The national healthcare system, once viewed as one of the strongest in southern Africa, now threatens to collapse under the weight of this political and economic turmoil, with the most acute consequences potentially for the 1.8 million Zimbabweans living with HIV/AIDS. Currently, less than one-fourth of the people in urgent need of life-extending antiretroviral (ARV) treatment receive it. This translates into an average of 3,000 deaths every week. And the prospects for a further scale up of the national AIDS program are dim.
Trained medical professionals are leaving the country, the government program for HIV/AIDS treatment is oversubscribed, and the lack of ARV supplies has stifled further expansion. Patients often face obstacles to reach hospitals or clinics because of high fuel and transport prices.
Médecins Sans Frontières continues to provide free medical care to about 29,000 people living with HIV/AIDS in Bulawayo, Tsholotsho (Matabeleland North province), Buhera (Manicaland province), Epworth (Mashonaland East province), and Gweru (Midlands province). Out of these, Médecins Sans Frontières is supporting more than 16,000 patients on Antiretroviral treatment. During the last years, Médecins Sans Frontières has put in place a strategy of decentralisation of patients from the hospitals to the peripheral clinics improving their access to treatment.
Floods, cholera and other watery diarrhoeal outbreaks have hit the country in the last months. In recent emergency interventions, Médecins Sans Frontières has been addressing diarrhoea and cholera cases in various locations in Mashonaland East province with some 250 cholera cases treated so far. In Kariba (Mashonaland West province), Médecins Sans Frontières has provided medical material and training to local health personnel in order to help respond to a cholera outbreak. Médecins Sans Frontières is also giving support to the health structures in Mashonaland West and Masvingo provinces and in Bulawayo to respond to diarrhoeas outbreaks. It has also assisted flood victims in the Save river area and in Tsholotsho district.
The difficulties of the permanent and transitory population around the border town of Beitbridge (Matabeleland South) - the entry point to South Africa for thousands of migrants- have collapsed the local health structures. Médecins Sans Frontières is therefore launching a new project of support to health care for its population, both residents and migrants.
Médecins Sans Frontières’s ability to care for more people in need is hindered by the lack of trained health workers, restrictions on which staff can prescribe ARV drugs, and stricter administrative requirements for international staff to work in the country. At the same time, Zimbabweans are feeling the health impact of degraded or nonexistent water-and-sanitation systems.
Médecins Sans Frontières has been helping to alleviate the devastating effects of the HIV/AIDS pandemic since 2002, which at that time had a prevalence rate among adults of 33% (according to UNAIDS figures). This disease is not only a burden on the people and families of Zimbabwe, but also on the economy of the country. The prevalence today is still one of the highest in the world, officially 15.6%, but still a lot higher in some areas of the country.
Médecins Sans Frontières is currently working in Zimbabwe with around 400 Zimbabwean and 50 international field staff. Médecins Sans Frontières has been working in Zimbabwe since 2000.
