neMunyori weKwayedza
August 6, 2009
Bhaibheri rinoti kunamata kwechokwadi kunosanganisira kuchengeta nherera neshirikadzi pamwe nokushanyira vanorwara.
Izvo ndizvo zvichange zvichionekwa zvichiiitwa nemubatanidzwa wemachechi ari kuChitungwiza pasi pezita rokuti Ecumenical Relief Services Association.
Mubatanidzwa uyu ipfungwa yakaunzwa naVaCharles Mutama, mukuru wesangano reMutama Development Trust, iyo vakavamba vari mhiri kwemakungwa nechinangwa chokuti machechi ave anoshanda pamwe mukubatsira nharaunda nokuunza sanduko yakatsarukana mubasa iri.
Chinangwa chavo kurwisa kutambura kuburikidza nokusimudzira dzidzo, kodzero dzekuva nezvivakwa, kuziva nharaunda pamwe nokuisimudzira.
Nokuda kweizvi, Mutama Development Trust ine basa rokuunza kurongeka munharaunda nokuona kuti batsiro yose inouya muChitungwiza inosvika kune vakakodzera kuiwana kuburikidza nemachechi achange achiunganidza zvokudya, zvipfeko nemamwe mabasa okuendesa vana kuzvikoro nokuchengeta vakafirwa.
Tarisiro iripo ndeyekuzopedza matambudziko anoberekwa munharaunda nokuda kwevana vanenge vashaya misha yakatsarukana yokugara, dzidzo uye hutano hwakanaka nokudya zvakafanira.
Naizvozvo mubatanidzwa uyu unotarisirwa kuti uchaunza sanduko yakanaka kune vanoda rubatsiro munharaunda yeChitungwiza kuburikidza nekushanda pamwe.
Thursday, August 6, 2009
Monday, June 29, 2009
Is the GNU doing enough to end decades of poverty?
The Government of National Unity in Zimbabwe has been in charge for more than 100 days now and it is interesting to figure out whether the administration has done enough to ameliorate poverty affecting the majority of Zimbabweans.
Unemployment is recorded to be around 80 % and the country's annual inflation is reported to have fallen and employment according to Mr. Tendai Biti is now around 15%. The economy has been dollarized and the rand has been introduced in the financial system while getting rid of the worthless Zimbabwean currency.Zimbabwe has asked its neighbors for $2 billion half to support retail and other sectors, and the rest to help schools and restore health and municipal services. It has said it needs billions more from other donors.
In short, the GNU has been implementing macroeconomic policies and it will be important to examine whether these have a positive effect on the ordinary people who work in the still functional private business organizations, the informal sector and the civil service and those who are unemployed.
According to the Zimbabwe Congress of Trade Unions, the poverty datum line currently stands at US$ 454 while the current mimimum wage is US$ 100. According to the Consumer Council of Zimbabwe, an average family of six needed $386 a month for a basic "basket" of goods that included food as well as rent and utilities. This figure is up 5 percent from $374 in February.
The council noted that though food prices in U.S. dollars fell, many basic goods were still far out of the reach of impoverished Zimbabweans.Finance Minister Tendai Biti, a top Tsvangirai ally, acknowledged that years of political and economic turmoil disrupted farming and industrial production and left just 5 percent of the population in formal jobs.
Others engage in informal trading and up to 7 million people, more than half the population, currently receive food aid.Biti noted that the new government receives revenues of about $20 million a month when it needs $100 million.
While there are reports of food availability in the shops there seems to be a widespread lack of purchase power on the part of the poor which makes the work of the GNU even more harder.
Unemployment is recorded to be around 80 % and the country's annual inflation is reported to have fallen and employment according to Mr. Tendai Biti is now around 15%. The economy has been dollarized and the rand has been introduced in the financial system while getting rid of the worthless Zimbabwean currency.Zimbabwe has asked its neighbors for $2 billion half to support retail and other sectors, and the rest to help schools and restore health and municipal services. It has said it needs billions more from other donors.
In short, the GNU has been implementing macroeconomic policies and it will be important to examine whether these have a positive effect on the ordinary people who work in the still functional private business organizations, the informal sector and the civil service and those who are unemployed.
According to the Zimbabwe Congress of Trade Unions, the poverty datum line currently stands at US$ 454 while the current mimimum wage is US$ 100. According to the Consumer Council of Zimbabwe, an average family of six needed $386 a month for a basic "basket" of goods that included food as well as rent and utilities. This figure is up 5 percent from $374 in February.
The council noted that though food prices in U.S. dollars fell, many basic goods were still far out of the reach of impoverished Zimbabweans.Finance Minister Tendai Biti, a top Tsvangirai ally, acknowledged that years of political and economic turmoil disrupted farming and industrial production and left just 5 percent of the population in formal jobs.
Others engage in informal trading and up to 7 million people, more than half the population, currently receive food aid.Biti noted that the new government receives revenues of about $20 million a month when it needs $100 million.
While there are reports of food availability in the shops there seems to be a widespread lack of purchase power on the part of the poor which makes the work of the GNU even more harder.
Wednesday, March 11, 2009
ZIMBABWE: Who controls the water determines the severity of cholera
ZIMBABWE: Who controls the water determines the severity of cholera
BULAWAYO, 10 March 2009 (IRIN) - A protracted tussle over Bulawayo's water and sanitation services between local councillors and the ZANU-PF controlled water parastatal allowed Zimbabwe's second city to escape the nationwide cholera epidemic relatively unscathed.
More than 4,000 people have died and nearly 90,000 have been infected by the waterborne disease since the outbreak began in August 2008; total infections could reach 120,000 cases before it abates.
Bulawayo's director of health, Dr Zanele Hwalima, said the city had recorded 440 cases and 18 deaths since the outbreak began, compared with 2,606 cases and 167 fatalities in Chitungwiza, a dormitory town near the capital, Harare, which has a population of similar size.
"We are fortunate that the drawn-out wrangle between us and the government, through the Zimbabwe National Water [ZINWA], apparently saved the city residents from an outbreak at a scale similar to Harare," said Bulawayo's mayor, Patrick Thabamoyo. "We resisted the takeover and we have somehow been vindicated."
The provision of services in urban areas became the source of an acute power struggle between President Robert Mugabe's ZANU-PF and the opposition Movement for Democratic Change (MDC), led by the recently installed Prime Minister, Morgan Tsvangirai.
Zimbabwe's urban populations were the first to turn against Mugabe - the country's only leader since independence from Britain in 1980 - and increasingly voted in MDC-dominated city councils.
ZANU-PF attempted to dilute the power of MDC municipalities by transferring the provision of services, and their budgets, to parastatals under the control of central government.
In May 2005, ZINWA, previously the bulk water supplier, took over water delivery and sewerage management. This was widely seen as the genesis of Zimbabwe's cholera epidemic, as the parastatal soon proved hopelessly inadequate in its new task and the services under its control collapsed.
By March 2006 Harare's civic organisations were warning of a "cholera time-bomb" after the disease killed 27 people that month. However, unlike Harare - the epicentre of the current outbreak - Bulawayo's councillors managed to stave off the imposition of ZINWA on their water affairs.
Since the formation of the unity government ZINWA has reverted to its role as a bulk water supplier.
Drought a friend in times of cholera
Water scarcity in Bulawayo, in the country's drought-prone region, has always demanded careful planning to keep the taps of its 1.5 million residents running. The city's main supply dams - Upper Ncema, Lower Ncema, Inyankuni, Insiza and Umzingwane - are located about 30km from the city in the Mzingwane area.
The rural setting of the dams makes them less susceptible to industrial pollution than is the case with Harare's water sources, and relatively free from the risk of burst sewage pipes contaminating streams and rivers.
Three months after the August 2008 cholera outbreak began, ZINWA admitted to pumping raw sewage into Lake Chivero, Harare's main water source.
"While it takes more than a dozen chemicals to purify water for Harare residents, our water requires at most three different chemicals because it is less polluted," Bulawayo councillor Emmanuel Munjoma told IRIN.
Zimbabwe's economic malaise, which has seen unemployment reach 94 percent and hyperinflation all but killing off the local currency, has resulted in the collapse of health services, made hard currency scarce, and the purchase of water purification chemicals extremely difficult.
In Harare, the response was an almost total shut-down of the public water supply, forcing residents to dig shallow wells or to source water from contaminated rivers and streams.
In Bulawayo, water scarcity had instilled a different discipline and the council made use of "208 boreholes drilled with financial assistance from aid agencies at the peak of water shortages, because of the drought in the past two seasons," Thabamoyo said.
"We deploy water bowsers to deliver water to affected suburbs whenever we run short of purification chemicals," he said. "These have been augmented by boreholes on the Nyamandhlovu aquifer outside of the city."
Cholera stabilizing
The World Health Organization (WHO) said in its regional cholera update on 6 March, "In Zimbabwe, the epidemic appears to be stabilizing in urban areas, while outbreaks in rural areas remain high or are on the increase."
Gregory Härtl, spokesman for the World Food Programme's Epidemic and Pandemic Alert and Response (EPR) in Geneva, told IRIN: "It is difficult to pinpoint one reason for the decline [of cholera cases in Zimbabwe].
"Health providers have been undertaking intensive infection control measures within hospitals, particularly training of health staff in appropriate control procedures, and social mobilization efforts have been continuing to raise awareness about the threats posed by the disease," Härtl noted.
"But the measures that have been promoted by WHO, the MoH [Ministry of Health] and other health providers are likely to have contributed to the declining rates of new cases."
BULAWAYO, 10 March 2009 (IRIN) - A protracted tussle over Bulawayo's water and sanitation services between local councillors and the ZANU-PF controlled water parastatal allowed Zimbabwe's second city to escape the nationwide cholera epidemic relatively unscathed.
More than 4,000 people have died and nearly 90,000 have been infected by the waterborne disease since the outbreak began in August 2008; total infections could reach 120,000 cases before it abates.
Bulawayo's director of health, Dr Zanele Hwalima, said the city had recorded 440 cases and 18 deaths since the outbreak began, compared with 2,606 cases and 167 fatalities in Chitungwiza, a dormitory town near the capital, Harare, which has a population of similar size.
"We are fortunate that the drawn-out wrangle between us and the government, through the Zimbabwe National Water [ZINWA], apparently saved the city residents from an outbreak at a scale similar to Harare," said Bulawayo's mayor, Patrick Thabamoyo. "We resisted the takeover and we have somehow been vindicated."
The provision of services in urban areas became the source of an acute power struggle between President Robert Mugabe's ZANU-PF and the opposition Movement for Democratic Change (MDC), led by the recently installed Prime Minister, Morgan Tsvangirai.
Zimbabwe's urban populations were the first to turn against Mugabe - the country's only leader since independence from Britain in 1980 - and increasingly voted in MDC-dominated city councils.
ZANU-PF attempted to dilute the power of MDC municipalities by transferring the provision of services, and their budgets, to parastatals under the control of central government.
In May 2005, ZINWA, previously the bulk water supplier, took over water delivery and sewerage management. This was widely seen as the genesis of Zimbabwe's cholera epidemic, as the parastatal soon proved hopelessly inadequate in its new task and the services under its control collapsed.
By March 2006 Harare's civic organisations were warning of a "cholera time-bomb" after the disease killed 27 people that month. However, unlike Harare - the epicentre of the current outbreak - Bulawayo's councillors managed to stave off the imposition of ZINWA on their water affairs.
Since the formation of the unity government ZINWA has reverted to its role as a bulk water supplier.
Drought a friend in times of cholera
Water scarcity in Bulawayo, in the country's drought-prone region, has always demanded careful planning to keep the taps of its 1.5 million residents running. The city's main supply dams - Upper Ncema, Lower Ncema, Inyankuni, Insiza and Umzingwane - are located about 30km from the city in the Mzingwane area.
The rural setting of the dams makes them less susceptible to industrial pollution than is the case with Harare's water sources, and relatively free from the risk of burst sewage pipes contaminating streams and rivers.
Three months after the August 2008 cholera outbreak began, ZINWA admitted to pumping raw sewage into Lake Chivero, Harare's main water source.
"While it takes more than a dozen chemicals to purify water for Harare residents, our water requires at most three different chemicals because it is less polluted," Bulawayo councillor Emmanuel Munjoma told IRIN.
Zimbabwe's economic malaise, which has seen unemployment reach 94 percent and hyperinflation all but killing off the local currency, has resulted in the collapse of health services, made hard currency scarce, and the purchase of water purification chemicals extremely difficult.
In Harare, the response was an almost total shut-down of the public water supply, forcing residents to dig shallow wells or to source water from contaminated rivers and streams.
In Bulawayo, water scarcity had instilled a different discipline and the council made use of "208 boreholes drilled with financial assistance from aid agencies at the peak of water shortages, because of the drought in the past two seasons," Thabamoyo said.
"We deploy water bowsers to deliver water to affected suburbs whenever we run short of purification chemicals," he said. "These have been augmented by boreholes on the Nyamandhlovu aquifer outside of the city."
Cholera stabilizing
The World Health Organization (WHO) said in its regional cholera update on 6 March, "In Zimbabwe, the epidemic appears to be stabilizing in urban areas, while outbreaks in rural areas remain high or are on the increase."
Gregory Härtl, spokesman for the World Food Programme's Epidemic and Pandemic Alert and Response (EPR) in Geneva, told IRIN: "It is difficult to pinpoint one reason for the decline [of cholera cases in Zimbabwe].
"Health providers have been undertaking intensive infection control measures within hospitals, particularly training of health staff in appropriate control procedures, and social mobilization efforts have been continuing to raise awareness about the threats posed by the disease," Härtl noted.
"But the measures that have been promoted by WHO, the MoH [Ministry of Health] and other health providers are likely to have contributed to the declining rates of new cases."
