A cancer survivor, a father fighting for his child’s life, and overwhelmed doctors all share one message: Zambia’s healthcare system is failing those who need it most.
The Ministry of Health says it has installed new CT scanners across nearly all provinces and is upgrading cancer treatment facilities. But a closer look reveals a stark reality: many public hospitals remain crippled by broken equipment, a shortage of radiologists, and life-threatening delays in diagnosis and treatment.
Meanwhile, Zambian politicians continue to fly abroad for medical care—funded by taxpayers—while ordinary citizens endure months-long waits for scan results or are forced to seek help at expensive private hospitals.
According to the Ministry, sixteen new CT (computed tomography) scanners have been procured and installed countrywide, ensuring that every province—except Western Province’s Lewanika General Hospital—now has at least one unit. Officials say installation at Lewanika is planned soon, aiming to reduce the long travel distances patients currently face to access CT scan services.
Additionally, a state-of-the-art 3.0 Tesla MRI machine is being installed at the University Teaching Hospitals (Adult Hospital section), and a new MRI scanner has been procured for the Cancer Diseases Hospital in Lusaka. Magnetic Resonance Imaging (MRI) is an imaging technology often used for disease detection, diagnosis, and treatment monitoring.
The Permanent Secretary, Dr. Kennedy Lishimpi says in statement that this is part of broader upgrades to improve radiotherapy services and provide advanced treatment options for cancer patients.
However, a MakanDay investigation has found that despite these developments, many hospitals across the country continue to suffer from critical shortages of essential medical equipment. The consequences for patients are often severe—many die or see their conditions deteriorate while waiting for diagnoses and treatment that are delayed due to equipment shortages.
A 2021 study by the University of Zambia School of Health Sciences and Midland University Hospital Tullamore painted a stark imbalance in the distribution of CT (computed tomography) scanners. Most of the machines are concentrated in Lusaka, with none available in the Western and Central provinces at the time.
The study also revealed that only 46% of CT scanners in public hospitals are functional and covered by service contracts, compared to 89% in private hospitals. According to WHO, a CT scan—or computed tomography—is a crucial diagnostic tool, particularly for children, as it provides fast and reliable imaging for conditions affecting the head, chest, abdomen, pelvis, and bones.
This crisis is further worsened by a critical shortage of qualified radiologists and alarmingly long waiting times for CT scan reports—an average of 76 hours in public hospitals compared to just 24 hours in private facilities. Radiologists are specialist doctors trained to interpret diagnostic imaging results.
The poor state of equipment and services in Zambia’s public hospitals may help explain why some well-off citizens — including politicians — have been direct beneficiaries of government-funded medical treatment abroad, particularly in South Africa and India.
A 38-year-old Zambian doctor, who requested anonymity for fear of government reprisal, described the daily frustration of turning patients away due to limited resources.
“It is always frustrating when you have to face patients and their relatives about what they need to do or tests they need, which are not offered in Zambia, especially advanced cardiac or surgical procedures,” the doctor said.
Zambia, with a population of nearly 20 million, has only one hospital currently providing comprehensive cancer care — the Cancer Hospital at the University Teaching Hospital (UTH) in Lusaka A second facility, the Ndola Cancer Hospital, is under construction along the Ndola-Kitwe road on the Copperbelt, and a versatile CT scanner is also expected to be commissioned at the Copperbelt cancer treatment centre once the hospital is completed.
Opened in 2006 and inaugurated in 2007, the cancer hospital in Lusaka has long struggled with outdated and non-functional equipment, forcing the country to revert to a pre-2006 state, when the hospital was first established.
In January 2023, Dr. Lishimpi—then Senior Medical Superintendent at the cancer diseases hospital—told a local radio station that much of the radiotherapy equipment installed in 2006 had not been upgraded. This outdated technology, he said, severely limits the hospital’s capacity to treat the broad range of cancers diagnosed in Zambia.
Dr. Lishimpi, now Permanent Secretary at the Ministry of Health, also revealed that although approximately 13,800 people are diagnosed with cancer each year, only around 3,000 are able to access treatment at the Lusaka facility due to resource constraints.
As the saying goes, ‘prescription without diagnosis is malpractice, whether in medicine or administration,’ many patients in Zambia have either died or seen their conditions worsen while waiting for a diagnosis or report.
Chola Bweupe Senior, a cancer survivor from Lusaka’s Olympia Extension, is a living testimony to the impact of inadequate diagnostic services on health care delivery in Zambia.
