Zimbabwe

Forty-eight-year-old Mary Marizani recently became the first MSF patient in Zimbabwe to conquer multidrug-resistant tuberculosis.

While gains made in the fight against HIV/AIDS in the past decade are encouraging, countries most affected by the pandemic continue to struggle to place enough people on treatment and implement the best science and strategies to fight the disease.

Not long ago, it was tempting to think the battle against measles was being won. Stepped-up vaccination campaigns had driven the number of reported cases down to 32,000 in 2007, according to the World Health Organization, the lowest ever recorded. Over the past three years, however, there has been a resurgence.

In early June, world leaders and global health officials gathered at the United Nations for a summit meeting on HIV/AIDS. Among the outcomes was a new treatment target, a plan to get 15 million people living with HIV/AIDS on antiretroviral (ARV) treatment by the year 2015.

As the Measles Initiative meets in Washington, D.C., MSF is calling for an effective outbreak response mechanism to be established immediately to deal with the rising numbers of severe outbreaks worldwide. 

“I’m afraid of my husband. He knows I’m positive but he lives in denial. And he has threatened with killing me if I bring condoms home,” explains a woman to the counsellor.

While several countries hardest hit by HIV/AIDS are improving treatment protocols to reduce deaths and illness, a lack of donor support still prevents many from implementing vital changes.

Several low-income countries highly affected by HIV risk being entirely or partly disqualified from the current funding round by the Global Fund to Fight AIDS, Tuberculosis and Malaria.

In South Africa, where the FIFA World Cup is getting under way, MSF is trying to show that beating HIV/AIDS should be the ultimate goal.

Malawi has been facing its biggest measles epidemic in 13 years. Working with the local health authorities, MSF has launched a vaccination campaign for more than 2.5 million children.

In June 2009, Doctors Without Borders/Médecins Sans Frontières (MSF) released a report, No Refuge, Access Denied, which outlined the severe risks Zimbabweans took in order to cross the border, the dangerous conditions under which they lived once they reached South Africa, and their lackof access to health care.

During the response to Zimbabwe’s cholera epidemic earlier this year, medical teams from Doctors Without Borders/Medecins Sans Frontieres (MSF) started to work in prisons across the country to treat cholera patients and prevent the spread of the deadly disease. As the four-month intervention is concluding, MSF’s project coordinator in Zimbabwe, Pip Millard, gives insight into the challenge of curbing an outbreak in penitentiaries.

In Murwira Clinic, southeastern Zimbabwe, Dennis Taronga is receiving antiretroviral (ARV) therapy with the help of MSF. Taronga, a husband and father of three who used to work as a builder, contracted cholera in January 2009 in the historic cholera outbreak that infected nearly 100,000 people and left thousands dead. This is his story.

In February, MSF released the report “Beyond Cholera: Zimbabwe’s Worsening Crisis” to draw attention to the humanitarian crisis ravaging Zimbabwe, most visibly expressed by the unprecedented cholera outbreak, which claimed thousands of lives. Now, six months later, the cholera has died down and the new unity government has been in charge for half a year. What has changed? MSF’s head of mission in Zimbabwe, Rian van de Braak, answered questions about the current situation.

In July, Doctors Without Borders/Médecins Sans Frontières (MSF) began an intervention in Kwekwe prison in Zimbabwe’s central Midlands Province. The intervention focuses on providing basic health care and therapeutic feeding to the inmates, many of whom are severely malnourished.

Despite the fact that many Zimbabweans risk their lives to flee Zimbabwe, the South African government has historically characterized them as ‘voluntary economic migrants’ and aggressively deported them. Until recently, approximately 17,000 Zimbabweans were deported each month by South African authorities, according to United Nations and South African Department of Home Affairs figures.

Johannesburg/Brussels/New York, June 2, 2009 – Violence, sexual abuse, harassment, appalling living conditions, and a serious lack of access to essential healthcare define the desperate lives of thousands of Zimbabweans in South Africa today, warned the international medical humanitarian aid organization, Doctors Without Borders/Médecins Sans Frontières (MSF).

