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Sasa si mgomo tena huu ni mgogoro wa sekta ya afya - hawawezi kututoa hapa

Discussion in 'Jukwaa la Siasa' started by Mzee Mwanakijiji, Feb 8, 2012.

  1. Mzee Mwanakijiji

    Mzee Mwanakijiji Platinum Member

    #1
    Feb 8, 2012
    Joined: Mar 10, 2006
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    Madaktari wanaweza kurudi kazini mara moja na wanaweza kuanza kutoa huduma kama "kawaida" lakini tatizo la msingi ltakwa limetatuliwa?

    Ndugu zangu, mgomo wa madaktari sasa umevuka kutoka kuwasuala la kudai maslahi na kuboresha mazingira ya kazi kwa madaktari wetu nakuwa ni mgogoro wa wazi wa sekta ya afya. Ni mashtaka yaliyo wazi na thabiti yakushindwa kwa sera ya Afya ya CCM. Tunachoona sasa hivi kila mahali ambapomgomo huu umefika ni kufunuliwa kule kushindikana kwa sera hizo. Nitaandikahili la kushindwa kwa sera za CCM katika kuinua na kuboresha maisha yaWatanzania wakati mwingine, inshallah.

    Leo itoshe kusema kuwa mgomo wa madaktari umetufunulia mambombalimbali ambayo kwa kweli yawezekana kwa wengine yalionekana kinadharia kwambali lakini sasa yamethibitika. Jambo la kwanza ambalo liko wazi ni kuwaserikali yetu inaamini kuwa iko juu ya wananchi. Narudia mstari huu tena –kwamba serikali yetu inaamini kuwa iko juu ya wananchi.

    Nadharia kuwa serikali iko juu ya wananchi – the supremacyof the government – ni nadharia ya hatari sana. Nadharia hii tuliiona mwakajana wakati wa mwamko wa Waarab ulipoanza. Serikali za Kiarabu zilipojaribukung'ang'ania madaraka zikajaribu kutumia nguvu sana. Serikali pekee ambayo kwakweli haikutumia nguvu sana dhidi ya wananchi wake ni ile ya Tunisia na Misri,lakini nyingi ya zilizotikiswa zilitumia sana nguvu. Tunaona hili likiendeleahuko Syria chini ya Bashar Assad ambaye anaamini kuwa serikali yake iko juu yawananchi wake. Serikali inapoinuka dhidi ya wananchi wake na kuwakandamiza kwajina la "usalama" au "nchi" basi imesimama dhidi ya wananchi.

    Tunaliona hili katika mgogoro huu ambapo serikali yetu tokamwanzo kabisa ilijaribu kupuuzia na kufanya hoja za madaktari wetu kuwa hazinamsingi. Kwa kweli tukikaa chini kufikiria tunaweza kuona mgomo wa madaktarihaukutakiwa kufika hapa. Ulikuwa ni mgomo ulioanza kwa maamuzi dhaifu yawatawala; maamuzi ambayo yalikuwa yanavumilika miaka nenda rudi – "tumesikiamadai yenu na tunayafanyia kazi". Jibu hili la "serikali inajitahidi kujipangahuku mchakato wa kutatua matatizo uko mbioni" limezoeleka kwa muda mrefuisipokuwa wakati huu. Madaktari walichoshwa na ahadi za "tunafuatilia", "tunajipanga","bado tunatashirikisha wadau" n.k

    Madaktari waliposema kuwa tutagoma serikali ilikuwa nauhakika mkubwa tu kuwa madaktari wakigoma wananchi watalalamika sana namadaktari watakaosa wa kuwaunga mkono na hivyo watu watakuwa upande waserikali. Huko serikalini walikuwa na uhakika mkubwa tu kuwa madaktariwasingeweza kudumu katika "mgomo" wao kwa siku mbili au tatu – walitarajia kuwamgomo ungemalizwa ndani ya wiki moja. Na imani hii ilitiwa moyo sana paleWaziri Mkuu alipojaribu kutumia nguvu ya vimulimuli na ving'ora na kuwapigamkwara wa mbuzi madaktari. Ulikuwa ni mkwara mzuri kuwatisha watu miaka mitanonyuma.