HEALTH IN RUINS: A Man-Made Disaster in Zimbabwe
An Emergency Report by Physicians for Human Rights January 2009
PREFACE
What happens when a government presides over the dramatic reversal of its population’s access to food, clean water, basic sanitation, and healthcare? When government policies lead directly to the shuttering of hospitals and clinics, the closing of its medical school, and the beatings of health workers, are we to consider the attendant deaths and injuries as any different from those resulting from a massacre of similar proportions?
Physicians for Human Rights (PHR) witnesses the utter collapse of Zimbabwe’s health system, once a model in southern Africa. These shocking findings should compel the international community to respond as it should to other human rights emergencies. PHR rightly calls into question the legitimacy of a regime that, in the report’s words, has abrogated the most basic state functions in protecting the health of the population. As the report documents, the Mugabe regime has used any means at its disposal, including politicizing the health sector, to maintain its hold on power.
Instead of fulfilling its obligation to progressively realize the right to health for the people of Zimbabwe, the Government has taken the country backwards, which has enabled the destruction of health, water, and sanitation – all with fatal consequences.
Heedless of concern for the population of Zimbabwe from world leaders and groups such as PHR, the Government has denied access to the country, detained journalists, tortured human rights activists, and even refused visas to former U.N. Secretary-General Kofi Annan, U.S. President Jimmy Carter, and Graça Machel. PHR’s team members legally entered the country and were transparent about the purpose of conducting a health assessment.
Nevertheless, the Government apparently planned and then falsely reported their arrest at the end of the investigation. Such actions are a desperate attempt by Robert Mugabe to conceal the appalling situation of his country’s people and to prevent the world from knowing how his Government’s malignant policies have led to the destruction of infrastructure, widespread disease, torture, and death.
This report is yet another wake-up call to Zimbabwe’s neighbors and all U.N. member states for urgent intervention to save lives and prevent more deaths.
These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity.
Richard J. Goldstone, Former U.N. Chief Prosecutor, International Criminal Tribunals for the former Yugoslavia and Rwanda (ICTY and ICTR); Current PHR Board Member
Mary Robinson Chair, Realizing Rights: The Ethical Globalization Initiative; Former President of Ireland; Former U.N. High Commissioner for Human Rights Chair,
The Most Reverend Desmond M. Tutu, OMSG, DD, FKC, Anglican Archbishop Emeritus of Cape Town; Chair – The Elders
EXECUTIVE SUMMARY
INTRODUCTION AND OVERVIEW
Physicians for Human Rights sent an emergency delegation to Zimbabwe in December 2008 to investigate the collapse of healthcare. The health and nutritional status of Zimbabwe’s people has acutely worsened this past year due to a cholera epidemic, high maternal mortality, malnutrition, HIV/AIDS, tuberculosis, and anthrax. The 2008 cholera epidemic that continues in 2009 is an outcome of the health systems collapse, and of the failure of the state to maintain safe water and sanitation. This disaster is man-made, was likely preventable, and has become a regional issue since the spread of cholera to neighbor states.
The health crisis in Zimbabwe is a direct outcome of the violation of a number of human rights, including the right to participate in government and in free elections and the right to a standard of living adequate for one’s health and well being, including food, medical care, and necessary social services. Robert Mugabe’s ZANUPF regime continues to violate Zimbabweans’ civil, political, economic, social, and cultural rights.
The collapse of Zimbabwe’s health system in 2008 is unprecedented in scale and scope. Public-sector hospitals have been shuttered since November 2008. While some facilities remain open in the private sector, these are operating on a US-dollar system and are charging fees ranging from $200 USD in cash for a consultation, $500 USD for an in-patient bed, and $3,000 USD for a Cesarean section. With fees in reach for only the wealthy, the majority are being denied access to health care.
» International human rights framework
Zimbabwe is a party to the International Covenant on Economic, Social and Cultural Rights (ICESCR or the Covenant), the Convention on the Rights of the Child (CRC), the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), and the African Charter on Human and Peoples’ Rights. The Government has a legally binding obligation to respect, protect, and fulfill these rights for all people within its jurisdiction.
The right to health imposes core obligations, which require access to health facilities on a non discriminatory basis, the provision of a minimum essential package of health-related services and facilities, including essential food, basic sanitation and adequate water, essential medicines, and sexual and reproductive health services, including obstetric care. Even with limited resources, the Government is required to give first priority to the most basic health needs of the population and to the most vulnerable sections of the population.
» Methods for this investigation
During a seven-day investigation to Zimbabwe (1320 December 2008) conducted by four human rights investigators, including two physicians with expertise in public health and epidemiology, PHR interviewed and met with 92 participants, including healthcare workers in private and public hospitals and clinics, medical students from both of the medical schools in Zimbabwe, representatives from local and international NGOs, representatives from U.N. agencies, Zimbabwean government health officials, members of parliament, water and sanitation engineers, farmers, and school teachers. The PHR team visited four of the ten provinces in Zimbabwe, in both urban and rural areas. Provinces visited included Harare, Mashonaland Central, Mashonaland West, and Mashonaland East.
FINDINGS
» The economic collapse
A causal chain runs from Mugabe’s economic policies, to Zimbabwe’s economic collapse, food insecurity and malnutrition, and the current outbreaks of infectious disease. These policies include the land seizures of 2000, a failed monetary policy and currency devaluations, and a cap on bank withdrawals. Mugabe’s land seizures destroyed Zimbabwe’s agricultural sector, which provided 45% of the country’s foreign exchange revenue and livelihood for more than 70% of the population. Hyperinflation has ensued while salary levels have not kept pace. A government physician in Harare showed PHR her official pay stub; her monthly gross income in November
2008 was worth 32 U.S. cents ($0.32 USD). The unemployment rate is over 80%. Low-income households have had to reduce the quantity and quality of food. The Mugabe ZANU-PF government must be held accountable for the violation of the right to be free from hunger.
» Public health system collapse
The Government of Zimbabwe has abrogated the most basic state functions in protecting the health of the population – including the maintenance of public hospitals and clinics and the support for the health workers required to maintain the public health system. These services have been in decline since 2006, but the deterioration of both public health and clinical care has dramatically accelerated since August 2008.
› Healthcare and healthcare delivery
As of December 2008, there were no functioning critical care beds in the public sector in Zimbabwe. The director of a mission hospital told PHR:
“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.”
Life expectancy at birth has fallen dramatically from 62 years for both sexes in 1990 to 36 years in 2006 – 34 years for males and 37 years for females, the world’s lowest.
› Limits to access: affordability, transportation, closures Since the dollarization of the economy in November 2008, only a tiny elite with substantial foreign currency holdings have any real access to healthcare. Transport costs, even within Harare, have made getting to work impossible for many healthcare employees. A rural clinic staff nurse reported that since he lived at the clinic, he had no difficulties in getting to work; however, since bus fare to get to the nearest town to collect his monthly salary cost more than the entire salary, it made no sense to collect it. He had not done so since April 2008. A senior government official said: Government salaries are simply rotting in the bank. When asked about how the absence of healthcare workers was affecting HIV treatment, the official said: This is not a strike. The problem is the staff and the patients cannot come due to travel costs.
Between September and November 2008 most wards in the public hospitals gradually closed. The most abrupt halt in healthcare access occurred on 17 November 2008, when the premier teaching and referral hospital in Harare, Parirenyatwa, closed along with the medical school.
› Essential medicines and supplies
Access to essential medications was raised by nearly all providers interviewed. In addition to drug shortages, medical supplies (including cleaning agents, soap, surgical gloves, and bandages) were also in critically short supply—or absent altogether. A rural clinic nurse
reported:
“Right now I have no anti-hypertensives, no anti- asthmatics, no analgesics, nothing for pain. ... I have a woman in labor right now, and I have no way to monitor blood pressure ... and I have no suture material to do a repair if she tears.”
› Health information and suppression
The Mugabe regime intentionally suppressed initial reports of the cholera epidemic and has since denied or underplayed its gravity. The Minister of Information and Publicity, Sikhanyiso Ndlovu, reportedly ordered government-controlled media to downplay the cholera epidemic, which he said had given the country’s enemies a chance to exert more pressure on President Robert Mugabe to leave office. The Minister instructed the media to turn a blind eye to the number of people who have died or [have become] infected with cholera, and instead focus on what the Government and NGOs are doing to contain the epidemic.
PHR heard from several sources in Zimbabwe that the Government has intentionally suppressed information regarding increasing malnutrition.
PHR asked a nurse staffing a public-sector clinic in a rural district if there had been cases of malnutrition. The nurse became visibly anxious and then replied:
“Malnutrition is very political. We are not supposed to have hunger in Zimbabwe. So even though we do see it, we cannot report it.”
DETERMINANTS OF HEALTH
» Failed sewerage and sanitation systems Before the ZANU-PF government nationalized municipal water authorities in 2006, water treatment and delivery systems worked, although suboptimally.
The Mugabe regime, however, politicized water for political gain and profit, policies that proved disastrous, and which have clearly contributed to the ongoing cholera epidemic.
All Harare residents PHR interviewed reported that trash collection has effectively ceased. Throughout Harare, and especially in the poor high-density areas outside the capital, PHR investigators saw detritus littering streets and clogging intersections. Steady streams of raw sewage flow through the refuse and merge with septic waste. A current Ministry of Health official reported to PHR: There is no decontamination of waste in the country.
» Nutrition and food security
The U.N. Food and Agricultural Organization (FAO) predicts that some 5.1 million (45% of the population) who will require food aid by early 2009 in order to survive. Agricultural output has dropped 50-70% over the past seven years. The ZANU-PF government has exacerbated food insecurity for Zimbabweans in 2008 by blocking international humanitarian organizations from delivering food aid and humanitarian aid to populations in the worst-affected rural areas. Patients with HIV/AIDS and TB are especially vulnerable to food insecurity.
In the months following the March 2008 elections, the Mugabe regime used food as a weapon of war against MDC supporters and the rural poor. On 31 December 2008, a government official in Chivhu prevented WFP from distributing food aid: “The villagers accused the chief of being corrupt and diverting donor aid and distributing it along party lines. They indicated that . . . the chief and his ZANU-PF supporters used to source maize from the nearby Grain Marketing Board and then sell it to the poor villagers.” A leader of a health NGO reported that:
“There is no food in many of the hospitals and there is starvation in the prisons.”
» Current health crisis: Cholera
The current cholera epidemic in Zimbabwe appears to have begun in August 2008. As of this writing, more than 1,700 Zimbabweans have died from the disease and another 35,000 people have been infected. The U.N. reports that cholera has spread to all of Zimbabwe’s ten provinces, and to 55 of the 62 districts (89%) and that the cumulative case fatality rate (CFR) across the country has risen to 5.0% - five times greater than what is typical in cholera outbreaks. Control has not been reached: There has been a doubling of both cases and deaths during the last three weeks of December, 2008.
› Cholera infectivity, epidemiology, and treatment The origin of the current cholera epidemic appears to stem from the failure of the Mugabe regime to maintain water purification measures and manage sewerage systems. Civic organizations in Harare warned of a cholera time-bomb in 2006, but the Mugabe regime ignored the warning signs. Not until 4 December 2008 did Zimbabwe’s Ministry of Health and Child Welfare finally request aid to respond to the cholera outbreak by declaring a national emergency. This negligence represents a four-month delay since the start of the cholera outbreak, but at least a three-year delay in responding to the water and sanitation breakdowns, which have allowed cholera to flourish.
Death rates from cholera are usually under 1%; however, in the current Zimbabwe epidemic, the cumulative death rate for the country is around 5%, and more than 40% of all districts have case fatality rates above 10%.
PHR asked a senior government official responsible for cholera surveillance why Zimbabwe’s case fatality rate was more than five times greater. She attributed the high death rate to three causes. First, in the initial phase there simply were no supplies, such as ORS and IV fluids. Second, few clinic or hospital staff were sufficiently experienced or trained to respond to cholera, and many patients died even in facilities that had adequate supplies. Finally, the issue of transport costs for patients and staff, exacerbated by the closure of the public hospitals, meant that many patients either could not reach care, or reached care in advanced dehydration, and could not be saved.
» Current health crisis: Anthrax
WHO has reported some 200 human cases of anthrax since November 2008 with eight confirmed deaths. These cases were attributed to the ingestion of animals (cattle and goats) that had died of anthrax. Zimbabweans avoid eating animals that have died of disease – but these cases appear to occurred in starving rural people scavenging carrion.
PHR was told that veterinary anthrax control programs in Zimbabwe, which had included regular monthly control programs, have been dramatically curtailed in the economic collapse. The surviving herds are now much more vulnerable to infectious diseases.
» Current Health Crisis: HIV/AIDS
UNAIDS figures show that Zimbabwe has a severe generalized epidemic of HIV-1, with an overall adult (ages 15-49) HIV prevalence rate of 15.3%. An estimated 1.3 million adults and children in Zimbabwe are living with HIV infection in 2008. Of these, some 680,000 were women of childbearing age.
In 2007, some 140,000 Zimbabweans died of AIDS, and the current toll is estimated at 400 AIDS deaths per day. Access to HIV/ AIDS care and treatment is threatened by the current collapse and HIV programs are currently capped: some 205,000 people are thought to be taking Anti-Retrovirals (ARVs), but no major program is currently able to enroll new patients. Some 800,000 Zimbabweans are thought to require therapy, or will require it in the coming months-years.
PHR investigators received corroborating reports from donors and HIV/AIDS patients in Zimbabwe that ZANU-PF government officials had plundered $7.3 million USD in humanitarian aid for HIV/AIDS treatment – part of $12.3 million USD from the Global Fund for AIDS, Tuberculosis and Malaria.
Following public outrage over the scandal months later in November 2008, the ZANU-PF-controlled reserve bank returned the stolen funds to the Global Fund.
