It’s a beautiful new hospital, gleaming and modern, befitting the wealth of the oil-rich nation of Angola.
Its rooms are furnished with X-ray machines, gurneys, chairs and pharmacy shelves. The signboards are up. The parking lots are ready. The grounds are immaculately landscaped with flowers and plants.
Yet the 125-bed hospital in the provincial town of Matala has sat idle since it was finished by Chinese construction workers late last year. It lacks an electricity connection. It lacks a road to the front door. And most importantly, it lacks staff. Of the 248 staff that the hospital needs, only 44 are available – and they would have to be pulled from existing health posts, leaving clinics elsewhere stretched even thinner than before.
“I don’t believe it will be possible to run the hospital with our available staff,” admits Daniel Cambungula, the district health director. “I’m very concerned with the situation. It’s a brand new hospital and we need to staff it properly.”
This, in a nutshell, is Angola’s dilemma: plenty of money and not enough health care; magnificent new buildings, but no doctors to fill them. Like many other developing nations, it has discovered that oil wealth is not the solution to its problems.
The figures are stark. Angola’s economy is booming, with annual growth of more than 7 per cent since 2004, and has almost the same proportion of its population in the middle class as China. The government’s annual budget of $35-billion (U.S.) is one of the biggest in southern Africa. Yet this hasn’t translated into good health. The average Angolan can expect to live only to the age of 42, one of the worst life expectancies in the world.
Angola’s child mortality rate is among the highest in Africa, with children still dying from preventable causes like measles, tetanus and cholera. It is the only country in the world where cases of urban polio are still recorded. Angola’s child survival rate is as bad as that of Sierra Leone, even though its average income is eight times higher. Two-thirds of its rural population has no access to safe drinking water. And the income gap between rich and poor is among the worst in the world.
Much of this is due to the devastating wars in Angola over the past four decades, beginning with a 14-year war of independence, and then a civil war that raged on for 27 years after independence in 1975.
Since the end of the war, Angola has become a massive producer of oil, rivalling Nigeria as the biggest producer in Africa. This has generated billions of dollars in revenue, not just from oil sales but also from multibillion-dollar loans. China has gained access to Angola’s oil wealth by lending $8-billion for new roads, railways and hospitals, built largely by China’s own companies.
The Chinese-built hospitals – including the empty one in Matala – are impressive showcases for the new Angola. But some health experts are calling them “white elephants”: unnecessary and costly. Instead of showcase projects, the country desperately needs to solve its shortage of doctors, nurses, midwives and other health professionals.
The district around Matala has a population of 230,000, yet it has only a single doctor – a Russian physician named Aydar Nuretdinov who volunteered to serve in Angola because he had always dreamed of working in Africa. He has been in Angola for three years, but he isn’t sure how much longer he will stay.
In the main clinic in the provincial capital, Lubango, there are no Angolan doctors either. Instead the city is dependent on Cuban doctors who are assigned to Angola under a contract between the two countries.
