Part 1: Beginnings

In the spring of 2009, Zambia’s Anti Corruption Commission reported that employees at Zambia’s Ministry of Health had misappropriated about 10 billion kwacha (about $2 million) meant to fund medical services throughout Zambia. A legislator said this money would have supported the construction of 10 permanent clinics in Zambia. As the investigation continued, the amount of funds missing increased to at least 27 billion kwacha (about $5 billion). Around the same time, allegations surfaced that Zambian President Rupiah Banda used Ministry of Health resources during his election campaign.

In response to these revelations, the Swedes and the Dutch cut off aid money earmarked for Zambia. Sweden froze payments of 59 billion kwacha that was set to be released; the Dutch cut off disbursement of the 92 billion kwacha per year it had planned to donate. These decisions had devastating effects, especially in rural areas: Donor money constitutes 55% of Zambia’s health budget.

Meanwhile, medical workers in Zambia suffered from a chronic lack of staff, medicine, and ambulances. Health workers’ “allowances” -- money given for a specific need, such as housing or purchasing uniforms -- had not been reviewed in 6 years. Over that period, high inflation decimated workers’ incomes. The government’s offer to raise nurses’ salaries by 15% in 2009 did not keep up with inflation over the past two years.

Several government decisions further stoked the anger of Zambia’s health workers. The public chafed at the purchase of 100 hearses from China at the cost of about $30,000 apiece. And the president endorsed a controversial $53 million proposal for mobile health centers when many thought the money would be better spent upgrading existing facilities or funding more health workers. But what really incensed many Zambians was the “mid-term” gratuity of over 400 million kwacha paid to each of the 150 members of the Zambian Parliament.