By BOB HERBERT
New York Times
Published: January 16, 2009
If you want to see hell on earth, go to
the madman Robert Mugabe has brought the country to such
a state of ruin that medical care for most of the
inhabitants has all but ceased to exist.
Life expectancy in
world: 37 years for men and 34 for women. A cholera
epidemic is raging. People have become ill with anthrax
after eating the decaying flesh of animals that had died
from the disease. Power was lost to the morgue in the
capital city of
Most of the world is ignoring the agony of
once prosperous and medically advanced nation in
economic turmoil - and the brutality of Mugabe's long
and tyrannical reign.
The decline in health services over the past year has
been staggering. An international team of doctors that
conducted an "emergency assessment" of the state of
medical care last month seemed stunned by the
catastrophe they witnessed. The team was sponsored by
Physicians for Human Rights. In their report, released
this week, the doctors said:
"The collapse of
unprecedented in scale and scope. Public-sector
hospitals have been shuttered since November 2008. The
basic infrastructure for the maintenance of public
health, particularly water and sanitation services, have
abruptly deteriorated in the worsening political and
Doctors and nurses are trying to do what they can under
the most harrowing of circumstances: facilities with no
water, no functioning toilets and barely any medicine or
supplies. The report quoted the director of a mission hospital:
"A major problem is the loss of life and fetal wastage
we are seeing with obstetric patients. They come so
late, the fetuses are already dead. We see women with
eclampsia who have been seizing for 12 hours. There is
no intensive care unit here, and now there is no
intensive care in
"If we had intensive care, we know it would be
immediately full of critically ill patients. As it is,
they just die."
Mugabe's corrupt, violent and profoundly destructive
reign has left Zim-babwe in shambles. It's a nation
overwhelmed by poverty, the H.I.V./AIDS pandemic and
hyperinflation. Once considered the "breadbasket" of
own people. The unemployment rate is higher than 80
percent. Malnutrition is widespread, as is fear.
A nurse told the Physicians for Human Rights team: "We
are not supposed to have hunger in
though we do see it, we cannot report it."
Mugabe signed a power-sharing agreement a few months ago
with a political opponent, Morgan Tsvangirai, who out-
polled Mugabe in an election last March but did not win
a majority of the votes. But continuing turmoil,
including violent attacks by Mugabe's supporters and
allegations that Mugabe forces have engaged in torture,
have prevented the agreement from taking effect.
The widespread skepticism that greeted Mugabe's alleged
willingness to share power only increased when he
ranted, just last month: "I will never, never, never
Meanwhile, health care in
abyss. "This emergency is so grave that some entity
needs to step in there and take over the health delivery
system," said Susannah Sirkin, the deputy director of
Physicians for Human Rights.
In November, the primary public referral hospital in
Harare, Parirenyatwa Hospital, shut down. Its medical
school closed with it. The nightmare that forced the
closings was spelled out in the report:
"The hospital had no running water since August of 2008.
Toilets were overflowing, and patients and staff had
nowhere to void - soon making the hospital
months into the cholera epidemic, arguably the worst of
all possible times to have shut down public hospital
access. Successful cholera care, treatment and control
are impossible, however, in a facility without clean
water and functioning toilets."
The hospital's surgical wards were closed in September.
A doctor described the heartbreaking dilemma of having
children in his care who he knew would die without
surgery. "I have no pain medication," he said, "some
antibiotics, but no nurses ... If I don't operate, the
patient will die. But if I do the surgery, the child will die also."
What's documented in the Physicians for Human Rights
report is evidence of a shocking medical and human
rights disaster that warrants a much wider public
spotlight, and an intensified effort to mount an
international humanitarian intervention.
Some organizations are already on the case, including
Doctors Without Borders and Unicef. But
dying, and much more is needed.