Back to Index
HIV/AIDS and poverty
for War & Peace Reporting (IWPR)
(Africa Reports: Zimbabwe Elections No 28, 11-Apr-05)
By Marceline Ndoro in Buhera
April 11, 2005
read "Folk tales to fund essential healthcare"
poor child spacing and poor water supply inevitably lead to malnutrition,
diarrhoeal diseases and sexually transmitted diseases," said
Dr Mike Thompson, a British medic who formerly worked at Murambinda
hospital in Zimbabwe.
He now helps
raise funds in Britain for the facility, which recently became the
benefactor of the entire royalties of the latest book by Scottish
novelist Alexander McCall Smith.
thrives on such a rich diet of misery, with malaria thrown in for
good measure. AIDS is a huge and growing problem," said Thompson.
have] to send terminal cases home as soon as possible to avoid swamping
the hospital and ruining families with debts run up for transporting
founded nearly 40 years ago by a Catholic order, the Sisters of
the Little Company of Mary, serves the drought-stricken district
of Buhera in the southeast of the country.
It is one of
the few efficient hospitals left in Zimbabwe’s ruined healthcare
But key services
– including free supplies of anti-retroviral drugs to patients with
HIV – are almost entirely dependent on the flow of overseas donations
like those from McCall Smith.
Dr Monica Glenshaw explained that the vast majority of patients
are extremely poor.
is the second poorest district in the whole of the country,"
she told IWPR. "It’s difficult to give a precise measure of
the poverty level because most of the people are subsistence farmers.
But the average income is less than 50 US cents a day."
The United Nations
sets its own measure of absolute poverty at twice that, one US dollar
The maize crop
in the district has failed this year as a result of drought – and
the hospital has seen an influx of patients suffering from kwashiorkor,
marasmus and other diseases symptomatic of malnutrition.
IWPR they know of at least 60 people who have simply starved to
death in surrounding villages in the last 12 months, but they believe
the total is higher. With the help of a Dutch charity, the hospital
has begun providing a free basic meal to patients.
The sole benefit
of the food crisis is that increasing numbers of people are signing
up for HIV tests in the desperate hope of receiving supplementary
hospital currently has 2,700 patients registered as HIV-positive.
So far just 53 have been supplied with anti-retroviral drugs, which
do not cure the condition but delay the onset of AIDS.
these drugs, charitable donations also make it possible for Murambinda
to charge some of the lowest fees of any hospital in Zimbabwe. A
consultation costs the equivalent of just eight US cents.
so affordable here," Tariro Goto, whose husband was a patient
at the hospital, told IWPR. "When I brought my husband once
before, I did not have 35,000 Zimbabwean dollars [just under six
US dollars] to pay for the medicines he needs, but I got them free
when I explained I had no money."
But the facility
is desperately short of staff.
at seven o’clock and my husband only saw a doctor 15 hours later,"
Goto added. "Then it took another six hours to be attended
by a nurse."
told IWPR that she really needs a minimum of four doctors and 55
nurses at the hospital, but is forced to struggle by with three
doctors and 30 nursing staff.
For every 100,000
patients, a developed country like Britain has 150 times more doctors
than are available in the Murambinda area. The ratio is similar
with regard to nurses. And the hospital has just 125 beds to cope
with the many thousands of people who need in-patient treatment
In an attempt
to address this problem, staff have been forced to establish an
extensive homecare programme under local AIDS activist Nonia Temberere,
with the support of the French charity Doctors Without Borders and
300 community volunteers.
work with terminally ill people, many of them AIDS patients in the
final stages of the disease.
With most AIDS
deaths in the 15 to 49 age group, Temberere said, "I have orphans
and children being asked to take care of their terminally ill mothers
very little or no guidance other than from my team and Murambinda
on how to administer home-based care, it has led to some of the
children themselves becoming diseased."
reflects the state of healthcare across the board in Zimbabwe, where
the hospital system was once the envy of other African countries.
Two decades of mismanagement, neglect and rampant theft have left
public health services in a catastrophic state, with doctors and
nurse leaving in large numbers to seek work elsewhere.
have lost faith in the system," a doctor at the main public
hospital in Bulawayo, Zimbabwe’s second city, told IWPR. "They
think, ‘Why spend our money on a substandard, ineffective service?’
Now, if they really want to be cured, they go to a witch doctor."
which was 63 in Zimbabwe in 1998, has plunged to 33 – largely as
a result of AIDS exacerbated by widespread hunger.
The money from
donors like McCall Smith – whose book is forecast to bring in over
190,000 dollars – will help provide a continuous supply of anti-retroviral
drugs from South Africa, which are otherwise becoming increasingly
unavailable in Zimbabwe as the national economy continues its tailspin.
But Dr Glenshaw
said she worries about what will become of the Murambinda hospital.
remains bleak, especially because of the country’s economic problems,"
she told IWPR. "And things are likely to get worse before they
get better. Finance is a constant worry for us, and the current
reliance on donor support is not sustainable in the long run.
future holds is uncertain."
Ndoro is the pseudonym used by a journalist in Zimbabwe.
Information on Murambinda hospital and efforts by overseas donors
to sustain its work is available at www.fmh.org.uk
Please credit www.kubatana.net if you make use of material from this website.
This work is licensed under a Creative Commons License unless stated otherwise.