Angola's ailing national health system hit by oil price cuts
Domingos Ngozulu shudders as he recalls the fate of his baby son. The child was born with breathing difficulties last December in a public paediatric centre in the Angolan capital of Luanda.Grimly aware of the shortages afflicting the country's health system, Ngozulu, a handyman in a residential building, brought latex gloves, dressings and disinfectant to help the baby's care.A day later, the newborn was turfed out of the clinic."The doctor told us that the baby was fine, that he had just drunk some amniotic fluid. There was only one nurse for 20 or 30 patients," said Ngozulu, 32.His son finally died at the Maria Pia hospital, one of the largest public health establishments in the capital, after some days in intensive care. In the decrepit unit, two or three infants sometimes had to share a single incubator.But the grieving family's nightmare was still not over. To Ngozulu's enduring horror, the hospital handed him the body of a different baby.The tale is emblematic of Angola's tottering public health system, grappling a surge in needs and a slump in income."People don't even want to go to the public hospital when they are unwell because they are so scared of dying there and they know that in any case they won't get any medicine," said Adao Goncalve, a 38-year-old driver.In spite of becoming Africa's second largest oil producer after Nigeria, Angola today has the world's highest mortality rate for children under five, with 157 deaths for every 1,000 births, according to the World Bank (2015)."The Angolan health service is free and paid for entirely by the state. There are almost no taxes. But the state budget depends entirely on oil," said Hernando Agudelo Ospina, representative of the World Health Organization (WHO) in Angola.A global decline in the price of oil has deprived Angola of vital resources to such an extent that in April, the regime of President Jose Eduardo dos Santos asked for financial assistance from the International Monetary Fund (IMF)."The health system worked better during the war because humanitarian organisations helped us," observed Ngozulu, referring to a civil war that wracked the southwest African nation for 27 years after independence from Portugal in 1975."After the end of the war in 2002, they withdrew because they believed that the state was rich enough."The crisis in health care has been compounded since December by the worst outbreak of yellow fever to strike Angola in 30 years, increasing the pressure on health clinics.In figures released late in April, the WHO reported that the acute viral disease, which is spread by mosquitoes, had claimed 258 lives out of 618 confirmed cases.With support from the UN body, Angolan authorities undertook a vaccination campaign reaching some six million people, almost all in Luanda, the epicentre of the outbreak. The threat has lessened, Ospina said, but the WHO on April 28 reported that "the outbreak in Angola remains of high concern".Many Angolans are angry about the poor facilities, especially when people are taunted by the flamboyant lifestyle of their veteran head of state, a onetime Marxist, and his billionaire daughter Isabel, said by Forbes magazine to be the wealthiest woman in Africa.Appalling videos on social networks show a never-ending series of families washing their dead, often children, in the courtyard of a Luanda state hospital before placing the bodies in coffins.Turning to a private sector clinic is way beyond the means of a huge majority of people, even from the middle class. The bill for one day's care can easily cost more than $1,000 (865 euros).Sick people "prefer to die at home or resort to traditional medicine," said Goncalve, whose mother-in-law went to hospital with eye trouble and did not come out alive."We still don't know what she died of," he sighed.Said Ngozulu: "It's the law of the strongest, it's the person who cries the loudest who gets cared for first. It's a permanent struggle."For 20 babies who are admitted into hospital, eight or 10 are bound to die."