I do sympathise and feel sorry for Minister of Health Silvia Masebo; she has an impossible mountain to climb! The UPND inherited a collapsed public health system. I mean “collapsed” as in “dysfunctional”, “broken down”, and “disintegrated”. Arguably, none of our government departments have suffered from massive theft, corruption, neglect and mismanagement more than our Ministry of Health.

Silvia Masebo has been in government before, as Minister. She knew then, as she does now; about the rot in the Ministry of Health. As a courageous and fiercely independent person, I am almost certain she must have volunteered personally to take on the Ministry of Health. Silvia Masebo, with the right scientific, technical and management support, is the kind of government minister I would want in a revolutionary government in which she would be entrusted with the task of dismantling the health ministry and creating a new one altogether!

For more than four decades, starting well into the Kaunda regime, the Ministry of Health has been in free fall, down a slippery downward slope into the wreck it has become. The introduction of private players in the supply of health consumables, drugs and medical equipment and technologies after 1991 simply accelerated the rate of collapse of the Ministry of Health – it became a fat cash cow of the greedy profit mongers willing to steal from the government in so many ways including pocketing government money without delivering anything in return!

Government spends colossal sums of money running government health centres, clinics and hospitals. These structures are spread throughout the country, thankfully Kaunda made sure even the remotest village has a clinic. The human costs into the government health system include salaries and other benefits for all health workers in the system including drivers, cleaners, health assistants, nurses, clinical officers and other specialists, doctors and ordinary management staff.

The government payroll of the Ministry of Health is huge, and it offers massive opportunities for stealing government money. Pocketing money for ghost workers is the most obvious example of how thieves make extra money in this department. Selling jobs by receiving bribes from job seekers is another way of corruptly becoming rich in the Ministry. Pocketing money for health services, especially in the radiography and pharmacy areas of these structures is another. Some in the ministry just resort to plain theft and sell drugs and other consumables. Other workers moonlight while on duty, pocketing government money for doing nothing. Taken as a whole, the sums of money lost in this way are massive, especially when multiplied over several years.

It is in the buying of vast quantities of medicines, equipment, technologies and many other consumables that a disproportionately massive amount of money is lost, by government. Some suppliers are masters at bribing officials to get tenders, jump the que to get paid, and falsifying invoices and other documents. Other suppliers get their drugs and other consumables from dubious sources. Others simply supply expired drugs. And yet others manage to supply rotten drugs and get away with it. The money involved in such deals is big and worthy the risks.

And so it happens that networks, over time, form, connecting government officials in the ministry of health to suppliers and even through to the Ministry of Finance. Over the years certain individuals actually become experts and very trusted criminals in these networks, among the community of thieves who raid the Ministry of Health for money. It has been like this for decades.

With extreme levels of poverty, mass unemployment and rural misery, government health facilities are the only available health services for millions of Zambians. These networks and communities of thieves, thriving on shortages, broken-down systems and poor internal controls in the Ministry of Health, actually operate throughout the system; from the remotest rural clinic to the largest hospital in the country upwards to the headquarters of the Ministries of Health and Finance.

Those of us who opt to pay in order to be given a drug said to be not available or to jump the que for a test actually contribute to sustaining these rotten thieving communities of blood vampires, who prey on the Ministry of Health.

Now, this incredibly huge problem is compounded by government’s insufficient funds to fully resource, police and monitor the system. Shortages of all sorts of things simply create a market for thieves, in those things. But, more dangerously, the many crises in the Ministry of Health are facilitated by the money culture which has overtaken Zambia especially after our 1991 multi-party elections. Zambia became a full-blown capitalist country. Everything was up for privatisation and making money became the single most important thing all of us had to start doing. The poverty wages in the public health sector simply lubricate the system.

Minister Silvia Masebo is charged with righting these and many other crises in the Ministry of Health. She is fully aware that patients die if they cannot receive the medicines they need in our clinics and hospitals. She knows that hers is a Ministry in which it is impossible to prevent public anger over the shortages of medicines and poor staffing, all contributing to incredibly inferior services Zambians get.

As if wishing her death from an early heart attack or stroke, there is the obvious problem of those wishing to participate in eating from this feeding trough, who were excluded by the Patriotic Front, in the UPND, who think that now is their time too, to put their snout in the feeding trough. This is a perfectly legitimate political expectation in a multi-party system of thieves, but not in a genuine democracy.

We see then, that Masebo is fighting a systemic, structural, social and political war in the Ministry of Health, all these elements are tied tightly together in an extremely impoverished country. Masebo thinks, believes and acts fully confident she can win this war. I truly wish her well, for if she succeeds, millions of poor working, unemployed and rural Zambians will be the winners.

Masebo is a reformer – she is confident she can sort out some of the rot and improve the system. She will win some battles but not the war, in the Ministry of Health.

Crises whose roots burrow deep into systemic, structural, social and political bases cannot be resolved by a piecemeal, incidental approach; the entire edifice needs to be brought down, sometimes violently, in order to give birth to a new system, new structures, emancipatory social conditions and a politics of liberation, and the mortal fear of stealing from the people.

I want to invite Masebo to begin to think about radical, no, actually revolutionary, solutions to our crises in the Ministry of Health even as she continues to fight the demons as she is doing. In one of her latest statements, she has actually alluded to the root of the problem: money! We are stuck in a culture which, from the poorest clinic in the remotest village to the ministry’s headquarters, money, rather than service to Zambians, permeates the system! This is the moral, political, economic and social problem at the heart of the crisis in the Ministry of Health: Zambia is in the vicious grip of the dictatorship of money.

From money, it is easy, theoretically, to unravel the rotten system; just follow the money routes!

We must celebrate the Silvia Masebos of Zambia; with all their weakness, they mean well, and once they graduate from reformist to radical, revolutionary politics, Zambia will be saved!

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