Despite the fact that many Zimbabweans risk their lives to flee Zimbabwe, the South African government has historically characterised them as ‘voluntary economic migrants’ and aggressively deported them. Zimbabweans say they had little choice but to leave and thousands continue to cross the border every day, legally and illegally, as a matter of survival.

Interview with Jane Boggini, MSF nurse and field coordinator, just returned from Zimbabwe where she worked during a major cholera outbreak.

Doctors Without Borders/Médecins Sans Frontières (MSF) has seen an increase in cholera patients in some urban areas of Zimbabwe, despite the reported downward trend at the national level.

Jane Hannon, a 39-year-old nurse from Baltimore, was in Manicaland Province in eastern Zimbabwe during November and December 2008. Here, she talks about trying to help people with cholera in the middle of a large-scale, rapidly spreading outbreak, in a country that has fallen into extreme disrepair.

Luis Maria Tello, MSF emergency coordinator in Zimbabwe, encountered a devastating scene when he arrived in the town of Chegutu, 100 miles south of the capital Harare, on December 12, 2008. “The situation was absolute chaos. There were no beds and patients everywhere,” said Tello. “People were dying of thirst because there was no water. Dead people were lying everywhere."

MSF has treated nearly 56,000 patients for cholera since the outbreak began in August 2008. The cholera epidemic in Zimbabwe is still far from being over, and MSF is finding increasing numbers of cholera patients in Harare for the third week in a row.

MSF's Head of Mission in South Africa speaks about the South African government's decision to close a refugee camp, which provides medical care, housing and food to thousands of Zimbabwean refugees.

Johannesburg/New York, March 4, 2009 – The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today denounced the decision by South African authorities to close the ‘showground’, a large open field in Musina town near the border with Zimbabwe, where 3,000 - 4,000 Zimbabweans line up to apply for asylum and seek refuge every night. The closure of the showgrounds demonstrates a flagrant disregard for the humanitarian and protection needs of Zimbabweans seeking refuge in South Africa, and will have extremely negative consequences as no allowances have been made to ensure their access to shelter, food, or medical assistance.

MSF International President Christophe Fournier speaks about the current health system collapse in Zimbabwe.

Dealing with cholera is different than other emergencies I have worked on. It was the speed of it that made it so different. When you enter an area with many people sick from cholera or a clinic completely overloaded with cholera patients, you know lives will soon be lost.

I was awakened in the night by a phone call from a nurse on night duty who had been told that four children were seen along the road too sick to continue their walk to the nearest CTU.

Zimbabwe's political and economic breakdown has led to abysmal access to public healthcare; a collapsed infrastructure; a crushing HIV epidemic; political violence; food shortages and malnutrition; internal displacement and displacement to neighboring countries. Above, more than three million Zimbabweans have fled to South Africa, including these children taking refuge in a church in Johannesburg.

The widespread cholera outbreak continues throughout Zimbabwe. As previously reported, the focus of the outbreak has shifted from urban to rural areas, but cities are still a concern.

Harare/Johannesburg/New York, February 17, 2009 —Zimbabwe's humanitarian crisis continues to rapidly deteriorate, causing appalling suffering, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) warned today. The organization’s medical teams have now treated almost 45,000 people for cholera, an estimated 75 percent of the total number of cases in the current outbreak, and the crisis is far from over.

Transcript of a press teleconference on Zimbabwe's humanitarian crisis, which continues to rapidly deteriorate, causing appalling suffering. MSF's medical teams have now treated almost 45,000 people for cholera, and the crisis is far from over.

Last week, the massive cholera outbreak in Zimbabwe exceeded the World Health Organization’s (WHO) worst-case scenario prediction of 60,000 suspected cholera cases. For the third consecutive week, this was the heaviest week for new cholera cases since the beginning of the outbreak, with approximately 10,000 newly affected people.

