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Saturday, 19 July 2014

Are some lives worth more than others?

On 3rd January 2011, PF President Michael Sata wrote to President Banda following his wife's treatment in South Africa arranged by the Zambian government. He expressed "profound gratitude" to President Banda for "the consideration, compassion and care extended to [Christine Kaseba] during the period of her illness and stay at Milpark Hospital". Mr Sata was particularly "pleased to see that [Christine Kaseba's] life was saved due to the government’s prompt action to evacuate her".

The action by President Banda to evacuate Christine Kaseba clearly created difficulties for Mr Sata because it meant Mr & Mrs Sata owed their lives to two separate taxpayer funded evacuations at expensive hospitals in South Africa. All down to the MMD government's policy of foreign evacuations for the political elite. A point Mr Sata could not resist to underline in his "letter of thanks" to President Banda :
"I would like to re-state my long held view about access to specialist treatment abroad. I said it after my return from South Africa in April 2008 following my heart condition that our government must invest in this area both in terms of human capital and equipment so that access to such specialist treatment does not continue to be a preserve of the privileged few in our country. It is, therefore, my considered view Your Excellency that health care must become a human right by law for our people and not a privilege after 46 years of independence".
President Banda responded to Mr Sata on 14th January, 2011, accepting thanks and underlining his belief that "the good values of humanity should rise above political belief and persuasion when we are faced with matters of human life". However, he "found it rather disappointing that [Mr Sata] decided to mix the issue of gratitude and the shortfalls of our health care system in Zambia". In his view, "the issue surrounding the evacuation of [Christine Kaseba] was an emergency which should ordinarily not be confused with the issue of the poor state of our health system in Zambia".

I think it is clear that President Banda's argument for evacuating Christine Kaseba rather than another suffering boy in Kashikishi was poor. In Zambia we are surrounded by health emergencies. So what made Christine Kaseba's emergence more important than other cases? Who decides who lives?

It should also be said that Mr Sata's position was entirely consistent with wider thinking within the PF at the time. PF was clear in its manifesto that under its government there would be "massive increase in staffing levels" and more medical equipment and ICUs. Crucially, rather than fly patients abroad, PF proposed to develop “a system of inviting specialists from abroad”. Though it never explained how this would work without facilities!

That of course has not happened. Zambians continue to see high profile individuals whisked abroad for medical treatement at the discretion of the sitting president. Many ageing traditional leaders with strong political influence regularly tour hospitals in India and South Africa at significant cost to tax payer. Chieftainess Nkomenshya has just returned. We do not know how much has been spent on such foreign medical trips. Perhaps a clever MP will raise a parliamentary question after reading this.

It certainly does raise an important question: are some lives more valuable than others? It seems in Zambia, the political elite and their friends are clearly more valuable than ordinary Zambians. The low life party cadre is worth nothing compared to his political master living the "high life". This is the message we get from constantly observing the ever expanding contingent of Zambia's elite receiving special treatment at tax payers expense.

The current situation is wrong morally and economically. On purely moral grounds, sending politicians and chiefs abroad for special treatment on tax payers expense is wrong because it robs the poorest members of society valuable medical care. Money spent on politicians and chiefs abroad is not free, it has an "opportunity cost". That money could be spent on saving hundred more lives within Zambia from curable diseases.

It is also wrong because it sends the wrong message that long health is only for privileged few. The life expectancy in Zambia for 70% of Zambians living on $2 a day is no more than 45 years at best. Many of our privileged politicians live well beyond 65 years. The message appears to be that we care more about preserving the health of those older but rich political elites than diverting the resources to fight infant mortality and targeted interventions for the poor.

The economic argument against repeated foreign medical referrals for our politicians and chiefs is even more straightforward. Sending politicians abroad distorts the economic incentives of our politicians to improve our health systems. The politicians are not only sent abroad because our health system is weak, our health system is weak because we keep sending politicians abroad.

Let these political actors experience our poor health system, may be just may be, they may do something about it. As they say, our jails will never improve until we start sending politicians there. The same goes for hospitals. We actually need more politicians and their friends in our hospitals before things can start improving. At the very least let them fund their own trips not using tax payers!

Chola Mukanga
Economist | Consultant | Researcher 
Copyright © Zambian Economist 2014

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