Patients sleeping in a hospital bed. Image by Department of Foreign Affairs and Trade on Wikimedia Commons (CC BY-SA 2.0 Deed).

CURE Children's Hospital of Zimbabwe. Image by Wheaton95 on Wikimedia Commons (CC BY-SA 4.0 Deed).

By Kudzai Tamary Chikiwa

Zimbabwe's public debt servicing crisis has had far-reaching consequences for the country's healthcare system. With a significant portion of the national budget dedicated to debt repayment, the healthcare sector has been left underfunded and understaffed. This has resulted in a shortage of critical equipment, medicines, and healthcare personnel, ultimately affecting the quality of care provided to patients. The story of Memory Ncube, a Zimbabwean mother and her baby, Tendai, is a tragic illustration of the human cost of this crisis.

In the quiet moments, Memory’s mind wanders back to the day her world shattered. Her preterm baby girl, Tendai, had been fighting for her life, struggling with respiratory distress syndrome (RDS). In a bid to save the new life, Memory was transferred from rural  Zvishavane district hospital to Mpilo Central Hospital in Bulawayo, Zimbabwe's second-largest city. This was not because the doctors in Zvishavane were incompetent, but because they lacked the necessary equipment, including a continuous positive airway pressure (CPAP) machine.

Full of hope that her child would make it, Memory traveled 185 kilometers (114.954 miles) to Mpilo Central Hospital, which is one of the referral hospitals for patients from the Southern region of Zimbabwe. Recently, the hospital received a lifeline in the form of a donation from the Higherlife Foundation, which provided critical equipment, including CPAP machines, suction machines, monitors, jaundice meters, and phototherapy machines. Prior to this donation, the hospital had been grappling with a shortage of equipment, often resulting in premature deaths of patients.

However, tragically for this family, when she arrived at the hospital, it was too late, and her daughter had died. She sobbingly recalled her baby's death:

My heart breaks when I think of what happened to my daughter. If only there was equipment at the hospital, I was not going to travel all this way with a critical baby. I wish the government knew the devastating impact of not servicing public hospitals.

A system in crisis

Zimbabwe's public debt servicing has become a suffocating burden, squeezing the life out of the healthcare system. With a total public debt of approximately USD 21.53 billion, with much of it owed to the World Bank, China, France, and other international creditors, the government's debt repayment obligations are consuming a significant chunk of the national budget. In the 2025 budget, the Ministry of Health and Child Care was allocated ZWD 27.8 billion (approximately USD 1.039 billion), just 7.1 percent of public spending, which falls short of the Abuja Declaration‘s 15 percent allocation target.

The Abuja Declaration is a commitment made by African Union member states, including Zimbabwe, in 2001 to allocate at least 15 percent of their national budgets to improve the healthcare system.

Finance Minister Mthuli Ncube has defended the move, saying,

We need to go through some period of austerity, but the same builds us towards prosperity.

However, for Memory and countless other mothers, the prosperity promised seems a distant dream. Memory's baby is just one of many newborns who die before they reach one month in Zimbabwe. The neonatal mortality rate in Zimbabwe stands at 37 deaths per 1,000 live births, a grim statistic that reflects the human cost of inadequate healthcare funding.

A call for change

Community Working Group on Health Zimbabwe Executive Director Itai Rusike concurred that the health sector remains distressed due to public debt servicing. He explained:

Shortages in healthcare personnel, inadequate infrastructure, high disease burden, and expensive specialist services continue to affect service delivery. These systemic issues are compounded by low public spending on health and weak financial protection mechanisms. Unfortunately, it's the poor who suffer the most.

He emphasised the need for increased investment in building a robust and accessible health system, particularly in rural areas. He noted:

Achieving universal health coverage requires strong public funding and a commitment to treating healthcare as a fundamental right.

To challenge economic injustice and notorious austerity measures, organizations like the Economic Justice for Women Project are educating women on public finances. The project aims to empower women with knowledge about public debt and its impact on service delivery, enabling them to advocate for change. Director Margaret Mutsamvi said: 

Issues to do with public debt seem complicated and elitist, but we are now going down to communities to educate them. We take time to explain to them the nexus between public debt servicing and service delivery. This can help them challenge the status quo from an informed perspective.

Mutsamvi reiterated that when a government introduces austerity measures in favor of public debt servicing, it's the ordinary citizens who suffer.

Right now, our health system is in shambles because a huge chunk of money is put towards clearing external and internal debt. The ordinary people suffer; this is why we have a high neonatal mortality rate in Zimbabwe. Women are the most affected, as they bear the brunt of austerity measures.

She added:

When the government is prioritising public debt servicing it affects public hospitals. This is why there is a rise of privatisation of health facilities, mushrooming of private hospitals, clinics and pharmacies. Sometimes we have seen cases where there are no painkillers in hospitals and it’s even worse in rural areas. When the government is not funding, It's a woman who is paying for it.

She continued:

Women bear the pain of losing a child, caring for the sick at home and going through all the emotional stress. This is unpaid carework.

The story of Memory and her baby, Tendai, is a heartbreaking reminder of the human cost of Zimbabwe's debt crisis. It is a call to action for policymakers to prioritize the health and well-being of the nation's most vulnerable citizens.