The International Narcotics Control Board¹⁶ has published the following figures for the consumption of narcotic drugs in Zimbabwe (2002): codeine 235 kg; morphine 10 kg; dextropropoxyphene 49 kg; tilidine 1kg; pethidine 35 kg.

For the years 2000-2002, the average defined daily dose consumption of morphine for statistical purposes (S-DDD)¹⁷ in Zimbabwe was 13. This compares with other African countries as follows: Swaziland 1; Egypt 2; Uganda 4; Namibia 73; South Africa 103. Twenty nine countries reported no morphine consumption during 2000-2002 (Table 2).

 Island Hospice Harare uses the WHO pain ladder and keeps a supply of morphine for patients who are unable to collect the drug from the government hospitals of Pariryanetwa and Harare. A local firm produces morphine whenever powder can be imported, although availability is erratic. The hospice doctor writes a prescription after discussion with a nurse. The Ministry of Health and the Drug Control Council have given permission for a hospice nurse to prescribe drugs falling within the Dangerous Drugs Act providing the prescription is validated by a hospice doctor. Island Hospice Bulawayo does not prescribe morphine. The service liaises with the patient’s doctor who prescribes the necessary morphine. Island Hospice Mutare does not prescribe morphine.

Table 2 Average daily consumption of defined daily doses (for statistical purposes) of morphine per million inhabitants, 2000-2002: countries of Africa

Source: International Narcotics Control Board (2000) Narcotic Drugs: Estimated World Requirements for 2000. Statistics for 1998. New York: United Nations

 Bekezela Community Home Based Care has access to doctors at Inyati District Hospital. These doctors prescribe morphine in injectable and MST forms; volunteers administer paracetemol and aspirin.

 Dananai Home Based Care (Murambinda) has access to three doctors at Murambinda Mission Hospital, who may prescribe liquid morphine.

 Family AIDS Caring Trust (FACT) has three qualified nurses who have responsibility for morphine prescription, supervised by a volunteer doctor.¹⁸

Lubancho House is limited to the administration of paracetemol; morphine is difficult to access and the hospital supply is frequently exhausted.

 Morgenster Mission Hospital does not prescribe morphine to home care patients. If a patient is taking morphine on discharge from hospital, relatives are able to collect repeat prescriptions (tablets and syrup) as required