For HIV/AIDS the most severe threat has been the interruption of regular supplies of antiretroviral drugs. Multiple key informants, patients, and providers told PHR that ARV supplies had become irregular due to breakdowns in drug delivery, distribution, provision, and theft of ARV drugs by ZANU-PF operatives. Most troubling were reports that some physicians were switching patients on established ARV regimens to other regimens based not on clinical need, but on drug availability. This can lead to drug resistant HIV strains. These dangerous practices constitute a significant threat to public health since the development and transmission of multi-drug resistant variants of HIV in Zimbabwe could undermine not only Zimbabwe’s HIV/ AIDS program, but regional programs as well.
» Current health crisis: Tuberculosis
PHR asked an expert working with the national program to describe the status of the program in December 2008: “There is no politically correct way to say this – the TB program in Zimbabwe is a joke. The national TB lab has one staff person. There is no one trained in drug sensitivity testing. The TB reference lab is just not functioning. This is a brain drain problem.
The lab was working well until 2006 and has since fallen apart. The DOTS program in 2000 was highly effective, but that has broken down now too.
There is no real data collection system for TB. This stopped in 2006 as well.”
Both MDR-TB and possible XDR-TB (a largely fatal and often untreatable
form) have emerged in Zimbabwe, but the critical capacity to diagnose and manage these infections has collapsed.
» Current health crisis: Maternal morbidity and mortality Maternal health in Zimbabwe has deteriorated greatly over the past decade.
The maternal mortality rate has risen from 168 (per 100,000) in 1990 to 1,100 (per 100,000) in 2005. The major contributors are HIV/ AIDS and a significant decline in availability and quality of maternal health services. PHR interviewed several Harare mothers at a distant Mission Hospital who had sought obstetric care. One went to Mbuya Nehanda Government Maternity Hospital for a cesarean section on 14 November 2008.
She was told that the operation could not be performed because there were no nurses, doctors, or anesthesiologists at work. Another woman said:
“I wanted to have my baby in Harare but Parirenyatwa hospital was closed.
I was having my prenatal care with my own doctor at [a private clinic] but they wanted so much money. They wanted only U.S. dollars, in cash. $3,000 dollars for the surgeon, $140 dollars for the nurse, and $700 dollars for the doctor who puts you to sleep.“
CONCLUSIONS
The health and healthcare crisis in Zimbabwe is a direct outcome of the malfeasance of the Mugabe regime and the systematic violation of a wide range of human rights, including the right to participate in government and in free elections and egregious failure to respect, protect and fulfill the right to health.
The findings contained in this report show, at a minimum, violations of the rights to life, health, food, water, and work. When examined in the context of 28 years of massive and egregious human rights violations against the people of Zimbabwe under the rule of Robert Mugabe, they constitute added proof of the commission by the Mugabe regime of crimes against humanity.
RECOMMENDATIONS
1. Resolve the political impasse
The UN Security Council and the South African Development Community should call on the Mugabe regime to accept the result of the 29 March election and allow the MDC to assume its place. Governments should end their support of Mugabe’s regime, engaging in intensive diplomacy to assure a democratic political transition. They should maintain and strengthen targeted bilateral sanctions until Mugabe cedes power and a stable government is established.
2. Launch an emergency health response
The government of Zimbabwe should yield control of its health services, water supply, sanitation, disease surveillance, Ministry of Health operations, and other public health functions to a United Nations-designated agency or consortium. Such a mechanism would be equivalent to putting the health system into a receivership pursuant to the existence of a circumstance that meets the criteria for the Responsibility to Protect. If the government of Zimbabwe refuses to yield such control, the U.N. Security Council, acting pursuant to its authority under Article 39 of the Charter, should enact a resolution compelling the Government of Zimbabwe to do so.
3. Refer the situation in Zimbabwe to the International Criminal Court for crimes against humanity The U.N. Security Council, acting pursuant to its authority under Article
41 of the U.N. Charter, should enact a resolution referring the crisis in Zimbabwe to the International Criminal Court for investigation and to begin the process of compiling documentary and other evidence that would support the charge of crimes against humanity.
4. Convene an emergency summit on HIV/AIDS, tuberculosis and other infectious diseases Donor governments and the Global Fund should consider this crisis as a first test-case of the collapse of a health system in a country that is a recipient of emergency AIDS and TB prevention and treatment programs. The Obama Administration, together with the Global Fund and other donors, should convene an emergency summit to coordinate action to address the current acute shortfalls in AIDS and Tuberculosis treatment and care.
5. Prevent further nutritional deterioration and ensure household food security To prevent further deterioration of nutritional status, especially among the most vulnerable (young children, mothers, HIV/AIDS, and TB sufferers), the international community needs urgently to fully fund the 2009 Consolidated Appeal (CAP) for Zimbabwe of $550 million USD. Importantly, donor governments must ensure non-interference by the current governing regime in obstructing, diverting, politicizing, or looting such humanitarian aid. The United States as well as other donor governments and private voluntary organizations should increase donations of appropriate foods to the responsible multilateral agencies, such as WFP, to meet the impending shortfall in the coming three to six months.
© Physicians for Human Rights http://physiciansforhumanrights.org
PREFACE
What happens when a government presides over the dramatic reversal of its population’s access to food, clean water, basic sanitation, and healthcare? When government policies lead directly to the shuttering of hospitals and clinics, the closing of its medical school, and the beatings of health workers, are we to consider the attendant deaths and injuries as any different from those resulting from a massacre of similar proportions?
Physicians for Human Rights (PHR) witnesses the utter collapse of Zimbabwe’s health system, once a model in southern Africa. These shocking findings should compel the international community to respond as it should to other human rights emergencies. PHR rightly calls into question the legitimacy of a regime that, in the report’s words, has abrogated the most basic state functions in protecting the health of the population. As the report documents, the Mugabe regime has used any means at its disposal, including politicizing the health sector, to maintain its hold on power.
Instead of fulfilling its obligation to progressively realize the right to health for the people of Zimbabwe, the Government has taken the country backwards, which has enabled the destruction of health, water, and sanitation – all with fatal consequences.
Heedless of concern for the population of Zimbabwe from world leaders and groups such as PHR, the Government has denied access to the country, detained journalists, tortured human rights activists, and even refused visas to former U.N. Secretary-General Kofi Annan, U.S. President Jimmy Carter, and Graça Machel. PHR’s team members legally entered the country and were transparent about the purpose of conducting a health assessment.
Nevertheless, the Government apparently planned and then falsely reported their arrest at the end of the investigation. Such actions are a desperate attempt by Robert Mugabe to conceal the appalling situation of his country’s people and to prevent the world from knowing how his Government’s malignant policies have led to the destruction of infrastructure, widespread disease, torture, and death.
This report is yet another wake-up call to Zimbabwe’s neighbors and all U.N. member states for urgent intervention to save lives and prevent more deaths.
These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity.
Richard J. Goldstone, Former U.N. Chief Prosecutor, International Criminal Tribunals for the former Yugoslavia and Rwanda (ICTY and ICTR); Current PHR Board Member
Mary Robinson Chair, Realizing Rights: The Ethical Globalization Initiative; Former President of Ireland; Former U.N. High Commissioner for Human Rights Chair,
The Most Reverend Desmond M. Tutu, OMSG, DD, FKC, Anglican Archbishop Emeritus of Cape Town; Chair – The Elders
EXECUTIVE SUMMARY
INTRODUCTION AND OVERVIEW
Physicians for Human Rights sent an emergency delegation to Zimbabwe in December 2008 to investigate the collapse of healthcare. The health and nutritional status of Zimbabwe’s people has acutely worsened this past year due to a cholera epidemic, high maternal mortality, malnutrition, HIV/AIDS, tuberculosis, and anthrax. The 2008 cholera epidemic that continues in 2009 is an outcome of the health systems collapse, and of the failure of the state to maintain safe water and sanitation. This disaster is man-made, was likely preventable, and has become a regional issue since the spread of cholera to neighbor states.
The health crisis in Zimbabwe is a direct outcome of the violation of a number of human rights, including the right to participate in government and in free elections and the right to a standard of living adequate for one’s health and well being, including food, medical care, and necessary social services. Robert Mugabe’s ZANUPF regime continues to violate Zimbabweans’ civil, political, economic, social, and cultural rights.
The collapse of Zimbabwe’s health system in 2008 is unprecedented in scale and scope. Public-sector hospitals have been shuttered since November 2008. While some facilities remain open in the private sector, these are operating on a US-dollar system and are charging fees ranging from $200 USD in cash for a consultation, $500 USD for an in-patient bed, and $3,000 USD for a Cesarean section. With fees in reach for only the wealthy, the majority are being denied access to health care.
» International human rights framework
Zimbabwe is a party to the International Covenant on Economic, Social and Cultural Rights (ICESCR or the Covenant), the Convention on the Rights of the Child (CRC), the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), and the African Charter on Human and Peoples’ Rights. The Government has a legally binding obligation to respect, protect, and fulfill these rights for all people within its jurisdiction.
The right to health imposes core obligations, which require access to health facilities on a non discriminatory basis, the provision of a minimum essential package of health-related services and facilities, including essential food, basic sanitation and adequate water, essential medicines, and sexual and reproductive health services, including obstetric care. Even with limited resources, the Government is required to give first priority to the most basic health needs of the population and to the most vulnerable sections of the population.
» Methods for this investigation
During a seven-day investigation to Zimbabwe (1320 December 2008) conducted by four human rights investigators, including two physicians with expertise in public health and epidemiology, PHR interviewed and met with 92 participants, including healthcare workers in private and public hospitals and clinics, medical students from both of the medical schools in Zimbabwe, representatives from local and international NGOs, representatives from U.N. agencies, Zimbabwean government health officials, members of parliament, water and sanitation engineers, farmers, and school teachers. The PHR team visited four of the ten provinces in Zimbabwe, in both urban and rural areas. Provinces visited included Harare, Mashonaland Central, Mashonaland West, and Mashonaland East.
FINDINGS
» The economic collapse
A causal chain runs from Mugabe’s economic policies, to Zimbabwe’s economic collapse, food insecurity and malnutrition, and the current outbreaks of infectious disease. These policies include the land seizures of 2000, a failed monetary policy and currency devaluations, and a cap on bank withdrawals. Mugabe’s land seizures destroyed Zimbabwe’s agricultural sector, which provided 45% of the country’s foreign exchange revenue and livelihood for more than 70% of the population. Hyperinflation has ensued while salary levels have not kept pace. A government physician in Harare showed PHR her official pay stub; her monthly gross income in November
2008 was worth 32 U.S. cents ($0.32 USD). The unemployment rate is over 80%. Low-income households have had to reduce the quantity and quality of food. The Mugabe ZANU-PF government must be held accountable for the violation of the right to be free from hunger.
» Public health system collapse
The Government of Zimbabwe has abrogated the most basic state functions in protecting the health of the population – including the maintenance of public hospitals and clinics and the support for the health workers required to maintain the public health system. These services have been in decline since 2006, but the deterioration of both public health and clinical care has dramatically accelerated since August 2008.
› Healthcare and healthcare delivery
As of December 2008, there were no functioning critical care beds in the public sector in Zimbabwe. The director of a mission hospital told PHR:
“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.”
Life expectancy at birth has fallen dramatically from 62 years for both sexes in 1990 to 36 years in 2006 – 34 years for males and 37 years for females, the world’s lowest.
› Limits to access: affordability, transportation, closures Since the dollarization of the economy in November 2008, only a tiny elite with substantial foreign currency holdings have any real access to healthcare. Transport costs, even within Harare, have made getting to work impossible for many healthcare employees. A rural clinic staff nurse reported that since he lived at the clinic, he had no difficulties in getting to work; however, since bus fare to get to the nearest town to collect his monthly salary cost more than the entire salary, it made no sense to collect it. He had not done so since April 2008. A senior government official said: Government salaries are simply rotting in the bank. When asked about how the absence of healthcare workers was affecting HIV treatment, the official said: This is not a strike. The problem is the staff and the patients cannot come due to travel costs.
Between September and November 2008 most wards in the public hospitals gradually closed. The most abrupt halt in healthcare access occurred on 17 November 2008, when the premier teaching and referral hospital in Harare, Parirenyatwa, closed along with the medical school.
› Essential medicines and supplies
Access to essential medications was raised by nearly all providers interviewed. In addition to drug shortages, medical supplies (including cleaning agents, soap, surgical gloves, and bandages) were also in critically short supply—or absent altogether. A rural clinic nurse
reported:
“Right now I have no anti-hypertensives, no anti- asthmatics, no analgesics, nothing for pain. ... I have a woman in labor right now, and I have no way to monitor blood pressure ... and I have no suture material to do a repair if she tears.”
› Health information and suppression
The Mugabe regime intentionally suppressed initial reports of the cholera epidemic and has since denied or underplayed its gravity. The Minister of Information and Publicity, Sikhanyiso Ndlovu, reportedly ordered government-controlled media to downplay the cholera epidemic, which he said had given the country’s enemies a chance to exert more pressure on President Robert Mugabe to leave office. The Minister instructed the media to turn a blind eye to the number of people who have died or [have become] infected with cholera, and instead focus on what the Government and NGOs are doing to contain the epidemic.
PHR heard from several sources in Zimbabwe that the Government has intentionally suppressed information regarding increasing malnutrition.
PHR asked a nurse staffing a public-sector clinic in a rural district if there had been cases of malnutrition. The nurse became visibly anxious and then replied:
“Malnutrition is very political. We are not supposed to have hunger in Zimbabwe. So even though we do see it, we cannot report it.”
DETERMINANTS OF HEALTH
» Failed sewerage and sanitation systems Before the ZANU-PF government nationalized municipal water authorities in 2006, water treatment and delivery systems worked, although suboptimally.
The Mugabe regime, however, politicized water for political gain and profit, policies that proved disastrous, and which have clearly contributed to the ongoing cholera epidemic.
All Harare residents PHR interviewed reported that trash collection has effectively ceased. Throughout Harare, and especially in the poor high-density areas outside the capital, PHR investigators saw detritus littering streets and clogging intersections. Steady streams of raw sewage flow through the refuse and merge with septic waste. A current Ministry of Health official reported to PHR: There is no decontamination of waste in the country.