He was diagnosed with breast cancer—a rare condition in men—in March 2021, following surgery on his left breast at Levy Mwanawasa University Teaching Hospital.
After the operation, his removed breast tissue and six lymph nodes were sent to India for testing to determine whether the mass was cancerous.
“The results came back after three weeks, confirming that the mass was indeed cancerous and that the cancer had progressed to stage three,” Bweupe recalled.
Following the diagnosis, he was referred to the cancer diseases hospital in Lusaka for further treatment. However, he could not undergo the recommended radiotherapy because the diagnostic machine was out of service.
“With the radiotherapy machine unavailable, the doctor placed me on chemotherapy, which I completed over six months,” he said.
Bweupe commended local medical professionals but lamented the lack of equipment and essential drugs.
“I have a lot of trust and respect for our Zambian doctors. What hinders their performance is the lack of diagnostic equipment and medication,” he said. “We have very good doctors, but without the right tools, their hands are tied.”
Bweupe’s experience is not unique. Dyson Goma of Lusaka’s Chilenje South, a reverend in the United Church of Zambia, shares a similar struggle.
His two-year-old son, who was being treated for a tumour at UTH’s children hospital, faced delays in receiving necessary tests. With the CT scan at UTH down, the family turned to a private hospital, but they were told they would have to book two weeks in advance.
The test was conducted at a private hospital because the Computed Tomography (CT) scan at the University Teaching Hospitals (UTH) was down.
“At Maina Soko Medical Centre, we were told we needed to book two weeks in advance,” Rev. Goma recalled. “Meanwhile, the doctor had warned that the tumour was growing rapidly.”
When the results were finally received, it took nearly a week for them to be interpreted, during which time the child received no medication. Rev. Goma explained that the tumour grew during this period, and the child had to start chemotherapy.
He emphasises that Zambia’s healthcare system lacks sufficient diagnostic services, stressing the urgent need for improved access to ensure timely care.
“I had the opportunity to meet other patients, and it was heartbreaking to hear their stories of being turned away because the machines were down,” he said.
A 2021 study confirms the dearth of diagnostic services in Zambia, particularly focusing on CT scan services. Titled “An Audit of Computed Tomography (CT) Services in Zambia” (https://mjz.co.zm/index.php/mjz/article/view/69), the study found longer waiting times for CT reports in public hospitals compared to private ones.
CT technology has been available in Zambia since 1994 as part of the healthcare delivery pathway. Radiographers perform CT scans to diagnose diseases, injuries, and to plan for radiotherapy treatments. The study revealed that the Western and Central provinces lacked CT scanners, with most facilities concentrated in Lusaka Province.
The results showed that 59% (13) of CT scanners were located in the public sector, while 41% (9) were in the private sector. In public hospitals, only 46% (6) of these CT scanners were functional and had service contracts, compared to 89% (8) in private hospitals. Additionally, 61.5% (8) of public hospitals had maintenance schedules, while 89% (8) of private hospitals adhered to maintenance schedules.
The study also revealed that only seven facilities had radiographers qualified in CT, and 12 out of 22 facilities had a radiologist. The average waiting time for CT reports was 76 hours in public hospitals, compared to just 24 hours in private hospitals.
While Zambia has made progress in equipping hospitals with diagnostic tools like CT scanners, the lack of skilled human capital to interpret the results remains a barrier to timely healthcare access.
Radiological Society of Zambia president, Eddie Mwansa, noted that while the government has procured CT scanners for general hospitals in all provinces, the challenge lies in the shortage of professionals who can interpret the images.
“The trained and experienced human capital is concentrated along the line of rail,” he explained.
Mwansa added that the shortage of skilled staff for interpreting diagnostic results leads to delays in treatment.
“There is usually a delay of up to three months before patients receive their results, and some succumb to their conditions during this wait,” he said.
He recommended that the government train more professionals, particularly radiographers, to address the shortage.
“The political will is there to improve the situation,” he stated. However, he pointed out that some resistance from doctors to allow radiographers to interpret images is also contributing to delays in patients receiving their test results.
His Secretary General, Nchete Kapapa, reiterates that the critical issue is the lack of adequately skilled professionals to interpret reports.
“UTH had two radiologists, but one retired and has only been recalled on a part-time basis. When you send a report to a radiologist, it can take weeks to be interpreted, which impacts patient results,” Mr. Kapapa explained.
The Resident Doctors Association of Zambia (RDAZ) also shares concerns about the country’s inadequate diagnostic services.