    Niliandika wakati ule kuwa mgogoro huu hauwezi kumalizwa kwanguvu au vitisho na bado nasimamia hilo. Mgogoro huu unaweza kuisha kwamazungumzo ambayo hatima yake ni kufikia makubaliano. Makubaliano ambayoyangegusia maslahi, na mazingira ya kazi. Lakini pia makubaliano hayoyangetanguliwa kwa sharti moja kubwa kuondolewa/kujiuzulu kwa Waziri, Naibu,Katibu Mkuu wa Wizara na Mganga Mkuu.Kwa madaktari viongozi hawa wamepoteza uhalali na msingi wa kuweza kuzungumzana madaktari wakaaminika. Hata sasa, nina uhakika kufukuzwa kwa hawakutatengeneza mazingira mazuri ya mazungumzo ya kufikia makubaliano.

    Jambo la pili ambalo liko bayana kufikia sasa kutokana namgomo huu wa madaktari ni kuwa sekta yetu ya afya ina matatizo makubwa. Kuanziaelimu na mafunzo, ubora wa huduma, upatikanakaji wa huduma hiyo na mfumo mzimawa huduma za afya nchini. Tayari tunajua kuwa baadhi ya hospitali zetu hatazilizokubwa kabisa tayari zilikuwa na changamoto kubwa zikionekana kutokufikiaviwango vya kimataifa vya tiba. Hospitali kama Temeke na Mwananyamalazilishageuka kuwa vituko.

    Tayari tulishajua kuwa mfumo wetu wa afya bado unapendeleamatajiri na wenye uwezo ambao wengi wanaweza kwenda kwenye hospitali binafsi nawale ambao wanalipiwa na serikali hawana tatizo la kwenda nje kwa "check up" nahata kwa matibabu. Tumetambua kwa muda mrefu sasa kuwa inatia aibu kuwa taifaletu hadi hivi sasa halina taasisi ya magonjwa ya moyo ambayo inaendana namahitaji ya nchi yetu – japo miaka michache hii iliyopita tumeona dalili zakuelekea huko. Inashangaza kuona kuwa pamoja na mipango yao yote hakuna hadihivi sasa hospitali za kitafa za watoto (Children's National Hospitals) ambazozingefungua hospitali hizi nyingine za rufaa kuhudumia watu wazima na magonjwaya watu wazima huku watoto wakihudumiwa katika hospitali ambazo zimejengwa kwaajili ya kukidhi mahitaji ya kitiba ya watoto.

    Mgomo huu umefunua bila ya shaka kuwa pamoja na fedha nyingiambazo zinaingizwa katika mambo ya afya bado hatujaweza kweli kweli kutengenezamfumo mzuri wa tiba. Kwa mfano, ni kwa nini hospitali kama ya Muhimbili inawezakwenda hata saa moja bila ya mashine ya CT Scan kufanya kazi na hakuna mtu anashtuka?Inakuwaje kwenye baadhi ya hospitali wanatumia bado vifaa vya kizamani? Nihospitali ngapi ambazo zinapata samani mpya za vyumba vya madaktari nakupumzikia wagonjwa? Inakuwaje karibu kila idara na wizara zinapatiwa magari nasamani mpya karibu kila mwaka na huwezi kwenda kwenye ofisi za wakubwa ukakutaviti vyenye matobo au makochi yaliyochakaa?

    Hivi kama tungekuwa hatupewi misaada ya sekta ya afya hudumahizi leo zingekuwaje. Naomba nitoemifano michache tu ya hali halisi ya afya ilivyo ilivyo:

    Mwaka 2007 Wizara ya Afya na Ustawi wa Jamii ilikuja nampango wa kutaka kuhakikisha kuwa afya ya msingi inapatikana kwa watu woteifikapo mwaka 2017. Mpango huu – MPANGO WA MAENDELEO YA AFYA YA MSINGI (MMAM)kwa jina rasmi. Mpango ulitaka kuwa ifikapo 2012 basi Watanzania wote wawe nauwezo wa kupata huduma ya afya ya msingi. Na miaka mitano ambayo itakuwaimebakia itumike katika kuboresha mafanikio mbalimbali ya mpango huo.

