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Are salaries demanded by doctors necessary and affordable?

You can’t miss them. Visitors and nursed walk around them the same way people walk around assorted merchandise on Kariakoo streets. Some looked as if they had been hastily patched together with recycled bandages. The sheer numbers and the extent of injuries were shocking to say the least. Clearly motorcycle accidents are a big problem and the mighty and famous Muhimbili hospital appeared unable to be on top of it.

Had doctors been coming regularly to minister to their mental wounds and doctor their physical pains, I ventured to ask. Not really, they pop in and out but have not been doing much. Were any of the victims in need of operation for the fractures and other wounds? Yes but. I could not get past the ‘but’. One confided in whispers that he had paid 50,000/- on admission and he was told he needed surgery to secure his broken bones with metal clips for proper healing.

But the doctor had postponed the surgery a few times. Finally somebody, presumably a staff member, told him if he wanted that operation to materialise he had to pay 400,000/-. He organised friends and relatives to contribute the money and within a week he paid the sum to an unnamed recipient.

He was on standby but did he succeed? I heard doctors were on go-slow strike and only those willing to bend the rules jumped the surgical queue figuratively speaking. Was this just a story or is it still happening? That is an assignment for PCCB. Is it any wonder these days civil servants and wealthy individuals are flocking in droves to private hospitals for simple and complicated medical and surgical treatment?

The young men I saw in pain on Sewa Haji ward floors had serious wounds whose recovery may take months to heal if at all. Yet they were getting little assistance. Why am I telling you this story? Not too long ago doctors of this land of the Kilimanjaro downed their tools, demanding salaries and allowances to be bumped up to a staggering 7,000,000/- per month for an entry level medic. Did they ask nicely? No.

They demanded to be paid what they believe they deserve. They refused to talk to the health minister or his associates who happened to be high level government executives. Instead they demanded the sacking of the minister, the chief medical officer and the permanent secretary.

They demanded to see the highest ranked political leader of the land. Religious leaders pleaded for them to spare the lives of innocent citizens by returning to work but the pleas of the men of the cloth went unheeded. When the prime minister showed up, they missed appearing the venue. Eventually they met the president of the nation and agreed to resume work for a specified time after which if their demands were not met, and so on and so forth. Why go on?

The thing is, people died, some must have suffered permanent physical and psychological complications arising from lack of treatment. A country that is highly indebted – national debt is twice the annual budget – has doctors who think they deserve emoluments of US $ 5,000 per month. Life of ordinary folks is not worth something anymore?

Some politicians and so-called activists actively supported the doctors’ strike, at the expense of lives of people. Because despite being among 30 countries with the lowest human development ranking, top ranked political and civil leaders already receive similar or higher salaries and allowances as the doctors were asking for. What is good for political goose must be good for medical gander, right? Meanwhile over 80% of Tanzanians live on less than a dollar a day.

I tell you solemnly we cannot afford it. We cannot afford to pay any dedicated and committed doctor in government service 5,000 dollars a month, let alone the go-slow in government but work-fast in Aga Khan or other private clinic doctors. Do you think a private hospital would tolerate doctors who work when they feel like?

Suppose we have 10,000 doctors. At 7,000,000’- per month, the wage bill alone would be 84 million shillings per doctor, or 840 billion/- annually. Let us add the teachers too. There are like 340,000 teachers. They are demanding minimum salary of 350,000/-. That will add some 1.42 trillion/- without allowances. So between the teachers and the doctors (nurses, pharmacists, laboratory staff excluded) we have a wage bill of 2.2 trillion/- from a national budget of 15 trillion/- or 15% of the government budget.

For that we get go-slow teaching, failures are grade 7 and mediocre secondary exams results especially for mathematics and science subject. Of the diseases that affect Tanzanians, 80% can be cured without intervention of medics. Diarrhoea, malaria, skin diseases, acute respiratory infections and acute infections of the eye are the most common problems of 80% of the population. We need many doctors to manage the epidemic of non-communicable diseases taking root in Tanzania.

By drinking beer and smoking, urban dwellers contribute sales tax to state coffers but end up messing their state of health big time. The 10 million or so people living in towns and cities suffer from too much food and too little walking, getting fat like Americans. It is why too many doctors want to be in Dar es Salaam and Mwanza cities, a few in Moshi-Arusha zone and perhaps Mbeya.

Those that are overweight risk getting diabetes, high blood pressure and heart failure, conditions that require doctors with degrees. Most diseases affecting Tanzanian millions living in rural areas are simpler, easy to manage with a few basic drugs and equipment. Will government buckle under pressure to pay what we cannot afford for substandard quality of service from doctors and teachers?

Cell: 0755-246136; 0713-246136


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