unpaid care work.

“16.4 billion hours are spent on unpaid care work every day—the equivalent of 2 billion people working 8 hours per day without pay. Women perform 76.2 percent of all unpaid care work globally, 3.2 times as much as men,” the UNRISD report said.

Faced with such statistics, a collective of civic groups, led by the Women’s Coalition of Zimbabwe (WCOZ) petitioned the Parliament of Zimbabwe in August this year over possible legislation to protect women who provide most of the unpaid care work.

WCOZ National Coordinator Sally Ncube told a press conference recently that; “Civil society organisations, for years, have been monitoring and raising awareness about the negative impact of the inattention to care policy and unequal distribution of unpaid care and domestic work which has stalled gender equality in every country globally.”

Speaking at the same press conference, Oxfam Gender Justice and Women’s Rights coordinator, social norms advisor Regis Mtutu said recognition of UCDW would lessen the burden of care work at household, community and society levels.

“We want to make sure that we recognise, reduce, redistribute and represent unpaid care and domestic work and working with our partners we have been pushing to make sure that government recognize UCDW as an economic, development and policy issue,” he said.

The Zimbabwe Congress of Trade Unions is also pushing the government.

“There is need for establishment of support centres to provide awareness, counselling and support for women in care work who suffer from domestic violence, stress and other mental issues. There must also be access to free medical services for women in full-time care work,” the ZCTU said.

In response to the renewed pressure, the Parliament of Zimbabwe through the Portfolio Committee on Women’s Affairs, Community, Small and Medium Enterprises Development launched public hearings around Zimbabwe to gather views on how government could develop policies that deal with issues around UCDW.

That Parliament has taken up the issue provides hope for women and girls who are mostly disadvantaged by the scourge of UCDW and advocates who have been pushing for recognition of the matter.
New Ziana