» Nutrition and food security
The U.N. Food and Agricultural Organization (FAO) predicts that some 5.1 million (45% of the population) who will require food aid by early 2009 in order to survive. Agricultural output has dropped 50-70% over the past seven years. The ZANU-PF government has exacerbated food insecurity for Zimbabweans in 2008 by blocking international humanitarian organizations from delivering food aid and humanitarian aid to populations in the worst-affected rural areas. Patients with HIV/AIDS and TB are especially vulnerable to food insecurity.
In the months following the March 2008 elections, the Mugabe regime used food as a weapon of war against MDC supporters and the rural poor. On 31 December 2008, a government official in Chivhu prevented WFP from distributing food aid: “The villagers accused the chief of being corrupt and diverting donor aid and distributing it along party lines. They indicated that . . . the chief and his ZANU-PF supporters used to source maize from the nearby Grain Marketing Board and then sell it to the poor villagers.” A leader of a health NGO reported that:
“There is no food in many of the hospitals and there is starvation in the prisons.”
» Current health crisis: Cholera
The current cholera epidemic in Zimbabwe appears to have begun in August 2008. As of this writing, more than 1,700 Zimbabweans have died from the disease and another 35,000 people have been infected. The U.N. reports that cholera has spread to all of Zimbabwe’s ten provinces, and to 55 of the 62 districts (89%) and that the cumulative case fatality rate (CFR) across the country has risen to 5.0% - five times greater than what is typical in cholera outbreaks. Control has not been reached: There has been a doubling of both cases and deaths during the last three weeks of December, 2008.
› Cholera infectivity, epidemiology, and treatment The origin of the current cholera epidemic appears to stem from the failure of the Mugabe regime to maintain water purification measures and manage sewerage systems. Civic organizations in Harare warned of a cholera time-bomb in 2006, but the Mugabe regime ignored the warning signs. Not until 4 December 2008 did Zimbabwe’s Ministry of Health and Child Welfare finally request aid to respond to the cholera outbreak by declaring a national emergency. This negligence represents a four-month delay since the start of the cholera outbreak, but at least a three-year delay in responding to the water and sanitation breakdowns, which have allowed cholera to flourish.
Death rates from cholera are usually under 1%; however, in the current Zimbabwe epidemic, the cumulative death rate for the country is around 5%, and more than 40% of all districts have case fatality rates above 10%.
PHR asked a senior government official responsible for cholera surveillance why Zimbabwe’s case fatality rate was more than five times greater. She attributed the high death rate to three causes. First, in the initial phase there simply were no supplies, such as ORS and IV fluids. Second, few clinic or hospital staff were sufficiently experienced or trained to respond to cholera, and many patients died even in facilities that had adequate supplies. Finally, the issue of transport costs for patients and staff, exacerbated by the closure of the public hospitals, meant that many patients either could not reach care, or reached care in advanced dehydration, and could not be saved.
» Current health crisis: Anthrax
WHO has reported some 200 human cases of anthrax since November 2008 with eight confirmed deaths. These cases were attributed to the ingestion of animals (cattle and goats) that had died of anthrax. Zimbabweans avoid eating animals that have died of disease – but these cases appear to occurred in starving rural people scavenging carrion.
PHR was told that veterinary anthrax control programs in Zimbabwe, which had included regular monthly control programs, have been dramatically curtailed in the economic collapse. The surviving herds are now much more vulnerable to infectious diseases.
» Current Health Crisis: HIV/AIDS
UNAIDS figures show that Zimbabwe has a severe generalized epidemic of HIV-1, with an overall adult (ages 15-49) HIV prevalence rate of 15.3%. An estimated 1.3 million adults and children in Zimbabwe are living with HIV infection in 2008. Of these, some 680,000 were women of childbearing age.
In 2007, some 140,000 Zimbabweans died of AIDS, and the current toll is estimated at 400 AIDS deaths per day. Access to HIV/ AIDS care and treatment is threatened by the current collapse and HIV programs are currently capped: some 205,000 people are thought to be taking Anti-Retrovirals (ARVs), but no major program is currently able to enroll new patients. Some 800,000 Zimbabweans are thought to require therapy, or will require it in the coming months-years.
PHR investigators received corroborating reports from donors and HIV/AIDS patients in Zimbabwe that ZANU-PF government officials had plundered $7.3 million USD in humanitarian aid for HIV/AIDS treatment – part of $12.3 million USD from the Global Fund for AIDS, Tuberculosis and Malaria.
Following public outrage over the scandal months later in November 2008, the ZANU-PF-controlled reserve bank returned the stolen funds to the Global Fund.
For HIV/AIDS the most severe threat has been the interruption of regular supplies of antiretroviral drugs. Multiple key informants, patients, and providers told PHR that ARV supplies had become irregular due to breakdowns in drug delivery, distribution, provision, and theft of ARV drugs by ZANU-PF operatives. Most troubling were reports that some physicians were switching patients on established ARV regimens to other regimens based not on clinical need, but on drug availability. This can lead to drug resistant HIV strains. These dangerous practices constitute a significant threat to public health since the development and transmission of multi-drug resistant variants of HIV in Zimbabwe could undermine not only Zimbabwe’s HIV/ AIDS program, but regional programs as well.
» Current health crisis: Tuberculosis
PHR asked an expert working with the national program to describe the status of the program in December 2008: “There is no politically correct way to say this – the TB program in Zimbabwe is a joke. The national TB lab has one staff person. There is no one trained in drug sensitivity testing. The TB reference lab is just not functioning. This is a brain drain problem.
The lab was working well until 2006 and has since fallen apart. The DOTS program in 2000 was highly effective, but that has broken down now too.
There is no real data collection system for TB. This stopped in 2006 as well.”
Both MDR-TB and possible XDR-TB (a largely fatal and often untreatable
form) have emerged in Zimbabwe, but the critical capacity to diagnose and manage these infections has collapsed.
» Current health crisis: Maternal morbidity and mortality Maternal health in Zimbabwe has deteriorated greatly over the past decade.
The maternal mortality rate has risen from 168 (per 100,000) in 1990 to 1,100 (per 100,000) in 2005. The major contributors are HIV/ AIDS and a significant decline in availability and quality of maternal health services. PHR interviewed several Harare mothers at a distant Mission Hospital who had sought obstetric care. One went to Mbuya Nehanda Government Maternity Hospital for a cesarean section on 14 November 2008.
She was told that the operation could not be performed because there were no nurses, doctors, or anesthesiologists at work. Another woman said:
“I wanted to have my baby in Harare but Parirenyatwa hospital was closed.
I was having my prenatal care with my own doctor at [a private clinic] but they wanted so much money. They wanted only U.S. dollars, in cash. $3,000 dollars for the surgeon, $140 dollars for the nurse, and $700 dollars for the doctor who puts you to sleep.“
CONCLUSIONS
The health and healthcare crisis in Zimbabwe is a direct outcome of the malfeasance of the Mugabe regime and the systematic violation of a wide range of human rights, including the right to participate in government and in free elections and egregious failure to respect, protect and fulfill the right to health.
The findings contained in this report show, at a minimum, violations of the rights to life, health, food, water, and work. When examined in the context of 28 years of massive and egregious human rights violations against the people of Zimbabwe under the rule of Robert Mugabe, they constitute added proof of the commission by the Mugabe regime of crimes against humanity.
RECOMMENDATIONS
1. Resolve the political impasse
The UN Security Council and the South African Development Community should call on the Mugabe regime to accept the result of the 29 March election and allow the MDC to assume its place. Governments should end their support of Mugabe’s regime, engaging in intensive diplomacy to assure a democratic political transition. They should maintain and strengthen targeted bilateral sanctions until Mugabe cedes power and a stable government is established.
2. Launch an emergency health response
The government of Zimbabwe should yield control of its health services, water supply, sanitation, disease surveillance, Ministry of Health operations, and other public health functions to a United Nations-designated agency or consortium. Such a mechanism would be equivalent to putting the health system into a receivership pursuant to the existence of a circumstance that meets the criteria for the Responsibility to Protect. If the government of Zimbabwe refuses to yield such control, the U.N. Security Council, acting pursuant to its authority under Article 39 of the Charter, should enact a resolution compelling the Government of Zimbabwe to do so.
3. Refer the situation in Zimbabwe to the International Criminal Court for crimes against humanity The U.N. Security Council, acting pursuant to its authority under Article
41 of the U.N. Charter, should enact a resolution referring the crisis in Zimbabwe to the International Criminal Court for investigation and to begin the process of compiling documentary and other evidence that would support the charge of crimes against humanity.
4. Convene an emergency summit on HIV/AIDS, tuberculosis and other infectious diseases Donor governments and the Global Fund should consider this crisis as a first test-case of the collapse of a health system in a country that is a recipient of emergency AIDS and TB prevention and treatment programs. The Obama Administration, together with the Global Fund and other donors, should convene an emergency summit to coordinate action to address the current acute shortfalls in AIDS and Tuberculosis treatment and care.
5. Prevent further nutritional deterioration and ensure household food security To prevent further deterioration of nutritional status, especially among the most vulnerable (young children, mothers, HIV/AIDS, and TB sufferers), the international community needs urgently to fully fund the 2009 Consolidated Appeal (CAP) for Zimbabwe of $550 million USD. Importantly, donor governments must ensure non-interference by the current governing regime in obstructing, diverting, politicizing, or looting such humanitarian aid. The United States as well as other donor governments and private voluntary organizations should increase donations of appropriate foods to the responsible multilateral agencies, such as WFP, to meet the impending shortfall in the coming three to six months.
© Physicians for Human Rights http://physiciansforhumanrights.org
WHO reports decline in new cases of cholera in Zimbabwe
The World Health Organisation this week reported that the number of people who have died from cholera in the country has topped 4,000, with over 89,000 infected by the disease, but there has been a decline in new cases.
WHO spokeswoman Fadela Chaib said they have recorded a certain decline in cases and deaths from week to week since the start of the new year. Last week WHO identified 2,151 new cases - a figure that well down from the 8,000 per week at the beginning of the year.
Lack of clean water together with the blocked sewage systems and the uncollected refuse overflowing in the streets has been at the center of this cholera outbreak, according to a report released in February by Medecins Sans Frontiere.
Now analysts are expressing shock at reports that the African regional office of the World Health Organisation, based in Harare, has done little to help with the cholera outbreak. Critics say the regional office has been ineffective because of mismanagement and a ‘cosy’ relationship with the government.
The South African based Mail and Guardian reports that health activists and academics have told them the regional office’s response to the outbreak was disastrously slow, despite the fact that it has a US$1.2 billion biennial budget at its disposal.
Observers have said that WHO-Afro is seen by many as an employment option in retirement, often employing ex-ministers. As one observer pointed out; ‘It is difficult to be critical when "you're sitting in cahoots with the
government.’
But other governments have been trying to help Zimbabwe pick up the pieces of its shattered health system. On Wednesday the Australian government lifted it’s long standing ban on non humanitarian aid and announced it would provide about US$10 million to repair the water, sanitation and health services that have been left in ruins by the ZANU PF government.
WHO spokeswoman Fadela Chaib said they have recorded a certain decline in cases and deaths from week to week since the start of the new year. Last week WHO identified 2,151 new cases - a figure that well down from the 8,000 per week at the beginning of the year.
Lack of clean water together with the blocked sewage systems and the uncollected refuse overflowing in the streets has been at the center of this cholera outbreak, according to a report released in February by Medecins Sans Frontiere.
Now analysts are expressing shock at reports that the African regional office of the World Health Organisation, based in Harare, has done little to help with the cholera outbreak. Critics say the regional office has been ineffective because of mismanagement and a ‘cosy’ relationship with the government.
The South African based Mail and Guardian reports that health activists and academics have told them the regional office’s response to the outbreak was disastrously slow, despite the fact that it has a US$1.2 billion biennial budget at its disposal.
Observers have said that WHO-Afro is seen by many as an employment option in retirement, often employing ex-ministers. As one observer pointed out; ‘It is difficult to be critical when "you're sitting in cahoots with the
government.’
But other governments have been trying to help Zimbabwe pick up the pieces of its shattered health system. On Wednesday the Australian government lifted it’s long standing ban on non humanitarian aid and announced it would provide about US$10 million to repair the water, sanitation and health services that have been left in ruins by the ZANU PF government.
Refugee crisis in Johannesburg sparks legal battle with church leader
The leader of the Central Methodist Church in Johannesburg, Bishop Paul Verryn, has been dragged into a legal battle with local businesses in the area, because of the swelling numbers of Zimbabwean refugees living on, and around, the church premises.
The church is fighting a High Court application filed by local businesses, who are seeking to have the refugees moved elsewhere. Business owners have argued that there are serious sanitation, hygiene and safety scares as a result of the numbers of exiles living on the streets outside the church, and many have a demanded that a fence be erected to cordon off the exiles from the rest of the city. Bishop Verryn is now facing a court action from two companies which are adjacent to the church on Pritchard Street. They want the church to remove the 20 mobile toilets which are a stone’s throw from one business which is a restaurant and to find an alternative place for the refugees.
On Wednesday an emergency meeting between business leaders, church leaders and City of Johannesburg officials was convened to find an urgent solution to the refugee crisis now affecting the heart of Johannesburg. City officials have now reportedly made steps to resolve the crisis, asking for a joint task team to be formed with all the relevant parties, to deal with the worsening hygienic conditions.
The Central Methodist Church has been a lifeline to thousands of Zimbabwean refugees forced to flee their own country, which has been crippled by combined humanitarian, economic and political crises. With nowhere else to go, more than 3000 men, women and children have been living on the church premises, receiving food and medical treatment from local NGOs, with an estimated 2000 living on the city streets outside. But that number has swelled significantly in the past week, after authorities in the border town Musina closed an overflowing refugee camp there.
