7 February 2009
Concern Over Grave Medical Condition and Denial of Access to Treatment of Detained Persons

The Zimbabwe Association of Doctors for Human Rights (ZADHR) unreservedly condemns the continued denial of access to adequate medical treatment of persons detained at Chikurubi Maximum Prison following their alleged abduction and subsequent torture.

In particular ZADHR is concerned about the medical condition of Mr Fidelis Chiramba, District Chairperson of the Movement for Democratic Change in Zvimba South. Mr Chiramba, who has been incarcerated for 100 days now, has been examined by medical practitioners who have confirmed that he needs to be urgently hospitalised.

Mr Chiramba continues to be denied access to adequate medical treatment despite an order being granted by Magistrate Mishrod Guvamombe on 31 December 2008 that he be taken to a hospital of his choice for treatment. This was not done. A second order was granted in the Magistrate’s Court on 30 January 2008 by Ms Gloria Takundwa for Mr Chiramba to be taken to a private clinic for treatment the same day.

14 August 2009
Junior Doctors Strike Threatens Health System Recovery

The Zimbabwe Association of Doctors for Human Rights (ZADHR) deplores the ongoing strike by junior doctors which threatens to damage efforts underway to rebuild the country’s health system. The health system is still struggling to emerge from a crisis that left the country’s major referral hospitals unable to deliver services at the end of 2008.

Health professionals are entitled to adequate remuneration and acceptable working conditions. However, this must also be balanced against the wellbeing of patients. Unavailability of health services ultimately results in increased morbidity and preventable deaths.

At a time when all public service employees are struggling to survive on the salaries and allowances they are receiving, the Human Resources for Health taskforce is working to improve the salaries and working conditions of health professionals. These efforts should not be undermined.

24 October 2008

Statement on Continued Cholera Outbreaks


ZADHR remains deeply concerned with the continued outbreak of cholera in Zimbabwe. Areas affected between September and October this year include Chinhoyi, Kariba and Makonde in Mashonaland West and Chitungwiza, Chikurubi, Dzivarasekwa, Kuwadzana Extension, Mabvuku, Highfield, Zengeza in Harare. 120 cholera-related deaths have been cumulatively recorded this year including cases from earlier outbreaks between February and August in Manicaland, Mashonaland Central, Mashonaland East and Masvingo. A case fatality rate of 11.5% was recorded in Chitungwiza with 16 deaths from a total of 149 reported cases and of 12.7% in Chinhoyi from a total of 47 cases as at 14 October 2008.

The Government of Zimbabwe has grossly underestimated the impact that infrastructure breakdown is having on public health in Zimbabwe. Water supply is irregular or completely absent in most urban areas, burst sewage pipes continue to be left unattended and there is a lack of refuse collection. These factors create ideal conditions for the outbreak and spread of diseases such as diarrhoea, including its deadly forms of cholera and dysentery. ZADHR reiterates that access to proper sanitation, the supply of clean running water and preventing the outbreak of epidemic diseases must be treated as urgent priorities by the Government.

20 November 2008

Pregnant women in grave danger

ZADHR is deeply concerned that the lives of pregnant women have been placed in jeopardy by the closure of the only 2 government maternity hospitals in Harare. If these women develop complications and are unable to afford private hospital care, they will no longer have access to lifesaving surgical and other forms of emergency obstetric care. Inevitably, this will result in the unnecessary deaths of many otherwise healthy women and an even larger number of infants.

An average of 3000 women deliver per month in public hospitals in greater Harare and between 250 and 300 of them require lifesaving caesarian sections. Many more have deliveries assisted by forceps or vacuum extraction when their babies show signs of distress and a lack of oxygen. In addition, mothers who miscarry earlier in pregnancy require surgery to evacuate the uterus to avoid serious and often fatal infections and bleeding. Without access to these interventions a significant number of mothers will die. The risk to their infants is much greater as the majority of caesarian sections and instrumental deliveries are performed to rescue babies who are suffering from a lack of oxygen during labour. We can therefore expect a dramatic increase in the number of stillbirths and of infants who have suffer irreversible brain damage which will result cerebral palsy and severe mental retardation.

