Page last updated at 10:10 GMT, Thursday, 15 January 2009

Zimbabwe's empty hospitals

With the Zimbabwean government accused of failing to protect the health of its people by the campaign group Physicians for Human Rights, Paul Martin sees first hand how the country's health system has disintegrated.

A demonstrating nurse in Zimbabwe
Many nurses and doctors in Zimbabwe have been on strike or left the country
At the age of 29, Charity was about to give birth to her first child in the maternity ward at the Central Hospital in Zimbabwe's second city, Bulawayo.

But there was no qualified nurse there, and no doctor, to observe an irregular heartbeat developing - until it was too late.

Local newspaper reports say more than half the nurses in Zimbabwe have now left their jobs or left the country in search of a better life abroad.

Wards closed

Much the same applies to the doctors, and many hospital wards have been forced to close.

I drove past the state-of-the-art Joshua Nkomo Hospital on the outskirts of Bulawayo. It lies locked and totally unused, a decade after being built: a criminal waste of resources.

Goods in a Zimbabwean supermarket are priced in foreign currency
Most imported goods have to be bought with foreign currency
To get into the city's mental hospital, I sneaked past guards at the big iron gates, ducking low in a car's back seat - the authorities do not like nosy journalists.

But I managed to get a few furtive words outside from one white-coated assistant. "I don't feel like a nurse," he said, "I feel like a mortuary attendant, that's all I am."

Outside one ward, I saw a smart white car, with no number plates. I was told that the government was so desperate to keep the remaining doctors, it was dishing out government vehicles as a sort of bribe.

After many months, the government has finally agreed to let nurses and doctors get paid in foreign currency. It is not much, but enough to survive.

Meanwhile, we were told, but it is impossible to confirm, that 50 patients at the mental hospital have died of starvation.

Foreign currency

The only way to get anything worth having - including petrol - is to pay in foreign currency - the Zimbabwean dollar is inflating so fast that no-one wants it.

Some businessmen are doing well from the crisis - mainly through barter deals.

One told me he received 4,000 crates of beer from the country's biggest brewery in exchange for supplying imported petrol for the brewery's fleet of trucks.

But most simply cannot get hold of foreign cash.

For example, a teacher who goes to work in a shared taxi spends his entire monthly wages on the five South African rand demanded each way by the taxi driver. Five rand is worth 34-pence at the time of writing (50 US cents).

A student in Zimbabwe studying by candlelight
Frequent power cuts have left people having to work by candlelight
It's no wonder teachers are now refusing to mark examination papers. But it means the pupils are not receiving the educational certificates which are vital in their hunt for jobs.

In any case, many schoolchildren - as many as four out of five, according to Unicef - have simply stopped turning up for class.

Teachers, too, are staying away, and the start of the new school year has been officially postponed.

It is not just the hospitals and schools that have ground to a halt. Bulawayo's main power station shut down long ago.

The authorities mistakenly thought they could rely on importing power from abroad. In a government office that is supposed to maintain the city's electricity grid, I watched as the boss desperately tried to locate enough petrol to enable his chief engineer to drive a vehicle to a broken-down electrical station. He failed.

Biggest killer

The saddest thing is seeing how Aids victims are suffering. A doctor from the charity, Medecins Sans Frontieres told me that Aids is easily the biggest cause of death in Zimbabwe. According to them, it is killing far more than the current cholera epidemic.

I drove into a poor township on the outskirts of the city, its streets in some places flowing with open sewage.

There, cooking some maize-meal porridge and huddled next to a small fire, because there was a power failure throughout the township, was Doris, an emaciated but still friendly and eloquent lady, hugging her two little grandchildren.

Zimbabwe cholera patient in wheelbarrow
Physicians for Human Rights wants the UN to take over the health service
Doris - I have changed her name for security reasons - is or was a university lecturer. She cannot work any more as the disease is slowly killing her.

"If I had relied on the normal health system to get my anti-retroviral drugs," she told me, "I would already be dead by now".

Locals say many sufferers die while they are still on a waiting list to be seen by a doctor. It is, one doctor told me, a natural cull.

If you do make it to see a doctor, there is a shortage of drugs anyway, and a shortage of places to get regular treatment.

Doris managed to get anti-retrovirals through connections that her teachers' union had. But her future is bleak. Her daughter simply disappeared when she discovered her mother had Aids, leaving both of her little children, aged four and six, in the care of this dying woman.

"When I'm gone, I am afraid these two children will die too," Doris told me.

The children nodded, wide-eyed and scared. "Who will look after them?"

I had no answer, except to go to the car, fish out some provisions I had bought in South Africa to avoid eating and drinking the local products. Chocolate. Her eyes lit up. "I haven't had that for two years," she said.

Each child got a block. A tiny moment of happiness in a world of anguish.

From Our Own Correspondent was broadcast on Thursday, 15 January, 2009 at 1100 GMT on BBC Radio 4. Please check the programme schedules for World Service transmission times.


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