A Family’s Struggle with a Broken Healthcare System
Angela Madzivaidze still remembers the heart-wrenching experience of her father’s illness and eventual passing just two months ago. What started as a desperate attempt to save his life turned into an emotional and financial nightmare. Despite their efforts, Madzivaidze said her family’s sacrifices were in vain, and she blames corruption at the local hospital where her father sought treatment for the delays in critical care that ultimately led to his death.
Madzivaidze recalls how her father was initially taken to Parirenyatwa Hospital, one of Zimbabwe’s largest public hospitals. There, they were told he needed a prostate cancer test. The doctor instructed them to go to a specific testing facility, which returned negative results. However, the family was then directed to another location for additional tests, which cost them $100. This was not the first time they had spent money on tests, as the initial one had already cost $80. They later learned that similar tests could be done elsewhere for as little as $30.
Throughout this period, her father was admitted to the hospital but only received painkillers without any proper diagnosis. “We were pumping out money for tests that the doctor wanted done specifically by certain providers,” Madzivaidze said. Eventually, she requested her father’s discharge, and they sought private care, where he later passed away.
The Shadow Referral System
Across Zimbabwe’s public hospitals, patients often find themselves referred to private facilities for essential services such as blood tests, X-rays, and scans. These referrals are not always based on medical necessity. Investigations have revealed that in many cases, healthcare workers receive commissions from private providers, creating a shadow referral system that exploits desperate patients and adds financial burdens on families already struggling to afford care.
In Zimbabwe, medical professionals are legally barred from profiting from patient referrals. According to the Code of Professional Conduct (2009), doctors must guide referrals solely by the patient’s best interests. Any payment, commission, or reward linked to referrals is considered professional misconduct and subject to disciplinary action.
A journalist recently observed a representative from OmniPath Medical Laboratories, identified as Judith, delivering test results at Parirenyatwa Hospital. She greeted nurses and parked her unbranded vehicle on hospital premises, operating in plain sight while patients were referred to her by doctors. An OmniPath representative, Nyaradzo, confirmed Judith was an employee but insisted she was acting outside company policy.
A Crumbling Public Healthcare System
Zimbabwe’s public healthcare system is in crisis. According to the Community Working Group on Health, healthcare coverage has declined by up to 40% due to chronic underfunding and an exodus of health professionals. In 2022, hospitals spent 73.1% of their budgets on salaries, leaving little for medication, supplies, or functional equipment.
By late 2022, only 1,724 doctors and 17,245 nurses were employed in public institutions—figures significantly below the World Health Organisation’s recommended minimum of 4.45 skilled health workers per 1,000 people. A 2024 report by the Zimbabwe Coalition on Debt and Development (Zimcodd) revealed that 64% of respondents reported a critical shortage of healthcare personnel in their communities.
The same report highlighted continuous weaknesses in healthcare delivery, with 61% of people rating the availability and condition of medical equipment in public hospitals as poor, and 58% expressing concern over unreliable access to essential medicines. These shortfalls have created opportunities for corruption.
Corruption and Its Impact on Patients
Patience, a nurse at Harare Hospital, confirmed that the practice of referral commissions is widely known. “When the hospital is not running certain blood tests and many aren’t done here, the doctors refer patients to either their labs or to private labs where they get a fee as commission,” she said. “Sometimes they end up writing blood tests that are not necessary just to get that incentive, and this disadvantages the patient.”
Memory, another nurse at Parirenyatwa Hospital, confirmed that the practice existed but added that not all referrals were corrupt. “At times it may be a matter of the doctor referring a client to a lab where he knows patients will get thorough tests,” she said.
Despite these challenges, Parirenyatwa Hospital public relations officials did not respond to a request for comment on this issue.
