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Doctors Without Borders: Zimbabwe restricting access

Aid organization says mounting cholera death toll is just one sign of a collapsed health care system.

A cholera patient is pushed on a wheelbarrow to Mabvuku Polyclinic in Harare. Zimbabwe's cholera epidemic infected more than 84,000 by the beginning of March. (Philimon Bulawayo/Reuters)

BOSTON — As Zimbabwe's cholera epidemic spins "out of control," the group Doctors Without Borders took the unprecedented step of of criticizing President Robert Mugabe's government.

The group's president Christoph Fournier, who recently returned from Zimbabwe, urged the government to provide "unrestricted access" for aid organizations to carry out their work.

Zimbabwe's health system has collapsed with government hospitals and clinics closing despite people's urgent need for care. Doctors Without Borders (also known as Medecins Sans Frontieres) and other groups have stepped in to help people cope with the emergency.

But Zimbabwe is restricting international aid, according to Doctors Without Borders. The World Health Organization estimates that more than 87,000 people have been infected with cholera and nearly 4,000 have died.

“The Zimbabwean government must respect independent assessments of needs, guarantee that aid agencies can work wherever needs are identified, and ease bureaucratic obstacles so that programs can be staffed properly and drugs and other urgent medical supplies can be imported quickly,” Fournier said speaking to GlobalPost.

The doctors' group has treated more than 75 percent of the cases in Zimbabwe. Fournier complained that the Zimbabwean government has imposed bureaucratic restrictions that have prevented the group from setting up more treatment centers for suspected cholera cases. 

Doctors Without Borders has called on the international aid community to recognize that Zimbabwe’s cholera epidemic is only the most visible sign of a health system that has collapsed.

“Zimbabwe is a country literally falling apart at the seams,”  Fournier said.

In addition to waiting three to six months to get a work permit, Doctors Without Borders physicians and nurses are required by Zimbabwean law to do a three to six month residency in the country before doing any clinic work.

“They have to do this training for three months with a senior doctor, a supervisor, in a hospital, which becomes a joke when you think that many hospitals are closed and that senior doctors are usually not there anymore,” said Manuel Lopez, head of Doctors Without Borders’ Zimbabwe mission.

Beyond cholera, the health situation in Zimbabwe is increasingly desperate. Clinics are often closed, medical staff have stopped showing up for work, and medicine and supplies are becoming harder to obtain. Pregnant women, according to Doctors Without Borders, are often forced to bring their own drinking water and gloves in order to deliver in clinics, since these items are not available.

Where medical treatment is still available, patients must pay in foreign currency, as the country’s hyperinflation of 231 million percent has rendered its currency effectively useless. Paying these fees for health care is beyond the reach of most Zimbabweans.

“Many of them stay at home or die at home. So that’s the way it is. It gets as bad as that,” Lopez said.

http://www.globalpost.com/dispatch/zimbabwe/090304/doctors-without-borders-zimbabwe-restricting-access