In 2014 when Levy Mwanawasa Hospital built by China on the Great East Road in Lusaka opened, it was meant to be the best. Eight years later, the imposing white-walled hospital, five kilometers east of the centre of Lusaka, is a casualty of a Zambian health-care system riddled with corruption and damaged by poor funding.

MakanDay had been told about allegations involving an ‘army of crooks’ at the hospital’s radiology department that are robbing Zambians of their aspirations for a healthy life. 

To prove these allegations, MakanDay Centre for Investigative Journalism prepared one of its reporters to pose as a patient needing Computerised Topography (CT) scan services.

Unraveling what goes on behind the walls of Levy Hospital

When she arrived at the hospital to find out how she can be assisted, one of the workers who offered to help advised her to return the next day.

Once our reporter had gained access to the radiology department, she obtained clearest evidence of how workers in the department have turned it into a cash-cow, depriving government of the much-needed revenue needed to keep the hospital running.  

At the reception is a huge coloured poster tacked to the wall. It carries a simple but powerful message: “Corruption leads to shortage of medicines, unfairness and poor service.”

But it is of no use. Every day, workers here solicit and receive bribes from patients who require express medical services for their ailments.

Inside the radiology department

When our reporter returned to take up an appointment, she made for the hallway leading to the radiology department where she was welcomed by a fine-looking young lady in her early thirties. She learnt later that the lady is one of the people working in the department.

Located on the first floor, the radiology department is a hive of activity. It is in fact one of the most active departments of the hospital.

According to our reporter, patients who are not registered with the National Health Insurance Management Authority (NHIMA) scheme, are the most vulnerable, and radiographers have taken advantage.

Although payments are made at the department and receipts are issued, it is not clear the money that is generated is paid into the hospital account.

Some patients are turned away

While at the hospital, our reporter said she witnessed several patients in need of CT scan being turned away under the pretext that the machine was being serviced.

CT scan is a specialised x-ray used to detect bone and joint problems, like complex bone fractures and tumors.

For example, if a patient has a condition like cancer, heart disease, emphysema, or liver masses, CT scans can spot it or help doctors see any changes.

With a CT scan, the machine circles the body and sends the images to a computer, where they’re viewed by a technician.

The current state

Currently, Zambia only has two publicly available functional CT scan machines - at the University Teaching Hospital (UTH) and Levy. But at the time the story was being put together, the machine at UTH was dysfunctional and all patients were being referred to Levy.

Our reporter was able to get the scan done on the same day, just a few minutes after she had arrived at the hospital.

"I was assisted to get the CT scan done for K900 by the lady who had advised to call her as soon as the money was ready,” she said.

The contrast liquid used to enhance x-ray images, which is injected into the patient through the vein cost K500.  She paid K1,400 for both the scan and the liquid.

The official hospital rate is also K900 for patients who require CT scan but are not on the government health scheme.

Because the contrast is out of stock at the hospital, a receipt was therefore not issued. What is not clear is where the radiographers sourced it.

The MakanDay reporter said the procedure took about five minutes, and after that, she was handed a CD. She was also advised to go with it to a private hospital for the quick results, as it requires 10–14 working days for Levy to issue them.

She revealed that the K900 for the scan was handed to the radiographer in a discrete room. The receipt was provided to her after it was arranged through someone in the accounts department.

MakanDay has established that the racketeers, include those working in the accounts department, as apparently genuine government receipts are issued by them.  

The medical superintendent at Levy was asked to comment on the matter but he referred all questions to the Ministry of Health Permanent Secretary (PS), who also redirected MakanDay to the hospital.

“How can I answer for Levy Mwanawasa when I’m sitting at Ndeke house?” Asked Professor Lackson Kasonka, PS in charge of technical services. “There is a full-fledged director who runs the whole institution who can provide answers.”

What has further been established is that hospital management is fully aware of the problem. Past efforts to deal with the problem, include transfer of staff to other departments, according to a well-placed source within the hospital.

He said at one time, workers in the radiology department used to work until 22:00 hours, executing their own commercial activities using state resources.

Testimony from other patients

A victim who also had to pay for the scan directly to radiographers, told Makanday that what was happening at Levy is an example of what has become of the Zambian health sector.

She said when she went to Levy to ask about the CT scan, a lady who offered to assist gave her the phone number to call once she had the money.

“I thought that was the procedure for those who are not on (NHIMA),but when I entered the room, I was surprised to find two radiographers arguing over the payment,” she said.

She expressed regret that nothing is being done to stop some health workers from stealing money that is meant to improve health services in government hospitals.

Main photo by Peng Weiwei