Some 207 new admissions to a cholera treatment center (CTC) near the Zimbabwean capital Harare were received in a 24-hour period yesterday.

As of January 7, MSF has seen more than 16,000 patients with suspected cases of cholera in Zimbabwe. Currently, MSF teams are seeing an overall decrease in the number of cases at the projects where they are working. However, the UN has reported a major spike in cases – on January 6 1,080 new cases and 19 deaths were reported while January 5 saw 675 new cases and 59 deaths.

The first months of 2008 marked a period of further economic meltdown and political violence throughout Zimbabwe. While the country has been in crisis for years, the situation deteriorated to ever more alarming levels, with inflation of 231 million percent, shortages of essential goods, repression of opposition supporters, and additional restrictions on humanitarian organizations in the lead up to contested elections in June.

Massive forced civilian displacements, violence, and unmet medical needs in the Democratic Republic of Congo, Somalia, Iraq, Sudan, and Pakistan, along with neglected medical emergencies in Myanmar and Zimbabwe, are some of the worst humanitarian and medical emergencies in the world, the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) reported today in its annual list of the “Top Ten” humanitarian crises.

A second cholera outbreak has hit Chegutu, a town 100 km south of Harare, where more than 100 people have died since the first cases appeared on November 24.

MSF has seen more than 11,000 patients since August in Zimbabwe’s worst cholera outbreak in years and has opened dozens of cholera treatment centers throughout the country. Cases have been found in nearly all provinces. More than 500 national and international MSF staff members are working to identify new cases and to treat patients in need of care.

MSF has been treating cholera in Zimbabwe since the latest outbreak started in August, and will continue to care for patients throughout the country as long as is needed.  The outbreak has reached many provinces of the country and is greatest in the capital, Harare, and its suburbs, where MSF has set up two cholera treatment centers

An MSF nurse is standing in the middle of dozens of cholera patients lying on the dirt in the backyard of Beitbridge’s main hospital. Cholera has overwhelmed this border town of about 40,000 like contaminated wildfire.

In Zimbabwe’s capital Harare, MSF is responding to a major outbreak of cholera, which the local Ministry of Health has declared “the biggest ever in Harare.” MSF has set up cholera treatment centers (CTC) in Budiriro Polyclinic and Harare Infectious Diseases Hospital, where 500 patients have been treated to date and, on average, 38 new patients are admitted every day.

Mankaza, 15, tried to get away inconspicuously from the other girls at her boarding school in southern Zimbabwe. But before she could leave the hall some of her classmates started jeering and soon all joined in, "Where are you going Mankaza? Mankaza's going to juice up, Mankaza's going to juice up!"

MSF is treating people affected by the recent cholera outbreak in the Zimbabwean town of Chitungwiza.

MSF is now treating close to 40,000 HIV-positive people in Zimbabwe, over 7,000 of whom are children. It is estimated that there are about 2 million HIV-infected people in the country. The virus can be transmitted to the fetus during the pregnancy through the placenta, though there is a higher risk of infection during delivery when the baby comes into contact with the mother’s blood.

Brussels/Johannesburg/New York, June 28, 2008 — The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today expressed alarm at the deportation of approximately 500 Zimbabweans, including women and children, from a detention center in Musina, South Africa, at the border with Zimbabwe.

In December 2007, Doctors Without Borders/Médecins Sans Frontières (MSF) began providing essential health services to Zimbabwean migrants in the South African border town of Musina, Limpopo province, and in central Johannesburg. It is estimated that more than one million Zimbabweans live in South Africa.

New York, December 20, 2007 — People struggling to survive violence, forced displacement, and disease in the Central African Republic (CAR), Somalia, Sri Lanka, and elsewhere often went underreported in the news this year and much of the past decade, according to the 10th annual list of the “Top Ten” Most Underreported Humanitarian Stories, released today by the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).