NEW YORK // As cholera spreads across Zimbabwe and leaves a death toll of more than 2,100, experts have warned of emerging health crises to compound the woes of Africa's ill-governed nation and its neighbours. This week's report from Physicians for Human Rights highlights weak governance, corruption and economic mismanagement as culpable for Zimbabwe's multiple health problems and plummeting life expectancy.
A crumbling and ill-funded healthcare system has failed to cope with the snowballing cholera epidemic, the report's authors say, while also turning the country into a breeding ground for drug-resistant strains of HIV and tuberculosis. Signatories to the report, including Archbishop Desmond Tutu and Mary Robinson, a former president of Ireland, argue that the health failings of Zimbabwe's leadership constitute a gross enough violation of human rights to warrant international action.
Archbishop Tutu accused the country's president, Robert Mugabe, who has governed Zimbabwe since the end of British colonial rule in 1980, of committing crimes against humanity by denying his population basic health care and sanitation. "When government policies lead directly to the shutting 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?" the archbishop asks in the preface to the 46-page report.
Michele Montas, the chief spokeswoman for the UN secretary general, Ban Ki-moon, warned that "no part of the country has been spared the epidemic". The World Health Organization said yesterday that Zimbabwe's cholera epidemic had killed 2,106 since August out of a total number of 40,448 cases. About 1,640 new cases were added on in a single day, it said. The physicians' report, Health in Ruins: A Man-Made Disaster in Zimbabwe, said the cholera epidemic results in a fatality rate of 5.1 per cent - five times the death toll normally expected from a large outbreak.
Last month, four researchers visited Zimbabwe after police violently broke up a peaceful protest on Nov 18 of healthcare professionals demonstrating against the lack of clean water and basic medical supplies. The investigators witnessed citizens drinking from sewers and water systems contaminated with human excrement, the most common cause of spreading acute diarrhoeal infections. They interviewed 92 experts, officials, patients and doctors who - often hungry and unpaid - struggled to treat growing numbers of sick, dehydrated and malnourished cholera victims in hospitals with no running water, basic drugs or food.
"I've been to some pretty bad countries before, but I've never seen what happens when a sanitation system collapses," the lead author, Richard Sollom, said of the week-long visit. "I wish I had the nerve to take pictures of it, but we feared that we were being followed." Analysts have long lamented Zimbabwe's decline from being "the breadbasket of Africa" with impressive corn-growing capacity to economic collapse brought about in part by Mr Mugabe's policy of appropriating white-owned farmland in 2000.
While Mr Mugabe argues with opposition leaders over power-sharing after last year's disputed presidential elections, the beleaguered population contends with 90 per cent unemployment and a life expectancy for men of only 34 years. The country's fiscal meltdown has accelerated since 2006. Hyperinflation quickly made Zimbabwean currency notes worthless although they have been recently replaced by US dollars as a stable alternative.
As public hospitals close down, only a "tiny proportion of the elite can actually afford" the US$200 minimum (Dh734) of consulting a private doctor, said Chris Beyrer, a report author and professor at Johns Hopkins School of Public Health, the United States. Weak healthcare services have seen pharmacists dole out "any anti-retroviral drug that is available" to the 15 per cent of the country's population infected with HIV/Aids, switching prescribed regimen with dangerous consequences, the doctor said.
"This is a potential public health disaster - this is how you generate multi-drug-resistant HIV," Dr Beyrer said. "In a country with people fleeing, as so many have, it really has the potential to undermine the treatment programmes across the region." Poor handling of tuberculosis is likewise spawning potentially untreatable drug-resistant strains of HIV/Aids. And rural Zimbabweans' scavenging on carrion has resulted in eight anthrax deaths since November.
Investigators argue that Mr Mugabe's neglect of basic health care constitutes a crime against humanity, and on Tuesday called on the UN Security Council to refer the case for investigation by prosecutors of the International Criminal Court. Acknowledging the double-veto of Russia and China that blocked a draft resolution on tougher sanctions against Mr Mugabe and his cronies in July, Mrs Robinson, called on Mr Ban himself to negotiate a solution.
She urged the world's top diplomat to "use his mandate and good offices" to implement an "emergency health response" that would see the UN assume control over Zimbabwe's healthcare system. "The situation is so serious, and has gone beyond the responsibility of a country that is not taking its responsibilities seriously," Mrs Robinson, the UN's former high commissioner for human rights, said in an interview.
Mr Ban's spokeswoman, Ms Montas, said the secretary general was closely monitoring the health situation in Zimbabwe, but would not comment on Mrs Robinson's request. George Charamba, Zimbabwe's government spokesman, refused to comment on charges from what he called a "stupid, western-created organisation". Mr Mugabe has previously blamed the cholera outbreak on a biological attack from the country's former colonial master, Britain.
jreinl@thenational.ae
