Zimbabwe faces a “major health disaster,” as hospitals close

BMJ 2008; 337 doi: (Published 25 November 2008) Cite this as: BMJ 2008;337:a2710
  1. Ryan Truscott
  1. 1Harare

    Zimbabwe’s health minister, David Parirenyatwa, has admitted that he is “scared” by the cholera epidemic in the country, which has killed more than 290 people since September.

    Last week the World Health Organization said that more than 6000 people had been infected in the outbreak.

    The highly contagious diarrhoeal disease has now spread to nine of Zimbabwe’s 10 provinces.

    Médecins Sans Frontières said that if left unchecked, cholera could threaten the lives of 1.4 million people in Harare.

    Mr Parirenyatwa told the local press that the widespread unavailability of clean piped water meant that it is impossible to control the cholera outbreak. “As the minister responsible for health, I am very scared, especially during this rainy season,” he said. Uncollected rubbish and frequent bursts in sewer pipes in many townships are also fostering the spread of the disease.

    The outbreak comes at the worst possible time for inflation battered Zimbabwe, where a strike by health workers about poor pay has led to the unofficial closure of almost all public hospitals.

    Douglas Gwatidza, the chairman of the Zimbabwe Association of Doctors for Human Rights, said that doctors had warned the government that a cholera outbreak was imminent. He said that the country now faced “a major health disaster.”

    Dr Gwatidza said that Harare’s two main hospitals, the 1000 bed Parirenyatwa and the 500 bed Harare Central, were not taking new patients.

    One medical source said that Harare Central was down to just four patients; Parirenyatwa had fewer than 100. Police and the army were manning Parirenyatwa last weekend, according to a report in the state media.

    The association has warned that the closure of maternity wards means that many pregnant women will die because they can no longer receive emergency obstetric care.

    A caesarean section at one of Harare’s private clinics can cost anything between $1500 (£1000; €1200) and $5000, which is beyond the reach for most people in a country where 80% of the population live below the poverty.

    Doctors have called for drugs to enable them to treat patients and for their salaries to be paid in foreign currency.

    A government doctor’s net pay in October wasn’t enough to buy a pint of milk, according to Amon Siveregi, the president of the 500 strong Hospital Doctors’ Association.

    Dr Siveregi talked of the decline he has witnessed firsthand while working at both of Harare’s main hospitals.

    A typical working day for him was to go to work hungry, face hopeless patients with no drugs, and go home frustrated at his inability to make people better.

    “We’ve now hit the bottom. We can’t go any lower than we are,” he said.

    Hundreds of doctors and nurses tried to march in central Harare last week to highlight the crisis in the public health sector. Riot police with batons swiftly broke up the demonstration.

    Mr Parirenyatwa’s subsequent promise of food hampers and transport for health personnel seems not to have persuaded them back to work.

    “What is needed to start with is that the government has to admit that it’s failed, and that it needs assistance,” said Dr Gwatidza.


    Cite this as: BMJ 2008;337:a2710


    View Abstract

    Log in

    Log in through your institution


    * For online subscription