Zimbabwe’s cholera death toll rising

JOHANNESBURG — Zimbabwe President Robert Mugabe’s negligence has caused a “man-made health disaster” for which the dictator should be investigated by the International Criminal Court, stated the Physicians for Human Rights in a report issued here.

Mugabe refused to comment on the report, but his spokesman, George Charamba, dismissed the physicians’ group  as a "stupid, Western-created organization", according to Associated Press in Harare.

The physicians charge that Mugabe’s government is responsible for the collapse of the health, water and sanitation systems, violating human rights, according to their report “Health in Ruins,” which was released Tuesday in Johannesburg and New York. As GlobalPost reported exclusively on Monday, the group called for Mugabe to be charged with crimes against humanity.

Further, the United Nations should step in and take control of Zimbabwe’s health system and sanitation, it says.

“These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity,” states the preface to the report, signed by South African Archbishop Desmond Tutu, form UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former prosecutor at the International Criminal Tribunal for Rwanda.

“The Mugabe regime has used any means at its disposal, including the politicization of the health sector, to maintain its hold on power,” states the preface.

Zimbabwe’s death toll is rising rapidly. More than 2,000 Zimbabweans have died from cholera and almost 40,000 have been infected, according to figures released Tuesday by the World Health Organization. Ordinarily cholera kills less than one percent of those infected but because of Zimbabwe’s shortage of clean water the death rate is approaching 20 percent.

Zimbabwe’s cholera has also spread to neighboring countries with at least 13 deaths and 1,419 cases recorded in South Africa, said WHO. The cholera outbreak could get worse because Zimbabwe’s seasonal rains could increase contamination of water sources, health experts warned.

“Cholera is not the issue,” said Frank Donaghue, chief executive of Physicians for Human Rights, who visited Zimbabwe last month. “Cholera is a symptom of a grossly collapsed health system.”

Donaghue called on the UN to order the International Criminal Court to investigate Mugabe for crimes against humanity. He urged U.S. President-elect Barack Obama’s foreign policy team to be more effective in resolving Zimbabwe’s plight.

Zimbabwe’s neighbors, particularly economic and political powerhouse South Africa, have the responsibility to act, said South African doctor David Sanders.

“South Africa could have done and could do a great deal more to resolve this impasse,” said Sanders, who said taught at Zimbabwe’s medical school for several years.

“The collapse of the Zimbabwean health system is startling,” said Sanders, who was part of the team that visited the country in December. “This is but the latest expression of a government that refuses to protect its own citizens,” he said.

Physicians for Human Rights, which is based in Cambridge, Mass., sent a team of doctors and public health specialists to assess the situation in Zimbabwe.

While the rise of cholera in Zimbabwe has grabbed international attention, the physicians’ report said the breakdown of health infrastructure throughout the country has much deeper implications that include the development of drug-resistant strains of HIV and tuberculosis.

The doctors’ week-long investigation in December included interviews with 92 health care workers, health officials, water engineers and other participants in the country’s sinking health care system.

What Donaghue, Sanders and two others say they found is a health system in complete disarray, with closed hospitals, drug shortages and large urban areas with no running water. The clinics that are still open face an exodus of health worker. One doctor was recently paid a monthly salary that amounted to 32 cents, according to the report. Many patients don’t even make it to the rare clinics that could accept them, as they can’t afford the cost of transportation, according to the organization’s report.

The health problems are compounded by malnutrition — the United Nations’ Food and Agricultural Organization predicts that 45 percent of the country’s population will require food assistance this year to survive — and especially by the lack of access to clean water. Many parts of the capital, Harare, have no running water, and streams of raw sewage are a common sight. The Physicians for Human Rights observers even said they saw a river near Harare covered in plants feeding on the flow of sewage and human waste below.

These conditions create a thriving environment for cholera, a diarrheal disease that spreads through food and water contaminated by human feces. Cholera can be easily treated through a solution of clean water, sugar and salt, but many infected people get treatment too late if at all.

The shortage of anti-retroviral drugs poses a longer-term problem for Zimbabwe — which is already dealing with an HIV infection rate of about 25 percent among adults – as well as the region. Without anti-retro-viral drugs available, doctors switch to other drugs, thereby increasing the likelihood of multi-drug resistant HIV strains that will be much harder to treat.