17 June 2008

Cases of Systematic Violent Assault and Torture Overwhelm Health Professionals


ZADHR is deeply concerned about the continuing violent trauma being inflicted on the Zimbabwean population. The escalation in numbers and severity of cases of systematic violent assault and torture during May was of a scale which threatened to, and for brief periods did, overwhelm the capacity of health workers to respond. Both first line casualty officers and specialists, especially surgeons and anaesthetists, to whom patients were referred had great difficulty in adequately managing the burden of serious physical trauma.

ZADHR commends the efforts of health professionals in Zimbabwe who continue to provide the highest possible quality of health care to victims of violence under extremely difficult circumstances.

In addition to individuals with significant physical injuries, members of ZADHR saw over 300 displaced patients with medical conditions such as pneumonia or asthma, or psychiatric diagnoses, in particular anxiety and depression, and many with chronic conditions such as diabetes whose medication had been lost or destroyed when the patients were violently forced, by arson or the immediate probability of injury or death, from their homes.

23 April 2008

Violent Assault and Torture Remains Unchecked


Further to the two statements ZADHR issued last week we report a further 81 cases of organised violence and torture which have been seen and treated by members of the Association in the three days ending Monday 21 April 2008. This is not a cumulative total – this is the number of cases seen in these 3 days alone. The total number of cases seen since 1 April 2008 is 323. It seems likely that there are substantial numbers of similar cases occurring across the country which have not presented to ZADHR members and are therefore not represented in these figures.

54 of these cases occurred in Harare, Chitungwiza or Epworth, 20 in Glen View alone. 13 more occurred in Mudzi and Murewa, 4 in Mount Darwin, and 6 in different areas of Manicaland.

By far the commonest alleged perpetrators are now the uniformed forces (ZRP and ZNA).
Fourteen (17%) of these 81 patients were women. They include a 7 year old girl who suffered a fracture of her right radius and ulna on falling down while running after her father who was being chased by members of the security forces, and a 10 year old boy with a probable dislocation of the right elbow resulting from being kicked by a soldier who was trying to kick someone else. One 47 year old woman reported being sexually assaulted.

19 November 2008

Collapsed Health System Violating Health Rights
Health System Collapse

Zimbabwe’s public health system is in a state of collapse and in need of urgent action to rescue it. It has been paralysed by drug shortages, insufficient medical supplies, dilapidated infrastructure, equipment breakdowns and brain drain. The main referral hospitals in the country – Harare Central Hospital and Parirenyatwa Hospital in Harare and Mpilo Hospital and United Bulawayo Hospitals in Bulawayo have been virtually closed. Most district hospitals and municipal clinics are barely functioning or closed. Sick people in need of medical attention are being turned away from Zimbabwe’s hospitals and clinics.

The withdrawal of maternity services at Harare and Parirenyatwa Hospitals means that healthy women requiring elective and emergency caesarean sections, and unable to afford private health care, will needlessly die in child birth. In the absence of specialist care tens of women could be victims of maternal mortality each weak due to the absence of a specialist response to complications.
The failure of the public health system is paralleled by private healthcare whose cost, now charged in US dollars, has skyrocketed beyond the reach of the majority of Zimbabweans.

19 September 2008

Urgent Action Needed to Address Water Shortages and Breakdown in Sanitation


A serious health crisis currently looms over Zimbabwe’s urban areas due to a severe shortage of running water in most areas. The Zimbabwe National Water Authority’s (ZINWA) failure to treat and pump adequate supplies of water has left most urban homes dry and forced residents to rely on unsafe supplies of water. This coupled with a breakdown in the sanitation system (burst sewage pipes and lack of refuse collection and proper disposal) is threatening the health of millions on Zimbabweans.