By last Wednesday the makeshift shelters of an estimated 5000 Zimbabweans exiles living at the Musina showgrounds had been torn down and burnt, after the Department of Home Affairs announced it was closing a mobile refugee registration office that was based near the camp. The decision to close the camp was met with outrage by charity groups, with Doctors Without Borders officials saying the move “demonstrates a flagrant disregard for the humanitarian and protection needs of Zimbabweans seeking refuge in South Africa and will have extremely negative consequences, as no allowances have been made to ensure their access to shelter, food or medical assistance.”
The charity described in a statement last week the cruel nature with which authorities shut down the camp, explaining that families were not even allowed to stay together. Last Tuesday authorities started dividing the refugees into different groups, according to their legal status, gender, and age. Women with children, pregnant women and unaccompanied minors were removed from a special location that had been established for them at the showground, despite having nowhere else to go. The remaining refugees were then ordered to vacate the area. With many holding no documentation protecting them from the threat of deportation, hundreds fled to Johannesburg seeking protection and shelter.
Meanwhile, the Department of Home Affairs has confirmed that it is considering giving Zimbabwean nationals temporary legal status in order for them to work in the country. The exemption card would allow them to work and live in South Africa for a period of time, yet to be decided by the Government.
The church is fighting a High Court application filed by local businesses, who are seeking to have the refugees moved elsewhere. Business owners have argued that there are serious sanitation, hygiene and safety scares as a result of the numbers of exiles living on the streets outside the church, and many have a demanded that a fence be erected to cordon off the exiles from the rest of the city. Bishop Verryn is now facing a court action from two companies which are adjacent to the church on Pritchard Street. They want the church to remove the 20 mobile toilets which are a stone’s throw from one business which is a restaurant and to find an alternative place for the refugees.
On Wednesday an emergency meeting between business leaders, church leaders and City of Johannesburg officials was convened to find an urgent solution to the refugee crisis now affecting the heart of Johannesburg. City officials have now reportedly made steps to resolve the crisis, asking for a joint task team to be formed with all the relevant parties, to deal with the worsening hygienic conditions.
The Central Methodist Church has been a lifeline to thousands of Zimbabwean refugees forced to flee their own country, which has been crippled by combined humanitarian, economic and political crises. With nowhere else to go, more than 3000 men, women and children have been living on the church premises, receiving food and medical treatment from local NGOs, with an estimated 2000 living on the city streets outside. But that number has swelled significantly in the past week, after authorities in the border town Musina closed an overflowing refugee camp there.
By last Wednesday the makeshift shelters of an estimated 5000 Zimbabweans exiles living at the Musina showgrounds had been torn down and burnt, after the Department of Home Affairs announced it was closing a mobile refugee registration office that was based near the camp. The decision to close the camp was met with outrage by charity groups, with Doctors Without Borders officials saying the move “demonstrates a flagrant disregard for the humanitarian and protection needs of Zimbabweans seeking refuge in South Africa and will have extremely negative consequences, as no allowances have been made to ensure their access to shelter, food or medical assistance.”
The charity described in a statement last week the cruel nature with which authorities shut down the camp, explaining that families were not even allowed to stay together. Last Tuesday authorities started dividing the refugees into different groups, according to their legal status, gender, and age. Women with children, pregnant women and unaccompanied minors were removed from a special location that had been established for them at the showground, despite having nowhere else to go. The remaining refugees were then ordered to vacate the area. With many holding no documentation protecting them from the threat of deportation, hundreds fled to Johannesburg seeking protection and shelter.
Meanwhile, the Department of Home Affairs has confirmed that it is considering giving Zimbabwean nationals temporary legal status in order for them to work in the country. The exemption card would allow them to work and live in South Africa for a period of time, yet to be decided by the Government.
Tuesday, February 24, 2009
UN says Zimbabwe cholera cases rise above 80,000
The U.N. health agency says the number of cholera cases in Zimbabwe has soared above 80,000.
The World Health Organization said Friday that the death toll is now 3,759 out of 80,250 cases.
Spokeswoman Fadela Chaib said those figures include all reported cases and deaths since the outbreak began in August through Thursday.
Cholera has spread rapidly in the African nation because of Zimbabwe's poorly maintained infrastructure and crumbling health care system.
The World Health Organization said Friday that the death toll is now 3,759 out of 80,250 cases.
Spokeswoman Fadela Chaib said those figures include all reported cases and deaths since the outbreak began in August through Thursday.
Cholera has spread rapidly in the African nation because of Zimbabwe's poorly maintained infrastructure and crumbling health care system.
Wednesday, February 18, 2009
New Minister of Labor Needs to Review Social Welfare Policy and Programs
The newly appointed minister of labor, Ms Pauline Gwanyanya, needs to take a closer look and develop a kin interest in the suffering of poor Zimbabweans who lack a safety net that can protect them from the very harsh economic situation in Zimbabwe.
As a graduate student studying social welfare and public policy I am moved by the social injustice that Zimbabweans have to endure during this period of global and national economic turmoil which has been accentuated by the hitherto incompetent Robert Mugabe government which has since been diluted by the Movement for Democratic Change.
The new minister needs to assess social needs of the people of Zimbabwe who are either unemployed or employed but earning insufficient incomes as well as the most vulnerable populations such as children, the sick, and the aged. Today, it has been reported that the United Kingdom announced a plan to repatriate aged British nationals who have been ignored by the Zimbabwean government. The plight of the weak and the aged needs to be put into perspective and strategies adopted to ameliorate their suffering.
There are a number of models that can be followed inorder to improve the living conditions of the poor in Zimbabwe. The American and Swedish welfare systems are commendable and certainly ideal models to follow.
As a graduate student studying social welfare and public policy I am moved by the social injustice that Zimbabweans have to endure during this period of global and national economic turmoil which has been accentuated by the hitherto incompetent Robert Mugabe government which has since been diluted by the Movement for Democratic Change.
The new minister needs to assess social needs of the people of Zimbabwe who are either unemployed or employed but earning insufficient incomes as well as the most vulnerable populations such as children, the sick, and the aged. Today, it has been reported that the United Kingdom announced a plan to repatriate aged British nationals who have been ignored by the Zimbabwean government. The plight of the weak and the aged needs to be put into perspective and strategies adopted to ameliorate their suffering.
There are a number of models that can be followed inorder to improve the living conditions of the poor in Zimbabwe. The American and Swedish welfare systems are commendable and certainly ideal models to follow.
Monday, February 9, 2009
Social Welfare Reform Needed in Zimbabwe
The current humanitarian crisis in Zimbabwe calls for an evaluation and restructuring of the Zimbabwe Social Welfare Policy and Programs. Priorities need to be centered on the welfare of children, women, the sick,the disabled, low-income families, and the unemployed.
There is a need to cut down spending in sectors such as defence and foreign affairs. The funds that will be saved from this exercise need to be diverted towards social welfare and additionally the national fiscus needs to expand the resource base for this crucial sector. Zimbabwe needs to address the current poverty affecting the majority of the population which cannot afford basic commodities such as mealie-meal, cooking oil, bread, milk, and meat. Tuition in schools is now out of reach for many while clinics and hospitals have since been closed worsening the HIV/AIDS situation and the recent outbreak of cholera.
This blogger recommends food vouchers, tuition assistance, universal health insurance, and unemployment benefits for the virtually idle population. This will stimulate the ailing economy and boost the agricultural, manufacturing, and retail industry. Above all, this will ameliorate the problem of poverty which has become a humanitarian catastrophe in Zimbabwe.
In the upcoming contributions on this subject this blogger will evaluate the current social welfare policy and the Millenium development goals and examine whether they are adequate and being met. This blogger will analyze the mission of the department of social welfare and evaluate whether the government is doing enough or nothing to achieve its goals. Finally, strategies will be recommended of improving the appaling living conditions of Zimbabweans today.
There is a need to cut down spending in sectors such as defence and foreign affairs. The funds that will be saved from this exercise need to be diverted towards social welfare and additionally the national fiscus needs to expand the resource base for this crucial sector. Zimbabwe needs to address the current poverty affecting the majority of the population which cannot afford basic commodities such as mealie-meal, cooking oil, bread, milk, and meat. Tuition in schools is now out of reach for many while clinics and hospitals have since been closed worsening the HIV/AIDS situation and the recent outbreak of cholera.
This blogger recommends food vouchers, tuition assistance, universal health insurance, and unemployment benefits for the virtually idle population. This will stimulate the ailing economy and boost the agricultural, manufacturing, and retail industry. Above all, this will ameliorate the problem of poverty which has become a humanitarian catastrophe in Zimbabwe.
In the upcoming contributions on this subject this blogger will evaluate the current social welfare policy and the Millenium development goals and examine whether they are adequate and being met. This blogger will analyze the mission of the department of social welfare and evaluate whether the government is doing enough or nothing to achieve its goals. Finally, strategies will be recommended of improving the appaling living conditions of Zimbabweans today.
Zimbabwe Government's Department of Social Services
MISSION STATEMENT
1. To provide assistance and support to the vulnerable through the development and implementation of effective policies and legal instruments, proffessional social work and training in order to promote self-reliance and social security.
2. To reduce poverty and enhance self-reliance through the provision of social protection services to vulnerable and disadvantagcd groups in society.
This is done through:-
the care and protection of minors; and adoption of children;
the establishment of corrective institutions and rehabilitation of beggars, vagrants and prostitutes;
family casework;
provision of therapy and counselling services for the physically and mentally handicapped;
counselling on alcohol and drug abuses;
provision of protection and care of refugees;
provision of rehabilitation services for the disabled, care for the aged and supervision of the services given by private old people's homes;
the administartion of the National Heroes Act;
the administration of the War Veterans Act;
the administration of the Disability Act;
distribution of drought relief in drought stricken areas;
provision of material assistance to destitutes such as school, examination and health fees and maintenance allowances; and
the registration and monitoring private voluntary organisations both local and foreign, operating in Zimbabwe.
The Department undertakes to administer, co-ordinate, monitor the effective and efficient delivery of social protection interventions through Central Government by:
(1) Co-ordinating the design and formulation of social policy on a continuous basis;
(2) Publicising all the social protection programmes at the beginning of every financial year;
(3) Registering private voluntary organizations within three-months of receipt of documents;
(4) Setting and reviewing standards and guidelines for the delivery of social protection by local authorities at the beginning of every financial year;
(5) Registering and counselling refugees within three months of arrival;
(6) Paying correct maintenance allowances/food vouchers to refugees at the end of every month;
(7) Repatriating refugees whenever conditions are conducive; and
(8) Processing business proposals submitted by micro-finance institutions within forty-five days. Through local authorities, in accordance with agreed standards by:
(9) Investigating and assessing public assistance cases within fourteen (14) working days of receipt of the necessary information;
(10) Paying correct public assistance entitlements to qualifying individuals at the end of every month;
(11) Paying fees and grants to institutions within thirty (30) days of receipt of claim documents;
(12) Providing relief assistance to survivors of disasters within a month upon the onset of the event;
(13) Assessing adoptive and foster parents within six (6) months of submission of application;
(14) Investigating cases of children at risk into places of safety within 48 hours;
(15) Removing and replacing children at risk into places of safety within 48 hours;
(16) Presenting cases to court within the prescribed legal period;
(17) Compiling reports and representing children in court within the prescribed legal period;
(18) Rehabilitating delinquents within three (3) years;
(19) Reviewing court orders before date of expiry of existing order;
(20) Processing applications for registration of welfare organizations within six (6) months;
(21) Investigating queries/complaints pertaining to welfare organizations and institutions within two (2) weeks of receipt of reports;
(22) Counselling individuals and families within seven (7) days after presentation;
(23) Promoting the rights of vulnerable groups by conducting awareness campaigns quarterly;
(24) Processing repatriations of non-nationals within four (4) months of application; and
(25) Registering creches within six (6) months of application and inspecting them every six (6) months
1. To provide assistance and support to the vulnerable through the development and implementation of effective policies and legal instruments, proffessional social work and training in order to promote self-reliance and social security.
2. To reduce poverty and enhance self-reliance through the provision of social protection services to vulnerable and disadvantagcd groups in society.
This is done through:-
the care and protection of minors; and adoption of children;
the establishment of corrective institutions and rehabilitation of beggars, vagrants and prostitutes;
family casework;
provision of therapy and counselling services for the physically and mentally handicapped;
counselling on alcohol and drug abuses;
provision of protection and care of refugees;
provision of rehabilitation services for the disabled, care for the aged and supervision of the services given by private old people's homes;
the administartion of the National Heroes Act;
the administration of the War Veterans Act;
the administration of the Disability Act;
distribution of drought relief in drought stricken areas;
provision of material assistance to destitutes such as school, examination and health fees and maintenance allowances; and
the registration and monitoring private voluntary organisations both local and foreign, operating in Zimbabwe.
