Coronavirus to push Zimbabwe to the brink?
With a shambolic health-care sector and an informal economy in which people are without basic necessities, experts are wary of how effective Zimbabwe’s Covid-19 containment measures will be
With Zimbabwe’s health-care sector crippled by a strike by doctors and nurses, underfunding and years of general neglect, fears are growing that Covid-19 will hit the troubled country very hard.
Already, the disease — confirmed in the country just two weeks ago — has claimed its first victim: Zimbabwean broadcaster Zororo Makamba. At the time of publication, the number of confirmed cases had reached eight, from 233 tests.
Fear has gripped the country.
Wilbert Mutaurwa, a vendor in the capital, Harare, believes infection with the virus would amount to a death sentence, given the dire state of health facilities in the country. "We will all die of corona," he tells the FM. "We will all die because we don’t have proper medical facilities."
Zimbabwe’s health-care sector is, indeed, a mess. It was paralysed for more than four months last year when doctors and nurses went on strike over wages. They only returned to work in January, after Zimbabwean billionaire Strive Masiyiwa set up a fund to cover subsistence and transport costs. The telecoms tycoon stepped in again to head off a strike this week, offering financial incentives, insurance and protective clothing to safeguard medical workers from the coronavirus.
Drugs are in short supply, and depleted state coffers mean the government is unable to buy supplies for state medical facilities.
The shambolic state of the country’s health-care system was captured in a report by UN human rights expert Hilal Elver, who visited Zimbabwe in November. She found that patients often travel 200km north of Harare to mission hospitals such as Karanda to seek health care.
For Zanu-PF bigwigs, the solution has always been to bypass the local health system and seek medical attention in SA and abroad. Former president Robert Mugabe, for example, died while undergoing treatment in Singapore, and Deputy President Constantino Chiwenga has sought treatment in China.
The situation has left the country ill-prepared for the pandemic.
"We were not operating at full capacity [before]," says medical doctor Munashe Rukweva. "We didn’t have the right staffing levels and enough stocks. With this pandemic, the major issue is [that] … our screening is not up to scratch.
"We don’t need body armour like astronauts — we need the very least, like masks, goggles and sanitisers. We have frontline people telling us that they have run out of supplies. They are telling us that they don’t feel safe."
For the Makamba family, the health authorities have also shown themselves to be negligent. By their account, the Wilkins Infectious Diseases Hospital — the designated Covid-19 quarantine centre, where Zororo died — is as good as a death trap.
The hospital did not have a ventilator available for Zororo, and the family was told to pay $120,000 to obtain one, says Tawanda Makamba, his elder brother. And, he says, the hospital didn’t have medication to help his brother. "The only medications available were the ones we bought from SA."
The family ended up sourcing a ventilator privately, taking it to the hospital at 2pm on March 22, says Tawanda. "When we got to Wilkins [Hospital], the portable ventilator had a US plug. They told us to get an adapter because they only had round sockets at the hospital. I then rushed to buy an adapter and came back, but they never used it. I asked why and they said there were no plugs in the room."
Unsurprisingly, concerns around the preparedness for the pandemic have Zimbabweans worried.
"Right now, HIV-positive people cannot access their antiretroviral drugs," says Harare resident Jabulani Gwenzi.
President Emmerson Mnangagwa has also voiced concerns about whether the country’s high HIV prevalence will complicate the fight against Covid-19.
"With our HIV prevalence of 14% or slightly below and malnutrition and other noncommunicable diseases, especially among children, we are deeply concerned," he said on launching the country’s coronavirus preparedness policy two weeks ago. "This situation is a real threat to the citizens of our mother country."
The threat could not have come at a worse time. The country is in the throes of an economic crisis. Professionals are struggling to make ends meet as earnings lose purchasing power at unbelievable rates. At the time of going to print, the Zimbabwe dollar was trading at Z$42/$ while inflation measured 540% in February and salaries are stagnant.
Crippling power shortages occur frequently, with outages stretching to 17 hours a day. And more than 8-million people could face food insecurity this year, Elver warned after her visit last year.
It’s not that the government has been inactive. In February, health minister Obadiah Moyo told parliamentarians that the country had "adequate thermal scanners at our borders. As far as isolation is concerned, we make sure that all visitors are well checked and, should there be symptoms, we will put them in quarantine. The best quarantine facility is in Victoria Falls, where there are tourists."
Two weeks ago, Mnangagwa declared a state of national disaster to contain the spread of the virus. He banned all public gatherings of more than 100 people — including church services and international sporting fixtures — for 60 days, closed schools, and designated Wilkins Infectious Diseases Hospital and Beatrice Road Infectious Diseases Hospital, along with some referral hospitals, as quarantine facilities. He also closed the country’s border, allowing only goods to enter.
Then on FridayEmergency & Crisis Management Authority, believes it will be a tall order to lock down an informal economy in which people are without water and necessities.
"It’s not practically possible … without any form of relief to the needy," she told television news channel Al Jazeera. "Yes, the whole world is on lockdown — it’s the right thing to do. But without water it’s a futile and grave exercise," she said, explaining how at 4am, for example, hundreds of people queue for borehole water in the district of Mufakose, Harare.
The Zimbabwe Human Rights NGO Forum, along with the Zimbabwe Association of Doctors for Human Rights and Zimbabwe Lawyers for Human Rights, says the government needs to do more. For a start, it suggests early detection and mitigation through "robust" screening at all major ports of entry. It also says the country needs a clear referral pathway, and must request back-up diagnostic kits, personal protective equipment and expertise.
Testing has, until recently, proved problematic. Two weeks ago, Norman Matara, secretary-general of the Zimbabwe Association of Doctors for Human Rights, bemoaned the country’s lack of action, saying only 16 people had been tested.
It’s an issue Moyo is aware of. In February already he said his ministry had identified equipment for testing for Covid-19. "The equipment is there, but what is missing are test kits so that we do not continue to send samples to SA."
Last week, Chinese e-commerce giant Alibaba and other Chinese organisations donated protective wear, diagnostic kits and other aid to help African countries manage the outbreak.
But government measures have not allayed citizens’ fears.
Posting on Facebook, businessman Vimbai Chakanetsa says the current "extraordinary circumstances" require extraordinary measures. "The current response to the coronavirus pandemic by the Zimbabwean government is too weak and shall lead this nation to dire consequences," he writes.
Rairo Gunguwo is another who believes the authorities have to do more.
"We have been watching the horrible effects of Covid-19 in Europe and recently SA, among other countries. We had much time to prepare and put in place measures for prevention and containment in Zimbabwe," she told the FM last week.
"The only notable thing our country has done so far is ordering the closure of schools and erecting a few wash basins in the Harare CBD."