Jully 2019, Maputo Province, Mozambique, Measles and Rubella Virus Isolation_Serology Laboratory_INS_Mozambique

Diagnostic tests for the new coronavirus are being illegally sold in the main health units in the Mozambican capital, Maputo.

A research conduceted by the Observatório do Cidadão para Saúde (OCS) found that the prices of the tests vary between 1.000 meticais to 1.500 meticais (a US dólar buys 75.26 meticais at current exchange rates).

The scam involves health officials and technicians from the health facilities where the OCS visited after receiving complaints.

This scheme can be witnessed at the Maputo Central Hospital (HCM), the country’s largest hospital, the Mavalane General Hospital, as well as José Macamo General Hospital.

The OCS team found that at least a dozen people take the tests daily, resorting to fraudulent schemes. The OCS decided to do this evidence-finding work after it had received a complaint in January 2021. We believe, however, that these fraudulent acts may have started in previous months and have intensified due to the current scenario marked by the increase in contamination and the growing number of Covid-19 deaths since January.

Covid-19 tests in the private sector cost between 3.800 to 5.000 meticais – a steep and unbearable amount for the large majority of Mozambican citizens living on minimum wage [1].

How does the scheme works?

The first and, perhaps, the most difficult step is to identify among the health workers a member of the test selling group.

After that, the subsequent steps are easy. You just go into the hospital, look for the group members who are part of the scheme and make clear that you arrived at that place through one of the group members.

Entering without having previously had contact with at least one employee who is part of the “scheme” automatically means that you are unable to purchase the test. Therefore, there must have been prior contact with one of the group members before proceeding with the illicit purchase and sale process.

At the hospital, and inside the tent, the patient goes through the common procedure of those who seek testing services: leave the cell phone contact, the residence and all the information that the testing form requires.

The required amount is handed over to the health professionals involved after the test has been carried out. Employees prefer to have it paid in cash and not through electronic money transaction systems (M-pesa or bank account).

Then, the patient waits for the test results which are ready in an interval of between 3 to 5 days.

“I had been to two hospitals, namely, José Macamo and Chamanculo to get tested, but they always said they didn’t have tests. I needed to know about my status and a health technician expressed an interest in taking the test, but suggested I had to pay 1.500 meticais. I didn’t have that amount. I negotiated and paid 2.000 meticais for me and my wife, ”a source told OCS.

IMAGE 1                                                                                          

The image below is of a conversation that was held with one of the actors, after a telephone conversation with one of the members of the group assigned to one of the four health units. In the end, there was interest on the part of whether it would have been possible to take the test.

[1]  The minimum wage fixed for the agriculture, livestock, hunting and forestry sector is 4.390 meticais

IMAGE 2 After obtaining the contact from the message above, the contact of the health professional who would be responsible for assisting in the process of confirming the amounts until payment is made was obtained.

IMAGE 3                                                                       

Test Result Received      

How the scheme arises? Impossibility to test generates demand

Since January 2021, the country has been experiencing an exponential increase in the number of people infected by Covid-19, the same happening in relation to deaths from the disease. That is, the number of people killed by Covid-19. Alone, January 2021 surpassed all deaths recorded in 2020, with at least more than ten people dying daily and hundreds of others becoming infected.

This fact is due to the relaxation of the preventive measures against Covid-19 granted by the President of the Republic, Filipe Nyusi, in December 2020.

This scenario gives rise to an increase in the demand for the test by the population, which, however, does not find a favourable response in the National Health System. People who have had contact with positive cases, are unable to do Covid-19 screening tests.

The lack of tests, the choosing of which patients should be tested, and, of course, the segregation of the most serious in relation to non-serious ones, may have led to the rise of this Covid-19 test sales scheme, which involves at least three employees in each health facility.

Health professional relatives have priority

During the research it was also possible to verify that there is another way of selling tests. It turns out that health professionals have the privilege of testing themselves as well as their families. So many employees include strangers (not family members) taking a test in exchange for money.

In one of the health units, OCS found this type of scheme and even tried to do it using this model, but without success because we didn’t have time to do the test before the survey was closed.

Based on this research, OCS calls on the competent authorities to create a more effective control model for testing, both for health professionals family members, as well as for the sale of tests involving all types of employees, from top to base. Since the public sector in at least the Greater Maputo does not have more than a dozen of sample collection centres for testing Covid-19, it does not make much sense that the few existing services are proving inefficient to satisfy public demand.

The sale of tests harms thousands of citizens who are unable to take a test because they lack the financial means to pay either in the private or in the public sector where this illegal practice flourishes in broad daylight.  

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