RDAZ president Mweushi Mpande attributes the issue to poor maintenance and the influx of patients, which places additional pressure on the available equipment.
“The issue of radiological services is multifaceted. For a long time, we didn’t have CT scanners or MRI machines. At UTH, the CT scanner was down for five years, and at the Cancer Diseases Hospital, it was working intermittently,” Dr. Mpande noted. “It is crucial to offer urgent services to patients. It is disheartening for a practitioner to look at a patient helplessly because treatment cannot begin without diagnostic results.”
He emphasised that the root of the problem lies in poor maintenance and the overwhelming number of patients, which strains the equipment.
“I am aware that the government is procuring more diagnostic equipment, but the real question is what strategy is in place for maintaining this equipment,” Dr. Mpande said.
Dr. Mpande also pointed to potential conflicts of interest among decision-makers, adding that some have ties to private medical facilities and may not prioritise addressing the issue in public hospitals.
“With NHIMA (National Health Insurance Management Authority), some decision-makers direct patients to private health facilities where they have a vested interest,” he explained. “They may not be keen on purchasing or maintaining equipment in public hospitals.”
He also questioned the frequent practice of referring patients abroad, suggesting that instead of sending patients overseas, Zambia could invest in acquiring the necessary equipment. “This is all because someone is benefitting,” he added.
Dr. Mpande believes that procuring more diagnostic equipment will improve the delivery of timely and quality healthcare. While he acknowledged the shortage of radiologists to interpret diagnostic reports, he noted that there has been progress since the establishment of the Zambia College of Medicine and Surgery (ZACOMS) in 2017, which has trained over ten radiologists.
According to the health ministry, these systemic challenges are being addressed. As part of the efforts, 47 digital x-ray units have been installed to replace outdated analogue systems introduced in 2005. This upgrade has significantly improved radiological diagnostics, particularly for conditions such as tuberculosis and trauma.
“Provinces like the Copperbelt and North-Western now boast modernised radiology services,” said Dr. Lishimpi. “Going forward, rural areas that still rely on older machines will also receive new equipment.”
The doctor called for greater investment in the health sector, stressing that it should not be the government’s responsibility alone. He urged the government to implement policies that encourage private sector involvement.
“For example, why not offer tax holidays to companies that establish specialised hospitals? Why should such incentives only apply to mines or supermarkets?” he asked. “Why not allocate a portion of the Constituency Development Fund (CDF) to support doctors in setting up clinics in underserved communities?”
“Look at the Citizens Economic Empowerment Commission (CEEC)—every sector is represented except health. Increased private sector participation would ease the burden on public facilities and improve access to healthcare,” he added.
Zambian Politicians Opt for Treatment Abroad, Shunning Local Hospitals
Zambian leaders, including former president Edgar Lungu, have frequently sought treatment in South Africa, sometimes at public expense. This trend has drawn criticism, with one medical doctor remarking that “they have no confidence in their own healthcare system.”
Healthcare at South Africa’s private clinics is not cheap. For example, the tariff schedules at various hospitals show that a private ward — often used by senior Zambian officials — costs R5,000.00 (K7,200 at the current exchange rate) per day.
Although Zambia’s healthcare system is intended to be universally accessible, in reality it suffers from chronic underfunding, severe shortages of essential medical supplies, and a limited number of doctors and nurses.
The trend of government-funded medical evacuations predates recent administrations. While still in opposition, the late President Michael Sata and his wife, Christine Kaseba-Sata, received medical treatment in South Africa at the government’s expense.
In January 2011, Sata wrote to thank then-president Rupiah Banda for evacuating his wife for treatment. However, he added the cheeky implied criticism that “healthcare must become a human right by law, [rather than being] for the privileged few, after 46 years of independence”.
Other top politicians who have benefited from government-funded treatment abroad include former presidents Frederick Chiluba and Rupiah Banda, as well as the late Local Government Minister Ben Tetamashimba. The most recent is Edith Nawakwi, former Finance Minister under Chiluba’s government and president of the opposition Forum for Democracy and Development (FDD), who died recently at a hospital in South Africa.
Breaking from this pattern, the late President Levy Mwanawasa opted not to travel to South Africa for medical check-ups. Instead, throughout his eight-year presidency, he flew to England for treatment.
Public service sources say treatment junkets abroad by Zambian politicians have cost taxpayers billions of kwacha.
The image is AI-generated and is for illustrative purposes only.
This story was written by a fellow in MakanDay’s 2024 training programme.
Discover more from MAKANDAY
Subscribe to get the latest posts sent to your email.