The Department undertakes to administer, co-ordinate, monitor the effective and efficient delivery of social protection interventions through Central Government by:
(1) Co-ordinating the design and formulation of social policy on a continuous basis;
(2) Publicising all the social protection programmes at the beginning of every financial year;
(3) Registering private voluntary organizations within three-months of receipt of documents;
(4) Setting and reviewing standards and guidelines for the delivery of social protection by local authorities at the beginning of every financial year;
(5) Registering and counselling refugees within three months of arrival;
(6) Paying correct maintenance allowances/food vouchers to refugees at the end of every month;
(7) Repatriating refugees whenever conditions are conducive; and
(8) Processing business proposals submitted by micro-finance institutions within forty-five days. Through local authorities, in accordance with agreed standards by:
(9) Investigating and assessing public assistance cases within fourteen (14) working days of receipt of the necessary information;
(10) Paying correct public assistance entitlements to qualifying individuals at the end of every month;
(11) Paying fees and grants to institutions within thirty (30) days of receipt of claim documents;
(12) Providing relief assistance to survivors of disasters within a month upon the onset of the event;
(13) Assessing adoptive and foster parents within six (6) months of submission of application;
(14) Investigating cases of children at risk into places of safety within 48 hours;
(15) Removing and replacing children at risk into places of safety within 48 hours;
(16) Presenting cases to court within the prescribed legal period;
(17) Compiling reports and representing children in court within the prescribed legal period;
(18) Rehabilitating delinquents within three (3) years;
(19) Reviewing court orders before date of expiry of existing order;
(20) Processing applications for registration of welfare organizations within six (6) months;
(21) Investigating queries/complaints pertaining to welfare organizations and institutions within two (2) weeks of receipt of reports;
(22) Counselling individuals and families within seven (7) days after presentation;
(23) Promoting the rights of vulnerable groups by conducting awareness campaigns quarterly;
(24) Processing repatriations of non-nationals within four (4) months of application; and
(25) Registering creches within six (6) months of application and inspecting them every six (6) months
Zimbabwe Government's Millenium Development Goals
Publicizing and Scrutinizing Social Welfare Policy in Zimbabwe
Zimbabwe Millennium Development Goals 2015
By 2015 Zimbabwe has pledged to:
GOAL 1.
Eradicate extreme poverty and hunger
Target 1:
* Halve, between 2002 and 2015, the proportion of people whose income is less than the Total Consumption Poverty Line (TCPL).
* Halve, between 2000 and 2015, the proportion of people in Human Poverty, as measured by the Human Poverty Index (HPI).
Target 2:
i Halve, between 2002 and 2015, the proportion of people who suffer from hunger.
ii Reduce by two-thirds, between 2002 and 2015, the proportion of under-five children who are malnourished.
GOAL 2.
Achieve universal primary education
Target 3:
. Ensure that, between 2000 and 2015, all Zimbabwean children, boys and girls alike, will be able to complete a full programme of primary education.
GOAL 3.
Promote gender equality and empower women
Target 4 (A):
Eliminate gender disparity in primary and secondary education, preferably, by 2005 and at ail levels ot education no later than 2015.
Target 4 (B):
. Increase the participation of women in decision-making in all sectors and at all levels (to 40% for women in senior civil service positions and to 30% for women in Parliament) by 2005 and to 50:50 balance by 2015.
GOAL 4,
Reduce child mortality
Target 5:
.Reduce bv two-thirds, between 2000 and 2015, the under-five mortality rate.
GOAL 5.
Improve maternal health
Target 6:
. Reduce by three-quarters, between 2000 and 2015, the maternal mortality ratio.
GOAL 6.
Combat HIV and AIDS, malaria and other diseases
Target 7:
. Have halted, by 2015, and begun to reverse the spread of HIV and AIDS.
Target 8:
.Have halted, by 2015, and began to reverse the increasing incidence of Malaria, TB and Diarrhoeal diseases.
GOAL 7.
Ensure environmental sustainability
Target 9:
Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources.
Target 10:
Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation.
Target 11:
By 2020, achieve a significant improvement in the housing condition of at least 1,000,000 slum dwellers, peri-urban and high density lodgers.
GOAL 8.
Develop a global partnership for development
Target 12:
Develop further an open, rule-based, predictable, non-discriminatory trading and financial system.
Target 13:
Not Applicable
Target 14:
Address the special needs of the countrv's landlocked status.
Target 15:
Deal comprehensively with debt problems.
Target 16:
In co-operation with strategic partners, develop and implement strategies for decent and productive work for everyone.
Target 17:
In co-operation with pharmaceutical companies, provide access to affordable essential drugs.
Target 18:
In co-operation with the private sector, make available the benefits of new technologies, especially information and communications.
Zimbabwe Millennium Development Goals 2015
By 2015 Zimbabwe has pledged to:
GOAL 1.
Eradicate extreme poverty and hunger
Target 1:
* Halve, between 2002 and 2015, the proportion of people whose income is less than the Total Consumption Poverty Line (TCPL).
* Halve, between 2000 and 2015, the proportion of people in Human Poverty, as measured by the Human Poverty Index (HPI).
Target 2:
i Halve, between 2002 and 2015, the proportion of people who suffer from hunger.
ii Reduce by two-thirds, between 2002 and 2015, the proportion of under-five children who are malnourished.
GOAL 2.
Achieve universal primary education
Target 3:
. Ensure that, between 2000 and 2015, all Zimbabwean children, boys and girls alike, will be able to complete a full programme of primary education.
GOAL 3.
Promote gender equality and empower women
Target 4 (A):
Eliminate gender disparity in primary and secondary education, preferably, by 2005 and at ail levels ot education no later than 2015.
Target 4 (B):
. Increase the participation of women in decision-making in all sectors and at all levels (to 40% for women in senior civil service positions and to 30% for women in Parliament) by 2005 and to 50:50 balance by 2015.
GOAL 4,
Reduce child mortality
Target 5:
.Reduce bv two-thirds, between 2000 and 2015, the under-five mortality rate.
GOAL 5.
Improve maternal health
Target 6:
. Reduce by three-quarters, between 2000 and 2015, the maternal mortality ratio.
GOAL 6.
Combat HIV and AIDS, malaria and other diseases
Target 7:
. Have halted, by 2015, and begun to reverse the spread of HIV and AIDS.
Target 8:
.Have halted, by 2015, and began to reverse the increasing incidence of Malaria, TB and Diarrhoeal diseases.
GOAL 7.
Ensure environmental sustainability
Target 9:
Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources.
Target 10:
Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation.
Target 11:
By 2020, achieve a significant improvement in the housing condition of at least 1,000,000 slum dwellers, peri-urban and high density lodgers.
GOAL 8.
Develop a global partnership for development
Target 12:
Develop further an open, rule-based, predictable, non-discriminatory trading and financial system.
Target 13:
Not Applicable
Target 14:
Address the special needs of the countrv's landlocked status.
Target 15:
Deal comprehensively with debt problems.
Target 16:
In co-operation with strategic partners, develop and implement strategies for decent and productive work for everyone.
Target 17:
In co-operation with pharmaceutical companies, provide access to affordable essential drugs.
Target 18:
In co-operation with the private sector, make available the benefits of new technologies, especially information and communications.
Thursday, February 5, 2009
Average Zimbabwean now living in extreme poverty
There are four categories of poverty, namely, absolute poverty, relative poverty, extreme poverty, and moderate poverty (Viggiani, 2007). Of these four, the average Zimbabwean(majority) aptly falls into the third category which has been defined by Viggiani as referring to chronic hunger and no access to health care, safe drinking water, sanitation, education, and housing. The World Bank uses a standard of income of U.S. $1 per day per person or less of purchasing power.
Recently, the estimate for cholera case was put at around 60 000 people and 3000 deaths due to this easily curable disease.The country's major hospitals such as Parirenyatwa, Harare, Mpilo, and Bulawayo Hospital have been closed living thousands to resort to rural hospitals and financially inaccessable private hospitals such as St. Annes, Baines, and Avenues Hospitals.
Zimbabwe has 80% unemployment and 7 out of 10 people eat one meal a day in a country whose inflation is a staggering 231 million percent.According to the Combined Harare Residence Association (19-24 January 2009 Report) a family of six requires US$86 per week to survive, that is, purchasing a 10kg bag of mealie meal, 2 litres cooking oil,6 kgs economy beef, transportation, bread, 2kgs of sugar, and 6 litres of drink. Meanwhile, lecturers in universities are earning US$50 per month.
The main cause of this extreme poverty has been structural, meaning, it is a result of a system presided over by the government of Robert Mugabe. There has been no policy intervention to create a safety net for the low-income population and the unemployed. Apparently, societal structures have been favoring the ruling elite over the rest of the impoverished population.
Recently, the estimate for cholera case was put at around 60 000 people and 3000 deaths due to this easily curable disease.The country's major hospitals such as Parirenyatwa, Harare, Mpilo, and Bulawayo Hospital have been closed living thousands to resort to rural hospitals and financially inaccessable private hospitals such as St. Annes, Baines, and Avenues Hospitals.
Zimbabwe has 80% unemployment and 7 out of 10 people eat one meal a day in a country whose inflation is a staggering 231 million percent.According to the Combined Harare Residence Association (19-24 January 2009 Report) a family of six requires US$86 per week to survive, that is, purchasing a 10kg bag of mealie meal, 2 litres cooking oil,6 kgs economy beef, transportation, bread, 2kgs of sugar, and 6 litres of drink. Meanwhile, lecturers in universities are earning US$50 per month.
The main cause of this extreme poverty has been structural, meaning, it is a result of a system presided over by the government of Robert Mugabe. There has been no policy intervention to create a safety net for the low-income population and the unemployed. Apparently, societal structures have been favoring the ruling elite over the rest of the impoverished population.
Thursday, January 15, 2009
Zimbabwe health crisis 'a crime'
The health crisis in Zimbabwe should be the subject of an investigation by the International Criminal Court, campaign group Physicians for Human Rights says.
President Robert Mugabe's government is responsible for the collapse of the health, water and sanitation systems - violating human rights, it says.
With no functioning public hospitals, the cholera epidemic has killed far more than 2,000 people, it added.
The US-based group called for the UN to take control of the health service.
Physicians for Human Rights says the "shocking" findings in its report - Health in Ruins, a man-made disaster in Zimbabwe - should compel the international community to act.
"They wanted only US dollars in cash. $3,000 for the surgeon, $140 for the nurse and $700 for the doctor who puts you to sleep"-
Woman wanting a caesarean
PHR's report Health in Ruins
"These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity," it says in the report's preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda.
New figures from the UN World Health Organization on Tuesday put the death toll from the cholera epidemic which broke out in August at 2,024.
The British Red Cross has warned that with the onset of the rainy season, flooding could seriously exacerbate the rate of infection as sewage may contaminate water sources further.
Health sector politicised
President Mugabe has been facing intensified criticism over the dire economic and humanitarian situation in Zimbabwe.
Robert Mugabe has blamed Zimbabwe's problems on the West
He signed a power-sharing deal with his rival, Morgan Tsvangirai, in September, intended to rescue the collapsing economy but progress has since stalled over who should control key ministries.
Mr Tsvangirai has threatened to pull out of power-sharing talks unless abductions of his supporters stop.
Among its recommendations, the report says the UN Security Council and Southern African Development Community (SADC) should call on Mr Mugabe to accept the first round of last year's presidential election, which was won by Mr Tsvangirai.
The opposition leader withdrew from a run-off in June citing state-sponsored violence.
The report's findings are based on a visit to the country by four human rights investigators and two doctors in December 2008.
It says the scale and scope of the health sector's collapse last year was "unprecedented" and the government deliberately tried to downplay the cholera outbreak at first.
"The Mugabe regime has used any means at its disposal, including the politicisation of the health sector, to maintain its hold on power," the preface says.
The government had ignored warnings from civic organisations in 2006 about the possibility of a cholera outbreak because of a failure to maintain water purification systems, it said.
Mr Mugabe's allies have accused western countries of trying to use the cholera outbreak as an excuse to topple him.
They blame Zimbabwe's problems on Western sanctions.
Dollarization
Physicians for Human Rights says the root of the crisis is the economic collapse - citing in particular the land seizures of 2000 and failure to control hyperinflation.
HEALTH CRISIS
Cholera: 2,204 died since August
Anthrax: Eight deaths since November
HIV/Aids: Estimated 400 deaths a day
TB: Brain-drain has practically closed the national testing laboratory which now has only one staff member
Maternal mortality: Risen from 168 per 100,000 in 1990 to 1,100 in 2005
As a result, there is more than 80% unemployment in the country and those with jobs find their salary is worthless unless they are paid in foreign currency.
A government doctor showed the PHR her payslip for November 2008; she was paid the equivalent of 32 US cents (22 pence) for the whole month.
The dollarization of the economy has meant that only a small elite now have access to healthcare.
There is now enormous pressure on mission hospitals which are having to treat patients from urban areas.
A mother who had her baby at a mission hospital told PHR investigators that she had tried to have a caesarean at the main government hospital in Harare, but it had been closed.
A private clinic would do the operation in November for "US dollars, in cash".
"$3,000 for the surgeon, $140 for the nurse and $700 for the doctor who puts you to sleep," she said.
The report also focussed on other health issues such as an anthrax outbreak, the HIV/Aids crisis, tuberculosis and maternal mortality.
It noted that life expectancy had fallen from 62 years for both sexes in 1990 to 34 years for men and 37 years for women in 2006, the world's lowest.
President Robert Mugabe's government is responsible for the collapse of the health, water and sanitation systems - violating human rights, it says.
With no functioning public hospitals, the cholera epidemic has killed far more than 2,000 people, it added.
The US-based group called for the UN to take control of the health service.
Physicians for Human Rights says the "shocking" findings in its report - Health in Ruins, a man-made disaster in Zimbabwe - should compel the international community to act.
"They wanted only US dollars in cash. $3,000 for the surgeon, $140 for the nurse and $700 for the doctor who puts you to sleep"-
Woman wanting a caesarean
PHR's report Health in Ruins
"These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity," it says in the report's preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda.
New figures from the UN World Health Organization on Tuesday put the death toll from the cholera epidemic which broke out in August at 2,024.
The British Red Cross has warned that with the onset of the rainy season, flooding could seriously exacerbate the rate of infection as sewage may contaminate water sources further.
Health sector politicised
President Mugabe has been facing intensified criticism over the dire economic and humanitarian situation in Zimbabwe.
Robert Mugabe has blamed Zimbabwe's problems on the West
He signed a power-sharing deal with his rival, Morgan Tsvangirai, in September, intended to rescue the collapsing economy but progress has since stalled over who should control key ministries.
Mr Tsvangirai has threatened to pull out of power-sharing talks unless abductions of his supporters stop.
