A year is not long in the death of a nation, but I was stunned by how much Zimbabwe had changed in the past 12 months. The healthcare system is in a state of collapse. The whole country is being destroyed.

Zimbabweans stoically put up with the extreme living difficulties caused by their government’s policies and its mismanagement of the economy. Since my last visit a year ago (BMJ 2008;336:98, doi:10.1136/bmj.39450.635579.0F) 10 zeroes have been taken off the currency, inflation has reached 231 000 000%, and chronic food shortages and daily power cuts continue.

How bad do things need to get? Why don’t people collectively stand up against the regime that has wrecked this beautiful and once functioning country? People are tired, hungry, scared, and oppressed. The violence perpetrated by the followers of Robert Mugabe and Zanu PF remains fresh in people’s minds.

As I leave Zimbabwe, Bulawayo’s health department is preparing for an expected cholera outbreak. There is cholera in Harare and other places in Zimbabwe, a sign that the public infrastructure is really breaking down.

Last week nurses and junior …