The new Government must address this crisis as a matter of urgency. It is a matter which cannot wait for resolution of differences or ‘sticking points’. Public service provision has been inadequate for several years and requires urgent and comprehensive remedial action.

Access to safe drinking water and to adequate sanitation are human rights and not privileges of the Zimbabwean population. They are determinants of health which if not made available can result in outbreaks of diarrhoea, cholera and dysentery that are life threatening. Lives have already been lost to cholera in Chitungwiza and health centres in Harare and Bulawayo are burdened by numerous cases of diarrhoea on a daily basis. It is highly likely that the number of deaths in Chitungwiza, currently reported at 12 individuals, is much higher, and that this is but the tip of an iceberg of much more morbidity. This has not been communicated to the public.

Statement on World Health Day
7 April 2008

The Zimbabwe Association of Doctors for Human Rights calls to attention the state of the public health system. Zimbabwe’s healthcare system, in a known state of crisis, is in need of urgent attention. It is crippled by dilapidated infrastructure, drug shortages, equipment breakdowns, brain drain and costs of healthcare skyrocketing beyond the reach of the majority of Zimbabweans.

Average life expectancy, according to the WHO, has declined from 60 years to 37 years for men and 34 for women during the past decade. Maternal mortality is rising to a level which meets that of the world poorest countries.

ZADHR commends health professionals and health workers in Zimbabwe who have continued to deliver health services in very difficult circumstances and remain committed to the recovery and improvement of the public health system.

1 June 2007
Prevailing Health Sector Emergency

The Zimbabwe Association of Doctors for Human Rights (ZADHR) deplores the failure by the Government of Zimbabwe to take urgent measures to address the prevailing emergency in the public health sector.

Inadequate remuneration and unacceptable working conditions for health workers across the country have resulted in a crisis and left the country’s major referral hospitals unable to function. Inadequately remunerated health workers across the country can no longer afford to go work and junior doctors in Harare have formally commenced strike action as at 1 June 2007.

1 June 2007
Prevailing Health Sector Emergency

The Zimbabwe Association of Doctors for Human Rights (ZADHR) deplores the failure by the Government of Zimbabwe to take urgent measures to address the prevailing emergency in the public health sector.

Inadequate remuneration and unacceptable working conditions for health workers across the country have resulted in a crisis and left the country’s major referral hospitals unable to function. Inadequately remunerated health workers across the country can no longer afford to go work and junior doctors in Harare have formally commenced strike action as at 1 June 2007.

10 January 2007
Statement on Junior Doctors Strike

The Zimbabwe Association of Doctors for Human Rights calls upon the Ministry of Health and Child Welfare to take urgent and practical steps to bring the ongoing strike by junior doctors to an end. The strike has severely compromised the standard of healthcare at the country’s major referral hospitals since 21 December 2006. Responsibility lies with the Ministry of Health and Child Welfare in liaison with other relevant Government departments to resolve the crisis immediately and prevent further loss of life and unavailability of health care.

ZADHR deplores the dilatory approach taken by the Ministry regarding the strike. Doctors had been on strike for two weeks before the Minister of Health agreed to meet with them to discuss their grievances. This offhand and disrespectful attitude to the country’s up and coming doctors has resulted in 20 years of distress among junior doctors and recurring episodes of industrial action. While protecting human life must remain the first priority, doctors must be granted appropriate remuneration and conditions of work in order to deliver effective health services.

Furthermore, inability to appropriately address the doctors’ legitimate concerns will ultimately lead to increased brain drain in a health sector already crippled by a massive exodus of health professionals. The knock on effect is being felt even now as medical school lecturers, already too few in the face of bloated intakes of students, find it impossible to teach while plugging the gaps in clinical services.