Among its recommendations, the report says the UN Security Council and Southern African Development Community (SADC) should call on Mr Mugabe to accept the first round of last year's presidential election, which was won by Mr Tsvangirai.
The opposition leader withdrew from a run-off in June citing state-sponsored violence.
The report's findings are based on a visit to the country by four human rights investigators and two doctors in December 2008.
It says the scale and scope of the health sector's collapse last year was "unprecedented" and the government deliberately tried to downplay the cholera outbreak at first.
"The Mugabe regime has used any means at its disposal, including the politicisation of the health sector, to maintain its hold on power," the preface says.
The government had ignored warnings from civic organisations in 2006 about the possibility of a cholera outbreak because of a failure to maintain water purification systems, it said.
Mr Mugabe's allies have accused western countries of trying to use the cholera outbreak as an excuse to topple him.
They blame Zimbabwe's problems on Western sanctions.
Dollarization
Physicians for Human Rights says the root of the crisis is the economic collapse - citing in particular the land seizures of 2000 and failure to control hyperinflation.
HEALTH CRISIS
Cholera: 2,204 died since August
Anthrax: Eight deaths since November
HIV/Aids: Estimated 400 deaths a day
TB: Brain-drain has practically closed the national testing laboratory which now has only one staff member
Maternal mortality: Risen from 168 per 100,000 in 1990 to 1,100 in 2005
As a result, there is more than 80% unemployment in the country and those with jobs find their salary is worthless unless they are paid in foreign currency.
A government doctor showed the PHR her payslip for November 2008; she was paid the equivalent of 32 US cents (22 pence) for the whole month.
The dollarization of the economy has meant that only a small elite now have access to healthcare.
There is now enormous pressure on mission hospitals which are having to treat patients from urban areas.
A mother who had her baby at a mission hospital told PHR investigators that she had tried to have a caesarean at the main government hospital in Harare, but it had been closed.
A private clinic would do the operation in November for "US dollars, in cash".
"$3,000 for the surgeon, $140 for the nurse and $700 for the doctor who puts you to sleep," she said.
The report also focussed on other health issues such as an anthrax outbreak, the HIV/Aids crisis, tuberculosis and maternal mortality.
It noted that life expectancy had fallen from 62 years for both sexes in 1990 to 34 years for men and 37 years for women in 2006, the world's lowest.
Health system problems aggravate cholera outbreak in Zimbabwe
WHO setting up a cholera control centre, seeking US$ 6 million in support
10 December 2008 | HARARE -- A widespread cholera outbreak, under-resourced and under-staffed health system, and inadequate access to safe drinking water and hygiene are threatening the wellbeing of thousands of Zimbabweans. As of 9 December, 16 141 suspected cases of cholera and 775 resultant deaths (case fatality rate of 4.8%) had been recorded since August in two-thirds of the country's 62 districts.
WHO is establishing a cholera control and command centre, in conjunction with the Ministry of Health and Child Welfare (MoHCW) and other health partners, to respond in a coordinated manner to Zimbabwe's health challenges. WHO is seeking donor support for a US$ 6 million proposal for its cholera response plan.
Approximately half of cholera cases have been recorded in Budiriro, a heavily populated suburb on the western outskirts of the capital, Harare. Other major concentrations of reported cases include Beitbridge, on the South African border, and Mudzi, on the border with Mozambique.
The outbreak could surpass 60 000 cases, according to an estimate by the Zimbabwe Health Cluster, which is a group coordinated by WHO and comprising health providers, nongovernmental organizations and the MoHCW. The estimate is based on six million people, or half of Zimbabwe's 12 million population, potentially being at risk of contracting cholera, with an estimated 1% of those at risk of actually suffering from cholera. With the rainy season commencing and increased transit of people likely due to the Christmas season, there are risks for further spread of cholera if strong measures are not taken.
There are also serious regional implications, with cholera cases crossing into South Africa and Botswana. On 2 December, South African health authorities said the country had recorded 460 cholera cases and nine related deaths, mostly in border areas near Zimbabwe.
"This outbreak can be contained, but it will depend on many factors, in particular a coordinated approach between all health providers to make sure we are providing the right interventions where they are needed most," said Dr Custodia Mandhlate, WHO Representative to Zimbabwe. "Such interventions include prevention, quick case detection and control, and improved treatment."
The major cause of the cholera outbreak is the inadequate supply of clean drinking water and poor levels of hygiene. Shortages of medicines, equipment and staff at health facilities throughout the country are compounding the health challenges. WHO is advocating for improved access to oral rehydration salts for treating moderate dehydration, which is a symptom of cholera. This could help quickly reduce sickness and deaths.
To help Zimbabwean authorities and partners respond to the health emergency, WHO has sent medical supplies to treat 50 000 people for common conditions for three months, as well as 3200 moderate cases of cholera. WHO has also sent epidemiologists, a water and sanitation expert and a logistician to Harare to strengthen response efforts on the ground.
For more information please contact:
Paul Garwood
Communications Officer
WHO, Geneva
Health Action in Crises (HAC)
Mobile (Geneva): +41 79 475 5546
Mobile (Harare): +263 912 433128
E-mail: garwoodp@who.int
Wendy Julias
Communications officer
WHO Zimbabwe
Telephone: +263 425 3724/30
Mobile: +263 91 243 1408
E-mail: JuliasW@zw.afro.who.int
Gregory Hartl
Team Leader, Information Management and Communications
Department of Epidemic and Pandemic Alert and Response (EPR)
WHO, Geneva
Telephone: +41 22 791 4458
Mobile: +41 79 203 6715
E-mail: hartlg@who.int
10 December 2008 | HARARE -- A widespread cholera outbreak, under-resourced and under-staffed health system, and inadequate access to safe drinking water and hygiene are threatening the wellbeing of thousands of Zimbabweans. As of 9 December, 16 141 suspected cases of cholera and 775 resultant deaths (case fatality rate of 4.8%) had been recorded since August in two-thirds of the country's 62 districts.
WHO is establishing a cholera control and command centre, in conjunction with the Ministry of Health and Child Welfare (MoHCW) and other health partners, to respond in a coordinated manner to Zimbabwe's health challenges. WHO is seeking donor support for a US$ 6 million proposal for its cholera response plan.
Approximately half of cholera cases have been recorded in Budiriro, a heavily populated suburb on the western outskirts of the capital, Harare. Other major concentrations of reported cases include Beitbridge, on the South African border, and Mudzi, on the border with Mozambique.
The outbreak could surpass 60 000 cases, according to an estimate by the Zimbabwe Health Cluster, which is a group coordinated by WHO and comprising health providers, nongovernmental organizations and the MoHCW. The estimate is based on six million people, or half of Zimbabwe's 12 million population, potentially being at risk of contracting cholera, with an estimated 1% of those at risk of actually suffering from cholera. With the rainy season commencing and increased transit of people likely due to the Christmas season, there are risks for further spread of cholera if strong measures are not taken.
There are also serious regional implications, with cholera cases crossing into South Africa and Botswana. On 2 December, South African health authorities said the country had recorded 460 cholera cases and nine related deaths, mostly in border areas near Zimbabwe.
"This outbreak can be contained, but it will depend on many factors, in particular a coordinated approach between all health providers to make sure we are providing the right interventions where they are needed most," said Dr Custodia Mandhlate, WHO Representative to Zimbabwe. "Such interventions include prevention, quick case detection and control, and improved treatment."
The major cause of the cholera outbreak is the inadequate supply of clean drinking water and poor levels of hygiene. Shortages of medicines, equipment and staff at health facilities throughout the country are compounding the health challenges. WHO is advocating for improved access to oral rehydration salts for treating moderate dehydration, which is a symptom of cholera. This could help quickly reduce sickness and deaths.
To help Zimbabwean authorities and partners respond to the health emergency, WHO has sent medical supplies to treat 50 000 people for common conditions for three months, as well as 3200 moderate cases of cholera. WHO has also sent epidemiologists, a water and sanitation expert and a logistician to Harare to strengthen response efforts on the ground.
For more information please contact:
Paul Garwood
Communications Officer
WHO, Geneva
Health Action in Crises (HAC)
Mobile (Geneva): +41 79 475 5546
Mobile (Harare): +263 912 433128
E-mail: garwoodp@who.int
Wendy Julias
Communications officer
WHO Zimbabwe
Telephone: +263 425 3724/30
Mobile: +263 91 243 1408
E-mail: JuliasW@zw.afro.who.int
Gregory Hartl
Team Leader, Information Management and Communications
Department of Epidemic and Pandemic Alert and Response (EPR)
WHO, Geneva
Telephone: +41 22 791 4458
Mobile: +41 79 203 6715
E-mail: hartlg@who.int
UN 'should take over control of Zimbabwe's health system'
Control of Zimbabwe's shattered health system should be handed over to the United Nations, an independent doctors group has demanded.
As the official death toll from the country's cholera epidemic yesterday topped 2,000, Physicians for Human Rights said government corruption was killing innocent people. The international doctors' group also called for President Robert Mugabe to be investigated by the International Criminal Court at the launch of a report titled Health in Ruins – A Man-made Disaster in Zimbabwe.
The World Health Organisation confirmed that at least 40,000 people have contracted cholera, a preventable disease, and 2,024 had died. Doctors and nurses working in Zimbabwe, as well as senior officials at the health ministry, have privately said that the real death toll is likely to be much higher. The report says: "These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity."
The findings of the US-based group were signed by the South African Nobel peace laureate Desmond Tutu and the former UN High Commissioner for Human Rights Mary Robinson among others.
The ongoing international outcry has had little impact on President Mugabe. Power-sharing talks with the opposition MDC have been deadlocked since last September, with the government refusing to dilute its control over the security services. "The Mugabe regime has used any means at its disposal, including the politicisation of the health sector, to maintain its hold on power," the report says.
The cholera crisis has brought renewed attention to the collapse of infrastructure in what was among Africa's wealthiest countries only 15 years ago. The doctors also accuse the government of deliberately using food shortages to political advantage, with supplies being denied to people who do not support Mr Mugabe and his party
"There is a lot of evidence that it [food] is being used as a political weapon," said David Sanders, a Zimbabwean doctor.
Malnutrition which has reached epic proportions, with five million people requiring food aid this year, has compounded existing health problems such as HIV and made curable diseases such as cholera fatal.
Zimbabwe is suffering the worst cholera outbreak in Africa since 1999 when 2,085 people died in Nigeria, according to UN data. The waterborne disease, which causes severe diarrhoea and dehydration, has spread to all 10 provinces of Zimbabwe.
The British Red Cross yesterday expressed concern that the continuing rains are making things worse, while the custom of returning the dead to their rural areas for burial was helping to spread the disease.
While Zimbabwe's government belatedly admitted the existence of the epidemic and called for international assistance, the economic meltdown in the country has destroyed its health system and left ordinary people without medical assistance. A government doctor's pay slip seen by Physicians for Human Rights showed she had been paid a monthly salary equivalent to 22p in sterling.
By Daniel Howden, Africa Correspondent
Wednesday, 14 January 2009
As the official death toll from the country's cholera epidemic yesterday topped 2,000, Physicians for Human Rights said government corruption was killing innocent people. The international doctors' group also called for President Robert Mugabe to be investigated by the International Criminal Court at the launch of a report titled Health in Ruins – A Man-made Disaster in Zimbabwe.
The World Health Organisation confirmed that at least 40,000 people have contracted cholera, a preventable disease, and 2,024 had died. Doctors and nurses working in Zimbabwe, as well as senior officials at the health ministry, have privately said that the real death toll is likely to be much higher. The report says: "These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity."
The findings of the US-based group were signed by the South African Nobel peace laureate Desmond Tutu and the former UN High Commissioner for Human Rights Mary Robinson among others.
The ongoing international outcry has had little impact on President Mugabe. Power-sharing talks with the opposition MDC have been deadlocked since last September, with the government refusing to dilute its control over the security services. "The Mugabe regime has used any means at its disposal, including the politicisation of the health sector, to maintain its hold on power," the report says.
The cholera crisis has brought renewed attention to the collapse of infrastructure in what was among Africa's wealthiest countries only 15 years ago. The doctors also accuse the government of deliberately using food shortages to political advantage, with supplies being denied to people who do not support Mr Mugabe and his party
"There is a lot of evidence that it [food] is being used as a political weapon," said David Sanders, a Zimbabwean doctor.
Malnutrition which has reached epic proportions, with five million people requiring food aid this year, has compounded existing health problems such as HIV and made curable diseases such as cholera fatal.
Zimbabwe is suffering the worst cholera outbreak in Africa since 1999 when 2,085 people died in Nigeria, according to UN data. The waterborne disease, which causes severe diarrhoea and dehydration, has spread to all 10 provinces of Zimbabwe.
The British Red Cross yesterday expressed concern that the continuing rains are making things worse, while the custom of returning the dead to their rural areas for burial was helping to spread the disease.
While Zimbabwe's government belatedly admitted the existence of the epidemic and called for international assistance, the economic meltdown in the country has destroyed its health system and left ordinary people without medical assistance. A government doctor's pay slip seen by Physicians for Human Rights showed she had been paid a monthly salary equivalent to 22p in sterling.
By Daniel Howden, Africa Correspondent
Wednesday, 14 January 2009
Cholera Watch- In Zimbabwe
The cholera epidemic in Zimbabwe has now killed more than 2,000 people, it was confirmed today.
Almost 40,000 have also now contracted the normally preventable disease as the crisis resulting from a collapsed health service threatens the entire region.
The World Health Organisation (WHO) said the outbreak in Robert Mugabe’s shattered nation now represented the worst in Africa in nearly a decade.
Meanwhile, the respected campaign group Physicians for Human Rights (PHR) said the death toll from the disease was much higher than official data showed and accused Mr Mugabe’s government of responsibility for the crisis. It called for an official investigation by the International Criminal Court and said the United Nations should take control of health in the country.
