Doctors Without Borders: Zimbabwe restricting access

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.

Zimbabwe used to have a health system that was the envy of other African countries. According to World Health Organization statistics, in 1990, a Zimbabwean could expect to live to 62. By 2008, just 18 years later, that number had fallen to 37 for men and 34 for women, the lowest life expectancy in the world. 

The country is in the midst of a food crisis as well, with 7 million people, more than half of its population, in need of food aid. For much of the developing world, February and March represent the hungry season — the time after food from the last harvest has run out and before this year's crop is edible. The World Food Programme expects to feed 5.1 million Zimbabweans in February, but in order to do so, it has halved its per person food rations.

As the country has fallen deeper into crisis, more than 3 million Zimbabweans have fled, most of them to South Africa. Having risked their lives to escape Zimbabwe, reaching South Africa provides no guarantee of safety. According to Doctors Without Borders, a group of 500 women and children crossed the Limpopo River last week. Once on the South African side, several were raped by a group of bandits known as “guma-guma.”

“Two babies were literally taken off their mothers’ backs and thrown into the river to drown,” said Rachel Cohen, head of mission for Doctors Without Borders South Africa.

The South African government considers Zimbabwean refugees to be “voluntary economic migrants,” a classification that affords no rights under South African law. According to Human Rights Watch, more than 18,000 are deported every month back to Zimbabwe.

“This is currently Africa’s most extraordinary exodus from a country not in open conflict,” said Cohen.

More GlobalPost dispatches on Zimbabwe:

Tsvangirai sworn in as Zimbabwe's new prime minister 

Mugabe should be charged