    Taarifa ya Action for Global Health ya mwaka 2010 kuhusu hali ya sekta ya afya nchini kwa kuangalia nafasi yamisaada ya kigeni inadokeza mambo kadhaa ambayo ninukuu sehemu yake moja "Just to name some of the major challenges the healthsector is facing during the coming years: High neonatal death rates areaccounting for 30% of all under-five deaths in Tanzania. With regard toMaternal Mortality rates, there is still no evidence to suggest a decline inthat ratio in recent years. The staffing situation of skilled human resourcesremains glaringly deficient. According to the Health Sector Performance Profilereport 2009, the health sectorwill require a threefold increase in itsworkforce with an annual tenfold increase in hiring rates over the next 10years if it were to successfully implement the MMAM."

    Ripotihiyo hiyo inatudokeza hivi kuhusu bajeti yetu ya afya "In terms of per capitaspending, actual Government spending for health is increasing and is expectedto reach USD 14 (ca. EUR 10) per capita in 2010/11. However, reaching the WHO'sestimated per capita spending of USD 40 (ca. EUR 30) in order to adequatelyaddress health challenges, remains an uphill task. It is worth noting that thebudget allocations are significantly lower than the HSSP III predicted annualgrowth rates of 24% for on-budget allocations. In general, the MoHSW estimatedthat
    therewill still be a funding gap of 24% during the implementation period of theHealth Sector
    StrategicPlan III"

    Naripoti hiyo inaongezea na kusema kuwa "These trends in recurrent anddevelopment budget indicatea significant boom in financing for development projects in the health sector,largely bythe Development Partners, but consequently also reflect Tanzania's increaseddependency on aid in the health sector. It also leads to the question as towhether the Abuja Declaration target of allocating 15% of the national budgetto the health sector should not be further specified, in that it should be seenas a minimum allocation from domestic budgets which should not include foreign aidcontributions to the health sector."

    Ninauhakika watu wengine wanaweza kuangalia vyanzo vingine vingi na kuona hali yetuya sekta ya afya ilivyo. Sasa kama hali iko hivi watumishi wetu wa sekta yaafya wanafanyaje kazi? Kama kuna upungufu mkubwa wa watumishi katika sekta yaafya ni kitu gani basi kinaweza kufanya tuamini kuwa hawa waliopo kwa kukubalikufanya kazi katika mazingira yetu na katika upungufu mkubwa wa hali na malihawajaonesha uzalendo tayari?

    Nikwa sababu hiyo naamini kabisa kuwa matokeo sahihi ya mgomo huu wa madaktarihayawezi na hayapaswi kuwa kuboresha mishahara tu na ahadi tamu tamu za "kushughulikia"matatizo mengine. Haitoshi tu kwa wahusika wizara ya afya kutimuliwa. Matokeosahihi ni lazima yaangalie mfumo mzima wa afya na kuona ni kwa jinsi ganitunaweza kuuboresha na hivyo kuhakikisha kuwa huduma bora ya afya inapatikanakwa kila Mtanzania.

    Nilazima mfumo wa sasa ufumuliwe kabisa na tuanze kujenga kutoka chini na kwakufikiria zaidi jinsi ya kutumia uwezo wetu na raslimali zetu. Hili linahitajiuongozi, maono, ujasiri na uthubutu wa maamuzi. Bahati mbaya sana mgomo huu wamadaktari umetuonesha jambo jingine la tatu – hivyo vitu havipo sasa hivi.Lakini lazima tujiulize – tulipowachagua watu wale wale, kutoka chama kile kile,chenye sera zile zile zikisimamiwa na watendaji wale wale kwanini tulitarajiamatokeo tofauti?