7 April 2006
Press Statement
Taking Stock of Health Rights in Zimbabwe on World Health Day

The Zimbabwe Association of Doctors for Human Rights (ZADHR) today commemorates World Health Day by registering its concerns for health rights in Zimbabwe. This year’s theme, “Working Together For Health” focuses on health workers and the essential contribution they make to strong, functioning health systems. We recognize that realization of the highest attainable standard of physical and mental health remains a daily struggle for all health workers in Zimbabwe.

The Zimbabwean health delivery sector is presently in a state of crisis with hospitals and clinics countrywide barely functioning due to a lack of sufficient nurses and in very many cases no doctors. Operations at referral hospitals in Bulawayo and Harare have been severely compromised and district and mission hospitals are threatened with closure, with some district hospitals operating without medical officers. This is the result of a continued massive exodus of qualified health workers. The failure to retain health workers results from many factors, amongst them poor remuneration and lack of basic medical equipment necessary for health workers to satisfactorily carry out their work.

4 October 2006
Press Statement
Nature of Injuries of Tortured ZCTU Members

The Zimbabwe Association of Doctors for Human Rights (ZADHR) states that the medically confirmed and documented pattern of injuries sustained by the Harare and Chitungwiza ZCTU members who were arrested on 13 September 2006 and detained in police custody until 15 September 2006 is consistent with the testimony given by the ZCTU members themselves.
This is, that these were injuries consistent with beatings with blunt objects, heavy enough to cause fractures (9 fractures in 7 individuals) to hands and arms and severe and multiple soft tissue injuries to the backs of the head, shoulders, arms, buttocks and thighs (29 individuals).
Soft tissue injuries to the soles of the feet (8 individuals), are also consistent with beatings, and correspond to the torture method called Falanga, which can leave a torture victim having difficulty with normal walking for the rest of his or her life.

The Medical examinations of the arrested ZCTU members showed no skin abrasions. Abrasions would necessarily result from the shearing forces associated with falling from a moving vehicle.

15 September 2006
Press Statement
Torture and Denial of Access to Treatment of ZCTU Members

Zimbabwe Association of Doctors for Human Rights (ZADHR) unreservedly condemns the assault and torture while in Zimbabwe Republic Police custody, and prolonged detention of seriously injured Zimbabwe Congress of Trade Unions (ZCTU) members and supporters from Wednesday 13 September 2006 until the evening of Thursday 14 September 2006.

In particular ZADHR is concerned about the medical condition of Lovemore Matombo, ZCTU President, Wellington Chibhebhe ZCTU Secretary General, and Lucia Matibenga ZCTU Vice President whose lives were threatened by lack of adequate medical attention. ZADHR condemns the initial refusal by the police to release the injured from Matapi Police Station to a medical facility, for urgent treatment.

ZADHR is also very concerned that other ZCTU members may be in grave medical condition, in other police stations in Zimbabwe, and calls for their release of those in need of medical attention, and for them to be assisted to get immediate medical assessment and treatment as required.

3 February 2006
Press Statement
Continuing Cholera and Disease Outbreak Threat In Zimbabwe

The Zimbabwe Association of Doctors for Human Rights (ZADHR) remains concerned over the state of the public service delivery system in the country and its contribution to disease outbreak, cholera in particular. It is essential that there be a more coherent central Government strategy to ensure that Zimbabweans are accorded the “best attainable state of physical and mental health”.

The Government’s knee-jerk response to the cholera outbreak earlier this year continues to be inadequate as a measure to prevent disease outbreak in the medium to long-term future. The ad hoc arrangement to close down Mbare Msika before alternative arrangements meeting minimum standards of health had been made is deplorable. Vendors were relocated to make-shift “satellite markets” in Belvedere, Dzivarasekwa, Mavbuku, Highfield and Hatcliffe under circumstances in which the necessary infrastructure such as running water and toilets is absent or insufficient to meet the needs of the populations already in place at these locations. This raises the potential for further outbreak of disease rather than addressing the problem.