Zimbabwe is—and is in—a problematic state. Once the breadbasket of Africa, the country’s population is suffering the consequences of government policies that have seriously affected its people’s health and quality of life.
With inflation rates soaring at an unprecedented 231 million percent, the country is trapped in a political impasse that seriously affects the humanitarian situation and demands urgent measures to avoid a catastrophe.
Hopes for a political settlement following the power-sharing agreement between President Robert Mugabe and opposition leader Morgan Tsvangirai are quickly being dashed following these adversaries’ incapacity to agree over control of the most important ministries, such as defense, home affairs, and finance.
In the meantime, the health situation in the country continues to deteriorate, affecting mainly children and those most vulnerable. The United Nations estimates that more than 5 million people—almost half of the country’s population—is in need of food aid. Eighty-three percent of Zimbabweans are living on less than two U.S. dollars a day, and 45 percent of the population is malnourished, according to the U.N. World Food Program.
Rachel Pounds, Save the Children’s Zimbabwe country director, has called attention to the increasing malnutrition level among children and to the need for increased food aid. Many children are eating rats or some inedible roots such as makuri—which is riddled with toxic parasites—to control hunger, according to that agency. That root has no nutritional value and provokes terrible stomach pains.
Lack of proper nutrition seriously affects people’s immune systems and makes them more vulnerable to illnesses. This is particularly important for those with HIV/AIDS, which affects one in five adults in Zimbabwe—the country with the fourth-largest rate of HIV infection in the world.
Only a third of the 300 000 Zimbabweans who need antiretroviral drugs are now receiving them. Lack of adequate statistics makes it difficult to follow the course of the epidemic.
Critical as is the situation in Zimbabwe’s main cities, it is even more critical in rural areas. There is a tremendous lack of basic materials, refrigerators, medicines, and medical personnel. Ambulances are grounded for lack of fuel and spare parts. Many of the rural clinics have been left under the supervision of nurses’ aides, who lack the knowledge and means to treat most patients.
Significant gains in child health in the 1980s are being eroded, according to the World Health Organization (WHO). Under-5 mortality rose from 80 per 1,000 live births in 1990 to 123 per 1,000 in 2005. Immunization programs now cover less than 70 percent of children for some major childhood diseases such as polio, diphtheria, and measles. Approximately 115 000 children under 14 years of age are infected with HIV, according to UNICEF.
Doctors have been leaving the country in droves because of low salaries and bad working conditions. The Zimbabwe Association of Doctors for Human Rights (ZADHR) declared on June of 2007, “It can no longer be said the health service is near collapse. The emptying of central and other hospitals of staff, and therefore patients, means the health service has collapsed.”
The food crisis has had a significant impact on children’s education. Many children drop out of school because they cannot afford to go, because they need to work for food, or because their teachers cannot afford the journey to the schools. In addition, many teachers have become HIV-infected.
This is a sad state of affairs for a country whose public health system was, together with South Africa’s system, among the most developed of most of the 40-odd other nations of sub-Saharan Africa, as I was able to see during a visit to the country in the mid 1980s.
While people’s rights in their widest sense have been systematically abused, President Mugabe has strongly denied any criticism of his policies. He has repeatedly declared, “Let me say once again that the West should spare us their lessons on human rights. They don’t have the moral authority to parade themselves as torchbearers of human rights.”
Zimbabwe needs massive foreign assistance to overcome this crisis. But the government has placed serious restrictions on the work of aid agencies. Although foreign aid is critical, it is up to Zimbabwe’s new unity government to lead the country out of this juncture, and restore what was once a model public health system.
Dr. César Chelala is an international public health consultant.