Desperate Zimbabweans cross Zambia border for cheaper healthcare, medicines
A group of young women walk along the main road leading away from the Chirundu border post, passing some of the hundreds of trucks which are parked overnight on the roadside awaiting customs clearance. This small settlement on the border of Zambia and Zimbabwe is a key transit point on the the trucking route from South Africa through to East Africa and it has become notorious for its congestion as every day hundreds of trucks try to pass through this border. Drivers often end up having to spend days, even weeks in this hot uncomfortable place waiting for their paperwork. It is estimated that there are more than 350 sex workers based in Chirundu who provide services to truck drivers and others and the area is known as a HIV/AIDS transmission hotspot in the region. Often more than 500 vehicles can be parked overnight. (Photo by Gideon Mendel/Corbis via Getty Images)
At 5pm at the Victoria Falls border post, Margaret Tshuma – who has a 24-hour day pass to be in Zambia – is in a rush to return home to Zimbabwe before dusk.
This is not the first time Tshuma, 53, has travelled from her rural home in Diki village, 120km (75 miles) away, to cross into Zambia for the day. It has become a routine trip she makes monthly to buy medication for her husband who has scleritis – an inflammatory condition that affects the outer covering of the eye.
The prescribed medication is barely available on the shelves of pharmacies in Hwange district, where she lives. Of what is there, the high cost makes it inaccessible to many, she said.
“The same medication is expensive back home. If you add transport and medication costs altogether, it is still cheaper to come to Zambia. Also most times, some of this medication is not readily available which risks the patients’ lives,” said Tshuma.
Buying the medicines in Zimbabwe costs Tshuma about $85 a month, whereas just across the border in Livingstone she pays 320 kwacha ($13). Even with travel, it works in her favour, as a two-way trip from Hwange to Livingstone costs $14.
Zimbabwe’s economy has been hit hard by decades of economic crises and soaring inflation. Many basics are not as easily available or affordable, and Zimbabweans themselves have lost confidence in the local currency.
At the border, Tshuma follows a small queue, before officials check her luggage and papers without much trouble and stamp her 24-hour pass – a process that takes less than 10 minutes.
Speaking to Al Jazeera, Mike Muleya, a commuter bus operator who ferries passengers back and forth to the border area, said a significant number of people make the daily trip from Hwange – a community of some 21,300 people – to buy medicines or visit hospitals in Zambia.
“My first early morning trip from Hwange, I carry at least six to nine passengers going to Victoria Falls to cross to Livingstone. We chat along the way and I find that five to seven are going for medical-related trips,” he said.
“In the evening, on my last trip, I literally park near the border as they will be calling me to take them back to Hwange. In between, I will be carrying one or two, so it’s a big number [making the daily trip], given that it’s not me alone in the transport business.”
The cost analysis
According to a 2023 report by the local advocacy group Community Working Group on Health, most Zimbabweans do not have access to quality and affordable healthcare. The group has called on the government to prioritise primary healthcare to achieve universal health coverage.
Poor Zimbabweans who depend on state healthcare struggle significantly more to obtain treatment than wealthier citizens, who can turn to more expensive private services. In addition to difficulties in obtaining care, many complain of long queues at public hospitals – often requiring four to seven hours of waiting.
In Matetsi Ward 1 in Hwange Rural, 20km (12 miles) from Victoria Falls, Mercy Khumalo recounted the ordeal of taking her aunt to Zambia for treatment.
It was not an easy situation for the family, Khumalo said. Using their meagre savings and the money from selling a cow, they were finally able to get enough to afford to see a specialist at a private hospital in Zimbabwe. But after doing a cost analysis, they chose to go to Zambia instead.
“We had consulted locally and got some quotations from various specialists. Aunt was diagnosed with a brain tumour. Our neighbour told us that treatment was affordable and a pure public service in Zambia. We saw that, with the money we had, it will have been spent within a month at a private doctor locally; yet, in Zambia, we will save a lot as we monitor the situation,” she explained.
“Foreigners are allowed to use the public healthcare system in Zambia and are generally free as long as you have your passport and health records in order,” Natasha Chola Mukuka, a public health practitioner and student of medicine at Levy Mwanawasa Medical University in Lusaka, Zambia, told Al Jazeera.
Although specialists and surgery cases do attract a cost, Zimbabwean patients told Al Jazeera they find it more affordable than at home.
5 Miles Hospital still miles away
Matabeleland North province, home to Victoria Falls and Hwange, is historically marginalised despite it being a tourism hub that also houses the largest colliery and the biggest national parks. Locals bemoan the lack of tangible infrastructural development, including health facilities.
The construction of the 5 Miles Hospital – named for being 5 miles (8km) from Hwange Town Central Business District – gave hope to residents and villagers. However, when it was nearly complete in 2018, construction stopped.
“The government started to build some hospitals to demystify that the region is marginalised but the structures have remained white elephants for decades,” said Fidelis Chima, the coordinator of the Greater Whange Residents Trust.
“There is nothing to indicate that the hospital will open soon. We have waited for the longest time. People in Hwange depend on Hwange Colliery Company Hospital, but it’s a private facility and very expensive. The government wanted 5 Miles Hospital to be a district hospital, covering both Hwange and Victoria Falls,” added Chima.
Matabeleland North has a record of poorly equipped hospitals. Existing facilities also lack essential drugs and sufficient trained personnel, locals say.
In Hwange district, five hospitals provide services to a population of about 125,800.
But according to Hwange Rural District Ward 12 Councillor Jowani Chuma, four wards are serviced by one hospital, St Marys – a missionary facility run jointly by the government and the Catholic church where patients receive a combination of free and paid-for services.
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