Sunday, January 18, 2009

Zimbabwe Is Dying

Zimbabwe Is Dying


New York Times

Published: January 16, 2009


If you want to see hell on earth, go to Zimbabwe where

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 Zimbabwe is now the lowest in the

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 Harare, leaving the corpses to rot.


Most of the world is ignoring the agony of Zimbabwe, a

once prosperous and medically advanced nation in

southern Africa that is suffering from political and

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 Zimbabwe's health system in 2008 is

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

economic climate."


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 Harare.


"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

Africa, Zimbabwe is now a country that cannot feed its

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 Zimbabwe. So even

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

surrender ... Zimbabwe is mine."


Meanwhile, health care in Zimbabwe has fallen into the

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

uninhabitable. Parirenyatwa Hospital was closed four

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 Zimbabwe is

dying, and much more is needed.




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