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ZIMBABWE-REPORT Jan-15-2009 (790 words) xxxi

Report: Zimbabwe health care collapse due to human rights violations

By Regina Linskey
Catholic News Service

WASHINGTON (CNS) -- Zimbabwe's health care system, once a model for southern Africa, has collapsed because of the government's egregious, systematic human rights violations, said a human rights report.

The report by the nonprofit, independent group Physicians for Human Rights said Zimbabwe's doctors do not have viable salaries and most public hospitals have closed. At the same time, Zimbabweans are suffering from a cholera epidemic, increasing maternal mortality, and cases of malnutrition, AIDS, tuberculosis and anthrax, said the report, released in mid-January by the Massachusetts-based organization.

The "findings add to the growing evidence that (President) Robert Mugabe and his regime may well be guilty of crimes against humanity," said the report, "Health in Ruins: A Man-made Disaster in Zimbabwe."

The crisis is due to 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," said the report.

An expert working with Zimbabwe's federal tuberculosis program told a Physicians for Human Rights investigator: "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. ... This is a brain-drain problem."

Tuberculosis, which is spread through the air by coughing or even talking, attacks the lungs and can attack the entire body.

The Physicians for Human Rights report was based on a seven-day investigation in December by two physicians and two human rights experts who interviewed 92 participants in public and private health care.

"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," it said.

For example, the cholera epidemic, caused by the collapse of the water and sewage systems, is a man-made disaster and probably could have been prevented, said the report.

"Civic organizations in Harare warned of a cholera time bomb in 2006, but the Mugabe regime ignored the warning signs," it said. Harare is the capital of Zimbabwe.

At least 40,000 people have contracted cholera, which causes severe diarrhea and dehydration, and more than 2,000 have died, the World Health Organization reported in mid-January. The disease also has spread to the neighboring countries of South Africa, Botswana and Mozambique.

The WHO also reported that, since November, 200 people had contracted anthrax and eight had died of the disease, which starts with flu symptoms but progresses into respiratory distress. Anthrax, which is contracted in part by ingesting cattle and goats that had died of the diesease, has occurred "in starving rural people scavenging carrion," said the physicians' report. Usually animals are tested for anthrax, but the report said this has been "dramatically curtailed in the economic crisis."

At a time when Zimbabweans increasingly need access to medical care, the public health care sector is in shambles, it said, noting that most public hospitals closed between September and November.

As of December, the report said, "there were no functioning critical care beds in the public sector."

Salary levels have not been able to catch up to the country's inflation rate -- the highest in the world -- and physicians' salaries have plummeted, said the report.

A government physician in Harare told Physicians for Human Rights investigators that she earned the equivalent of 32 cents in November's monthly paycheck. A nurse at a rural clinic told the investigators that the bus fare to the nearest town to collect his salary was more expensive than his salary, so it made no sense to collect it.

"Government salaries are simply rotting in the bank," a senior government official told the investigators.

The director of a mission hospital reported: "We see (pregnant) 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."

But the private health care sector is not a feasible alternative, the report said. In a country where the unemployment rate is 80 percent, a consultation with a private doctor costs $200 cash, a patient bed is $500 and a Caesarean section is $3,000, said the report.

The deterioration of the economy, water sanitation and sewage systems, and health care in Zimbabwe has led to a dramatic shift in life expectancy.

In 1990, life expectancy at birth in Zimbabwe was 62 years for men and women; in 2006 the life expectancy for men fell to 34 years and 37 years for women, "the world's lowest," said the report.


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