    MPANGO WA MAENDELEO YA AFYA YA MSINGI

    RIPOTI YA HALI YA AFYA YA ACTION FOR GLOBAL HEALTH


     
  2. Companero

    Companero Platinum Member

    #2
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    tatizo la msingi halitatuliki sasa hivi - labda kwa mapinduzi!
     
  3. BAK

    BAK JF-Expert Member

    #3
    Feb 8, 2012
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    Mkjj umeshaisikia hii Serikali hata siku moja kuja na mkakati wa kupambana na tatizo lolote!? Juzi Kikwete kazungumza kwamba Serikali imeishiwa lakini cha kushangaza hakuzungumzia mikakati yoyote ya kupunguza matumizi ya Serikali yasiyo na umuhimu wowote na pia kutafuta njia za kuongeza mapato ya Serikali. Nchi haina uongozi ndio maana inayumba kupita kiasi. Hili la madaktari pia walichukulia kama mzaha.
     
  4. Mzee Mwanakijiji

    Mzee Mwanakijiji Platinum Member

    #4
    Feb 8, 2012
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    Nimeangalia hiyo ripoti ya Action for Global Health ambapo wananukuu takwimu zifuatazo za mgawanyo wa fedha za bajeti kati ya 2006 na 2008

    BREAKDOWN OF HEALTH AID BY SUBSECTOR - COMMITMENTS

    2006-2008
    USD Million average

    Population policy & admin. management 3.5
    Basic health infrastructure 10.6
    Medical services, training & research 5.1
    Family planning 5.9
    Reproductive health care 27.7
    Infectious disease control 77.6
    Basic health care 72.6
    Health policy & admin. management 69.8
    STD control including HIV/AIDS 279.2
    Grand Total 552.1
    Source: OECD Health Focus Charts 2006-2008

    SWALI: Tunatumia kiasi gani katika mafunzo, elimu na huduma mbalimbali za tiba?
     
  5. Hassan J. Mosoka

    Hassan J. Mosoka JF-Expert Member

    #5
    Feb 8, 2012
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    Mwanakijiji Mgomo wa madaktari haupo kwa mujibu wa Kauli ya serikali Bungeni. Waziri Alisema matatizo yamekwisha na mambo ni shwari so kama watz wataendelea na aina hii ya upole na ujinga tutaangamia. Leo/Jana Madam Speaker amekataa kwa jeuri tu kujadili mgomo pale mjengoni na wabunge wooote 300 wakanywea na kuendelea na mambo mengine bila aibu. Nchi imeanguka inatia hasira hata kujadili yanayoendelea sasa.
     
  6. Dr.Chichi

    Dr.Chichi JF-Expert Member

    #6
    Feb 8, 2012
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    kiburi chao ndio kitakachowaangamiza
     
  7. ntamaholo

    ntamaholo JF-Expert Member

    #7
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    kuufumua mfumo mzima wa afya na sekta nyingine nyingi katika jamii yetu, haitowezekana kwa kuwa na aina ya uongozi ambyo tumekuwa nayo kuanzia miaka ya 1980s, uongozi unaamini katika kupewa misaada na wafadhili. Wafadhili wanakuja na masharti yao, na hawawezi kutufadhili kwa kiwango tunachokihitaji kubadilika.

    Tanzania tunajiweza kwa mali, ila tumokosa kwa mda mrefu viongozi wanaojali mali tulizonano zinazoweza kutupatia vitu tunavyovihitaji, mabadiliko tunayoyahitaji katika jamii yetu, si idara ya afya tu, hata idara nyingine ambazo utendaji wake hauna tija kwa maendeleo ya taifa
     
  8. K

    Kanyafu Nkanwa JF-Expert Member

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    Mjj kujiuzulu watendaji wakuu hakuwezi saidia hata kidogo. Muhimu na major overhaul ya system.
     
  9. Michael Scofield

    Michael Scofield JF-Expert Member

    #9
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    Sikio la kufa halisikii dawa.
     
