Inside Zimbabwe's healthcare crisis

The collapse of Zimbabwe's health sector, once the envy of many African countries, has quickly spread the country's internal crisis to neighboring countries.

By Scott Baldauf | Staff writer of The Christian Science Monitor
and a contributor

from the May 30, 2008 edition

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HARARE and BULAWAYO, ZIMBABWE - Lucia Munenzwa was shell-shocked when she was presented with a list of items that the local clinic needed for her to give birth at the health center.

Top of the list were 10 pairs of latex gloves to be used by the midwives. There were also a surgical blade, clamp cord, cotton wool, linen saver, and rehydration fluid. To buy all the requirements, Ms. Munenzwa, a young widow who survives by selling items on the street, needed about $20 billion Zimbabwean dollars (nearly US $40) – a figure well beyond the reach of any ordinary Zimbabwean.

"The nurses have just told me that without the items, they can't allow me to give birth here," she said with tears in her eyes as she walked out of the clinic, heading home. Two days later, Munenzwa gave birth at home, with the assistance of an elderly neighbor. She named her baby boy Lucky.

The collapse of Zimbabwe's health sector, once the envy of many African countries, may seem to be an internal matter – yet another sign of the country's economic woes. But the flood of an estimated 3 million Zimbabwean refugees from their country – fleeing as much for food and medical care as for political freedom – has quickly spread Zimbabwe's internal crisis to other countries. The ongoing anti-immigrant violence in South Africa shows that Zimbabwe's problems have regional repercussions, putting pressure on African leaders to come up with solutions ... fast.

"What this shows is that effectively there is no government in Zimbabwe," says Chris Maroleng, a Zimbabwe expert at the Institute for Security Studies in Tshwane, as Pretoria is now called. "It says to us that in the end, we must have this issue of human security as an essential starting point for solving the crisis. But the question is how to get to the starting point. The international community that normally intervenes in situations like this is unwelcome now in Zimbabwe. So unless we resolve the underlying political problem, we're going nowhere."

Signs of the healthcare crisis have been obvious for some time to the few doctors still available in the country's largest hospitals, Parirenyatwa and Harare General Hospital.

At Parirenyatwa Hospital, only 1 out of 18 dialysis machines works. At Harare General, only 3 out of 50 incubators works, and the neonatal unit is seriously understaffed as nurses and doctors leave for more stable jobs abroad. There is only one radiologist who is servicing Harare and Parirenyatwa hospitals and the Zimbabwe National Army (ZNA). That radiologist is "borrowed" from the Army.

Refrigerators in the mortuary area at Harare General have stopped working.

Two weeks ago, surgeons and anesthesiologists at Parirenyatwa stopped doing any operations to protest the poor working conditions and inadequate supplies. The surgeons say they are afraid of ruining their reputations by continuing to lose patients by going into theater without adequate supplies.

Douglas Gwatidzo, chairman of the Zimbabwe Association of Doctors for Human Rights, describes the situation in Harare's health centers as "dire." "About one doctor is serving over 8,000 people in the country, [compared with] the world standard of 1 doctor to 500 patients," says Mr. Gwatidzo. "It's quite sad."

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