HEALTH SERVICE

One of Mozambique’s most prominent doctors, Helder Martins, who was the country’s first Minister of Health (from 1975 to 1980), on Monday warned that the national health service is underfinanced and lacking in qualified staff.Martins was speaking to a Maputo audience, which included President Filipe Nyusi, during a ceremony at which he was granted an honorary doctorate in Health Sciences by the Higher Mozambican Institute of Science and Technology (ISCTEM). Martins has had a remarkable career – he was once a member of the Portuguese navy, but he was court-martialled and sentenced to death in absentia when he deserted and escaped to Tanzania to join the liberation movement.He became a member of the Mozambique National Democratic Movement (UDENAMO), one of the three movements that merged in 1962 to form the Mozambique Liberation Front (FRELIMO).

When he became Minister of Health under Mozambique’s first president, Samora Machel, (In the photo, H.Martins behind S.Machel)his task was to create a health service that would essentially be free of charge, and would serve the mass of the Mozambican people rather than the colonial elite who had benefitted from hospitals prior to independence. The primary health care model built up under his leadership won international recognition from the World Health Organisation (WHO).But Martins said he is saddened at the current state of the health service. “It is very badly treated, under-financed, lacking in essentials, and very inefficient”, he said.Furthermore, although there had been some “slight improvements” in recent years, “in general, there are poor qualifications, and low technical and ethical capacities among the health service staff. Worse still, there is no strategic vision of how to deal with the real health problems of the population”. “A lot has changed for the worse”, he said. “There are more environmental problems, and there is more measureless greed for money and for easy profits through unsustainable forms of development in favour of a small minority, and with no respect for the survival of the poor and of humanity itself”. He thanked Nyusi for his openness towards doctors, and the fact that on Mozambican Doctors’ Day (28 March), “he came to celebrate the date with us, and his cordial and friendly attitude won the hearts of all the doctors”.Martins contrasted this with the hostility towards doctors shown by the previous government, headed by President Armando Guebuza. He accused that government of “an attitude of hostility, lack of understanding and disrespect for the basic rights of doctors, and negligence towards the National Health Service”.Martins believed that doctors could not remain silent faced towards the current situation of political-military tension. “We doctors and other health professionals cannot be resigned when faced with these questions”, he said. “We have to raise loudly our cry for peace. We have to tell the politicians: please reach an understanding!”The conflict between the government and the Renamo rebels had a direct impact on the health sector, and Martins pointed in particular to “the dramatic haemorrhaging of the health budget”. 

Public health depends on political stability and effective peace. “We are not at peace, we have dead and injured”, he said. “Every day there are more kidnappings and murders motivated by political questions and this constitutes a problem for public health”. In response, Nyusi urged Mozambican doctors to seek mechanisms to solve the main problems affecting the health sector.He said Martins was right to raise criticisms, “because doctors ought to pose a strategic vision”. Nyusi asked doctors and other health professionals “don’t bring us problems, bring us solutions”. He regretted that the Statute of Doctors, approved by the Mozambican parliament a decade ago has not met the expectations of doctors “which means that they did not participate in drawing it up, as should have been expected”. Nyusi urged young doctors to follow in the footsteps of Helder Martins, “because he has left a great legacy for the new generation of doctors”.