  10. ntamaholo

    ntamaholo JF-Expert Member

    #10
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    ni aibu kubwa kipengele cha huduma za afya, mafunzo na utafiti na kipengele cha miundombinu
     
  11. ntamaholo

    ntamaholo JF-Expert Member

    #11
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    walimu nao wameomba site kwa bajeti ijayo, kima cha chini iwe 500,000 huku mwalimu akipewa asilimia kadhaa za kufanya kazi mazingira magumu na posho ya ufundishaji. Mwakani patanoga. Bado majeshi tu
     
  12. Ngisibara

    Ngisibara JF-Expert Member

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    Naamini ni,.......Medical services, training & research 5.1

    Halafu angalia Health policy & Admin Management eti 69.8
     
  13. I

    IPECACUANHA JF-Expert Member

    #13
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    As far as I understand there is a serious gap between people in the leadership and the rest of the community. The leaders are getting it wrong more than often in almost everything. It is obvious that the minister is not informed not only on the doctors issues but operational issues at the ministry. It is also true that the level of arrogance that Principal Secretary has shown disqualifies her from that post and wonder we see Chief Medical Officer like a Zombi from vilima vya Kolelo. CMO is steped on right,left,center and on top. Their intercept is MONEY obtained from scrupulous deals and their personel relation to the president. In this scenario nothing can be managed at the Ministry of Health and as a result people are dying and the ones am seeing around who are continuing with what they are doing, are doing that because they are not able to comprehend the risk they are in just because there is no one to attend their medical problems because of the strike. Am Scared.
     
  14. Gwalihenzi

    Gwalihenzi JF-Expert Member

    #14
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    Kwani 'major overhaul' ya system inaanzia wapi kama sio kujiuzuri watendaji wakuu?
     
  15. Tausi Mzalendo

    Tausi Mzalendo JF-Expert Member

    #15
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    Limeshaanza! CWT imeshaiambia serikali iwaongezee walimu mshahara kwa asilimia 100 vinginevyo mgomo waja!
     
  16. Maishamapya

    Maishamapya JF-Expert Member

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    Ngoma inogile! Tatitzo la serikali ya JK ni ku-major on minor issues and to minor on major issues.
     
  17. G

    Gagnija JF-Expert Member

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    Kama taifa, kuna mahali tulikosea kwenye usimamizi na mgawanyo wa rasilimali zetu. Utatuzi wa tatizo hili kwa mapinduzi nao utategemea lengo la mapinduzi hayo, na yanaongozwa na watu wa aina gani.
     
  18. Saint Ivuga

    Saint Ivuga JF-Expert Member

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    halafu wanaoumia ndio sisi sisi tuliowachagua watu wale wale
     
  19. P

    Petu Hapa JF-Expert Member

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    Sawa. Lakini mabadiliko hayo yafikiriwe kwa ujumla wake - maana sekta nyingi sana tanzania zinahitaji kufumuliwa, mojawapo ikiwa elimu. Sidhani kama tunaweza kupata ufumbuzi kwa kuangalia sekta ya afya tu. Tunapaswa kutambua, kuuthubutu na kukubali kwamba taifa la Tanzania linaumasikini ambao usipopewa kipaumbele, ndoto ya kuwa taifa linalojitegemea ni za Abunuwasi. Ni vyema tukumbuke, nje ya utandawazi, Taifa bado ndio mipaka ya miingiliano ya kiuchumi na hao wananchi ndio dhana ya upambanaji katika kuendeleza taifa lolote lile ndani ya mfumo wowote ule. Sasa, hatuwezi kukimbia muono utakao chambua mfumo. Na ili tanzania itoke hapa, kupitia mfumo wowote ule hata kama ni wa kipebari - ubepari huo usipokuwa wa kitaifa kuangalia na kulinda maslahi ya taifa - hasa wananchi wanaoweza kukupa nguvu kazi, tanzania tutabaki kuwa omba omba tu.
     
  20. Mnama

    Mnama JF-Expert Member

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    Feb 8, 2012
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    Serikali iko likizo ndefu hapa tumeliwa
     
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