By Michael Andindilile.

Though considered some of the best trained and dedicated in the Southern African region, Zambian doctors are the most underpaid. But it is not their poor salaries (averaging US$250 per month)that dishearten them the most. The hospitals they work in are so run-down that they helplessly watch some of their patients die of minor diseases because the government has failed to provide basic life-saving facilities such as IV fluids or oxygen. Even surgical gloves and painkillers are rare and hospital pharmacies are dry.

The government of President Frederick Chiluba is aware of this pitiful state of affairs, and rather than risk their lives in the country's hospitals (locally dubbed "mortuaries") all senior government officials and their families fly abroad (particularly to South Africa) for better but expensive treatment at the state's expense.

Therefore, the sacking last month of 300 striking junior doctors, while raising serious ethical issues, has highlighted the plight of many African professionals.

The junior doctors, from different parts of the country, began their strike on 20 December, imploring the government to improve not only their conditions of service but the quality of facilities in the country's hospitals where, at times, patients with tuberculosis are made to share the same wards with victims of non-infectious diseases such as malaria.

Some of the junior doctors do not even have official accommodation. At the country's main hospital, UTH, in Lusaka, 30 doctors share four common toilets and one bathroom in an intern's block. They have one room each in the block which some of them share with their wives and children.

Many Zambians, although against the strike, symphathised and backed the doctors' demands. There was widespread outrage at the news of the sacking, particularly after the government announced the immediate recruitment of new doctors from abroad, particularly Cuba. Ironically the imported doctors will be paid tenfold more than what domestic doctors get.

Even after the dismissals, the issues that led the doctors to the strike in the first place remain unresolved. "The dismissal of the junior doctors rather than resolving the matter amicably is tantamount to imposing a death sentence on the sick and those currently in hospital," said Sylvester Tembo, the secretary-general of the Zambia Congress of Trade Unions (ZCTU).

As NA went to press, senior doctors were threatening to down their stethoscopes too, demanding the immediate reinstatement of their junior colleagues. They also want the government to consider the issues raised by the junior doctors, particularly the appeal for better patient care and drug supply.

The local semi-official Times of Zambia newspaper aptly offered the government some advice: "It is accepted in the [Southern African] region that Zambian doctors are highly trained. They are consultants in neighbouring countries where prominent [Zambian] personalities are rushed for treatment. This is the imbalance the doctors want removed. The money that is spent ferrying VIPs abroad for treatment must be spent on bringing drugs and equipment, and to improve salaries of our local experts."

According to the senior doctors, even if ethically and morally doctors should not abandon their patients, the crisis in Zambia shows that governments in Africa should be more responsive to the needs of their professionals and improve their working conditions instead of waiting until things get out of hand. "The brain drain on the continent has done enough harm already", said one of the senior doctors.