COMMUNITY WORKING GROUP ON HEALTH “Organising People’s Power for Health” JUNE 6TH: NATIONAL HEALTH AND SAFETY DAY The Community Working Group on Health will this year commemorate June 6th National Health and Safety day under the theme “Organising People’s power for health”, we do this in solidarity with the Trade Unions of Zimbabwe. The Community Working Group on Health is a network of 30 membership based civic/community based organisations that aim to collectively enhance health and community participation in health in Zimbabwe. On June 6th we commemorate those lost to accidents and injury at work. Today we add thousands more lost to diseases that could have been prevented like AIDS, TB, Malaria and Cholera. The industry and commerce of the country has been adversely affected by the AIDS pandemic were the disease has claimed lives of most people in the productive sector. How many more have now died due to unavailability of drugs, or because they could not afford hospital services? The death rate is rising dramatically and more mothers die in pregnancy and childbirth than ten years ago. June 6th should be a nationally recognised day marked as a National event of the Government, the Trade Unions, Employers and the rest of the Zimbabwean community. What is causing the decline? The AIDS pandemic is a major cause. More and more people are also unhealthy because they are poor. People are also unhealthy because their living conditions are miserable, they cannot get or afford decent quality health services and the situation is exacerbated by the prevailing economic conditions. Poor people depend on public health services and cannot afford private services. Yet the cost of health services in these institutions has also gone beyond the reach of many, with impact being felt seriously in Maternity. People have a role to play in health being a major stakeholder in the promotion of Primary Health Care at community level. However, government has the first responsibility to make sure that public funds are allocated and spent on services that communities need, and also support and recognise the importance of their input and decisions in matters of significance to their health. The way the government Health budget is structured also does not reflect the needs of the population, or even the policy priorities of the Ministry of Health. The low-income population can no longer afford to get ill, because they cannot afford expensive curative services. With so many diseases that can be prevented, a reasonable share of funds should go to preventing disease (Primary Health Care), such as through building safe water supplies and sanitation, immunising children, antenatal care, malaria prevention, family planning and so on. There is need therefore for major focus on preventive strategies and outreach programmes. Falling government expenditure has adversely affected the lower levels of the Health system, the Clinics. Clinics have the worst level of drug supplies and staff availability. The funds that can and should be tapped for community and Clinic health activities only trickle to the lowest levels of the Health system. The AIDS Levy fund has collected billions of dollars, but the funds in some areas have not reached the intended beneficiary. The CWGH has surveyed its membership and collected strong feedback that people want more investment in prevention, in making essential drugs available, in staffing clinics and District Hospitals and in ambulance services. Community Home Based Care Volunteers, Village Health Workers, Environmental Health Technicians, Community Nurses, Clinic Nurses, District Medical Practitioners and the greater community are vital for the better performance of the Health system. There should be adequate resources to support the working and living conditions of staff, and also for the promotion of community participation and support of community initiatives and input into the Health sector. Greater transparency is needed around the AIDS Levy funds. The public needs to know how much has been collected, where the funds have gone to, who is involved in the distribution and administration of funds at all levels and who has benefited from the funds. 75% of the AIDS Levy should go to the Districts through democratic and effective DAAC and WAAC committees. The National Aids Council Board should follow up, monitor and evaluate the use of funds at District level, to ensure that the funds reach the intended beneficiary at community level. The CWGH is advocating for formal recognition and strengthening of civic and community participation in the health delivery system, in Hospital Boards and Health Centre Committees, with training and information support to enable people to play a stronger role in managing and monitoring their services. The CWGH expresses its solidarity with the Trade Unions and the workers in formal, informal, rural, urban and domestic employment in Zimbabwe. Many work under harsh conditions, and live under even worse conditions. The day commemorates the biggest work related accident at Wankie Colliery Company in 1972 when 427 workers were killed. 30 years later another work related accident at Millennium Towers in Harare confirmed that workers suffer the risk of inadequate Health and Safety protection at work. “Creating and sustaining a culture of health and safety through total participation”