Its report, entitled “Health in Ruins, a man-made disaster in Zimbabwe”, followed a visit by a team of six specialists, four human rights experts and two doctors to the country last month. PHR, which won the Nobel Peace Prize for its work lobbying against land mines, said the team was shocked by what they found.
The analysis found that the scale of the health sector's collapse was "unprecedented" and that government had deliberately tried to downplay the cholera outbreak.
"These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity," states the report's preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda.
The government had ignored warnings from civic organisations in 2006 about the possibility of a cholera outbreak because of a failure to maintain water purification systems, it said.
Mr Mugabe's allies have accused western countries of trying to use the cholera outbreak as an excuse to topple him. They blame Zimbabwe's problems on Western sanctions – an assertion dismissed by the team which said the root of the crisis was economic collapse, citing in particular the land seizures of 2000 and failure to control hyperinflation.
The WHO update showed 2,024 people had been killed by cholera from 39,806 cases. It is the worst outbreak of the disease in Africa since 1999. In normal cholera outbreaks the death toll is around one in every 100. In Zimbabwe, it is between four and five in every 100.
The waterborne disease has also spread to Zimbabwe’s neighbours with at least 13 deaths and 1,419 cases in South Africa. Botswana, Mozambique and Zambia have also reported cholera cases.
Almost 40,000 have also now contracted the normally preventable disease as the crisis resulting from a collapsed health service threatens the entire region.
The World Health Organisation (WHO) said the outbreak in Robert Mugabe’s shattered nation now represented the worst in Africa in nearly a decade.
Meanwhile, the respected campaign group Physicians for Human Rights (PHR) said the death toll from the disease was much higher than official data showed and accused Mr Mugabe’s government of responsibility for the crisis. It called for an official investigation by the International Criminal Court and said the United Nations should take control of health in the country.
Its report, entitled “Health in Ruins, a man-made disaster in Zimbabwe”, followed a visit by a team of six specialists, four human rights experts and two doctors to the country last month. PHR, which won the Nobel Peace Prize for its work lobbying against land mines, said the team was shocked by what they found.
The analysis found that the scale of the health sector's collapse was "unprecedented" and that government had deliberately tried to downplay the cholera outbreak.
"These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity," states the report's preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda.
The government had ignored warnings from civic organisations in 2006 about the possibility of a cholera outbreak because of a failure to maintain water purification systems, it said.
Mr Mugabe's allies have accused western countries of trying to use the cholera outbreak as an excuse to topple him. They blame Zimbabwe's problems on Western sanctions – an assertion dismissed by the team which said the root of the crisis was economic collapse, citing in particular the land seizures of 2000 and failure to control hyperinflation.
The WHO update showed 2,024 people had been killed by cholera from 39,806 cases. It is the worst outbreak of the disease in Africa since 1999. In normal cholera outbreaks the death toll is around one in every 100. In Zimbabwe, it is between four and five in every 100.
The waterborne disease has also spread to Zimbabwe’s neighbours with at least 13 deaths and 1,419 cases in South Africa. Botswana, Mozambique and Zambia have also reported cholera cases.
Thursday, January 1, 2009
Social Welfare background information for African Immigrants living in the U.S.
Federally funded and governed US welfare began in the 1930’s during the Great Depression. The US government responded to the overwhelming number of families and individuals in need of aid by creating a welfare program that would give assistance to those who had little or no income.
The US welfare system stayed in the hands of the federal government for the next sixty-one years. Many Americans were unhappy with the welfare system, claiming that individuals were abusing the welfare program by not applying for jobs, having more children just to get more aid, and staying unmarried so as to qualify for greater benefits. Welfare system reform became a hot topic in the1990’s. Bill Clinton was elected as President with the intention of reforming the federally run US Welfare program. In 1996 the Republican Congress passed a reform law signed by President Clinton that gave the control of the welfare system back to the states.
Eligibility Requirements for State Welfare Program
Eligibility for a Welfare program depends on numerous factors. Eligibility is determined using gross and net income, size of the family, and any crisis situation such as medical emergencies, pregnancy, homelessness or unemployment. A case worker is assigned to those applying for aid. They will gather all the necessary information to determine the amount and type of benefits that an individual is eligible for.
The Federal government provides assistance through TANF (Temporary Assistance for Needy Families). TANF is a grant given to each state to run their own welfare program. To help overcome the former problem of unemployment due to reliance on the welfare system, the TANF grant requires that all recipients of welfare aid must find work within two years of receiving aid, including single parents who are required to work at least 30 hours per week opposed to 35 or 55 required by two parent families. Failure to comply with work requirements could result in loss of benefits.
Types of Welfare Available
The type and amount of aid available to individuals and dependent children varies from state to state. When the Federal Government gave control back to the states there was no longer one source and one set of requirements. Most states offer basic aid such as health care, food stamps, child care assistance, unemployment, cash aid, and housing assistance.
How to Apply for a Welfare Program
To apply for a welfare program one must contact the local Human Service Department located in the government pages of the phone book. It may be listed as Human Services, Family Services or Adult and Family Services. An appointment is made with a case worker. The case worker will give a list of required documents needed at the appointment. Common documents asked for are proof of income, ID, and utility bills or other proof of residency.
Once an appointment is completed a case worker will review all required documents, applications and information provided at the meeting. They will use this information to determine eligibility and the amount of assistance.
http://www.welfareinfo.org/
The US welfare system stayed in the hands of the federal government for the next sixty-one years. Many Americans were unhappy with the welfare system, claiming that individuals were abusing the welfare program by not applying for jobs, having more children just to get more aid, and staying unmarried so as to qualify for greater benefits. Welfare system reform became a hot topic in the1990’s. Bill Clinton was elected as President with the intention of reforming the federally run US Welfare program. In 1996 the Republican Congress passed a reform law signed by President Clinton that gave the control of the welfare system back to the states.
Eligibility Requirements for State Welfare Program
Eligibility for a Welfare program depends on numerous factors. Eligibility is determined using gross and net income, size of the family, and any crisis situation such as medical emergencies, pregnancy, homelessness or unemployment. A case worker is assigned to those applying for aid. They will gather all the necessary information to determine the amount and type of benefits that an individual is eligible for.
The Federal government provides assistance through TANF (Temporary Assistance for Needy Families). TANF is a grant given to each state to run their own welfare program. To help overcome the former problem of unemployment due to reliance on the welfare system, the TANF grant requires that all recipients of welfare aid must find work within two years of receiving aid, including single parents who are required to work at least 30 hours per week opposed to 35 or 55 required by two parent families. Failure to comply with work requirements could result in loss of benefits.
Types of Welfare Available
The type and amount of aid available to individuals and dependent children varies from state to state. When the Federal Government gave control back to the states there was no longer one source and one set of requirements. Most states offer basic aid such as health care, food stamps, child care assistance, unemployment, cash aid, and housing assistance.
How to Apply for a Welfare Program
To apply for a welfare program one must contact the local Human Service Department located in the government pages of the phone book. It may be listed as Human Services, Family Services or Adult and Family Services. An appointment is made with a case worker. The case worker will give a list of required documents needed at the appointment. Common documents asked for are proof of income, ID, and utility bills or other proof of residency.
Once an appointment is completed a case worker will review all required documents, applications and information provided at the meeting. They will use this information to determine eligibility and the amount of assistance.
http://www.welfareinfo.org/
Zimbabwe child malnutrition rises
Some five million Zimbabwean rely on food aid, the aid agency says
Acute child malnutrition in parts of Zimbabwe has increased by almost two-thirds compared with last year, aid agency Save the Children says.
In a report, the UK-based agency concluded that some children were "wasting away from lack of food".
It said there was a shortage of 18,000 tonnes of food needed for January and urged world donors to increase aid.
The agency said innocent Zimbabweans should not suffer because of a political crisis out of their control.
"There is no excuse for failing to provide this food," said Lynn Walker, programmes director for Save the Children in Zimbabwe.
The agency said some five million people in Zimbabwe - or about 50% of the country's population - were now in need of food aid.
Zimbabwe's farming sector collapsed after President Robert Mugabe launched a controversial land reform programme more than five years ago.
As well as suffering economic meltdown, Zimbabwe is experiencing a cholera outbreak, fuelled by the collapse of its health, sanitation and water services.
Aid agencies have warned that the disease, which has already claimed more than 1,100 lives, could infect more than 60,000 unless its spread is halted.
President Mugabe has blamed the West for his country's problems.
Acute child malnutrition in parts of Zimbabwe has increased by almost two-thirds compared with last year, aid agency Save the Children says.
In a report, the UK-based agency concluded that some children were "wasting away from lack of food".
It said there was a shortage of 18,000 tonnes of food needed for January and urged world donors to increase aid.
The agency said innocent Zimbabweans should not suffer because of a political crisis out of their control.
"There is no excuse for failing to provide this food," said Lynn Walker, programmes director for Save the Children in Zimbabwe.
The agency said some five million people in Zimbabwe - or about 50% of the country's population - were now in need of food aid.
Zimbabwe's farming sector collapsed after President Robert Mugabe launched a controversial land reform programme more than five years ago.
As well as suffering economic meltdown, Zimbabwe is experiencing a cholera outbreak, fuelled by the collapse of its health, sanitation and water services.
Aid agencies have warned that the disease, which has already claimed more than 1,100 lives, could infect more than 60,000 unless its spread is halted.
President Mugabe has blamed the West for his country's problems.
Cholera in Zimbabwe - update
26 December 2008 -- As of 25 December 2008, a total of 26 497 cases, including 1 518 deaths, have been reported by the Ministry of Health in Zimbabwe. Cases are now being reported from all 10 of the country's provinces. Harare, particularly Budiriro suburb in the south west, accounts for the majority of cases, followed by Beitbridge in Matabeleland South and Mudzi in Mashonaland East. The current outbreak is the largest ever recorded in Zimbabwe and is not yet under control. In fact, the epidemiological week ending 20 December saw over 5 000 new cases - an increase in the number of weekly cases relative to previous weeks - and an increase in deaths outside treatment/health centres.
The overall Case Fatality Rate (CFR) has risen to 5.7% - far above the 1% which is normal in large outbreaks - and in some rural areas it has reached as high as 50%. Mortality outside of healthcare facilities remains very high. This is a clear indication that better case management and access to healthcare is needed - in particular an increased use of oral rehydration therapy with Oral Rehydration Salts in communities very early after onset of the disease.
The outbreak has taken on a subregional dimension with cases being reported from neighboring countries. In South Africa as of 26 December, 1 279 cumulative cases and 12 deaths (CFR of 0.9%) had been recorded, with the bulk of the cases (1 194) in the Limpopo area. Cases have also been reported in Botswana (Palm Tree).
The current situation is closely linked to the lack of safe drinking water, poor sanitation, declining health infrastructure, and reduced numbers of healthcare staff reporting to work. Other current risk factors include the commencement of the rainy season and the movement of people within the country, and possibly across borders, during the Christmas season. WHO, together with the Ministry of Health and partners from the health and Water and Sanitation clusters, has established a cholera outbreak response coordination unit in order to strengthen the reporting and early detection of cases, improve the response mechanism and access to healthcare and ensure proper case management. WHO has also deployed experts in public health, water and sanitation, logistics and social mobilization. In light of the extent and pace of expansion of the outbreak, reinforcing all control activities across the country is critical.
Given the current dynamic of the outbreak and the context of the collapsed health system, a cholera vaccination is not recommended. Moreover, the use of the internationally available WHO prequalified oral cholera vaccine is not recommended once an outbreak has started due to its 2-dose regimen and the time required to reach protective efficacy, high cost and the heavy logistics associated to its use. The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the occurrence of severe adverse events.
In controlling the spread of cholera WHO does not recommend any special restrictions to travel or trade to or from affected areas. However, neighboring countries are encouraged to reinforce their active surveillance and preparedness systems. Mass chemoprophylaxis is strongly discouraged, as it has no effect on the spread of cholera, can have adverse effects by increasing antimicrobial resistance and provides a false sense of security.
The overall Case Fatality Rate (CFR) has risen to 5.7% - far above the 1% which is normal in large outbreaks - and in some rural areas it has reached as high as 50%. Mortality outside of healthcare facilities remains very high. This is a clear indication that better case management and access to healthcare is needed - in particular an increased use of oral rehydration therapy with Oral Rehydration Salts in communities very early after onset of the disease.
The outbreak has taken on a subregional dimension with cases being reported from neighboring countries. In South Africa as of 26 December, 1 279 cumulative cases and 12 deaths (CFR of 0.9%) had been recorded, with the bulk of the cases (1 194) in the Limpopo area. Cases have also been reported in Botswana (Palm Tree).
The current situation is closely linked to the lack of safe drinking water, poor sanitation, declining health infrastructure, and reduced numbers of healthcare staff reporting to work. Other current risk factors include the commencement of the rainy season and the movement of people within the country, and possibly across borders, during the Christmas season. WHO, together with the Ministry of Health and partners from the health and Water and Sanitation clusters, has established a cholera outbreak response coordination unit in order to strengthen the reporting and early detection of cases, improve the response mechanism and access to healthcare and ensure proper case management. WHO has also deployed experts in public health, water and sanitation, logistics and social mobilization. In light of the extent and pace of expansion of the outbreak, reinforcing all control activities across the country is critical.
Given the current dynamic of the outbreak and the context of the collapsed health system, a cholera vaccination is not recommended. Moreover, the use of the internationally available WHO prequalified oral cholera vaccine is not recommended once an outbreak has started due to its 2-dose regimen and the time required to reach protective efficacy, high cost and the heavy logistics associated to its use. The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the occurrence of severe adverse events.
In controlling the spread of cholera WHO does not recommend any special restrictions to travel or trade to or from affected areas. However, neighboring countries are encouraged to reinforce their active surveillance and preparedness systems. Mass chemoprophylaxis is strongly discouraged, as it has no effect on the spread of cholera, can have adverse effects by increasing antimicrobial resistance and provides a false sense of security.
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