“Maybe certain people who wouldn’t normally pay attention, maybe they will,” said Hirsch after returning from a field visit with Oxfam America to its emergency programs in the southern African country in April, 2009. “It reminds me of how fortunate we are: The tap water [at home] doesn’t taste like Evian, but at least I’m not going to get cholera.”
Not like the 98,592 people in Zimbabwe who contracted the deadly diarrheal disease when the collapse of water and sewer systems across the country led to one of the world’s largest recorded outbreaks. The outbreak left 4,288 people dead, and early on hit hard in Mudzi, a rural region in the northeast corner of the country on the border with Mozambique where Hirsch spent four days.
For most people in Mudzi, tap water is a luxury beyond their reach. Instead, they trek with their empty water jugs to community wells drilled deep into the ground and outfitted with hand pumps. They fill the jugs and lug them home again—sometimes several kilometers away. But as Zimbabwe grappled with hyperinflation, many of Mudzi’s wells—known as boreholes—and other water systems across the country fell into disrepair. For their drinking water, people turned to different sources, like streams, that were easily contaminated, and cholera began to spread.
Though the outbreak is now over, what Hirsch saw and experienced as he traveled from the capital, Harare, to some of the most remote regions of the country have made him examine more closely the comforts of home.
“It really puts things into perspective,” said Hirsch, who starred in the lead role in Into the Wild and played a gay rights activist alongside Sean Penn in Milk. “There’s a lot we take for granted in the US. At a hospital in Mudzi, there was a fully functioning X-ray clinic with no chemicals to look at the X-ray, so that rendered it completely non-functional.”
This was not Hirsch’s first exposure to hardship in Africa. In June, 2008, he traveled with Oxfam America to the eastern provinces of Democratic Republic of Congo where years of conflict have ravaged the mostly rural region, leaving people destitute. But for Hirsch, Zimbabwe was different. It was a place not so far from his ken, a place more like home—particularly Harare, with its gardens, parks, and architecture, a city that Zimbabweans say was one of the most beautiful in the world 15 years ago. Because of that familiarity, Hirsch felt the country’s challenges with greater acuity.
“There are gas stations. Just no gas. Hospitals. But no supplies,” said Hirsch. “People in the US are talking about how the economy is really bad here. It is. But it’s nowhere near the level of Zimbabwe.”
Prep for the trip included loading himself up with stacks of small bills. Anything bigger than $20s wouldn’t have been easily exchangeable in a country where people have so little and credit cards don’t work. Hyperinflation had left the Zimbabwe’s currency virtually worthless: early in the year a newly minted 10-trillion bill wouldn’t even have been enough to buy a small bottle of drinking water.
“It’s ridiculous…when you look at a 10-trillion bill just to calculate that figure,” said Hirsch. “To be a cashier you have to have a calculus degree.”
Calculus or not, what most people do have is command of the English language—testament to the fact that Zimbabwe has one of the highest literacy rates of any country in Africa.
“Even in the remote villages, everyone can speak English,” said Hirsch, pointing out that he can’t do the reverse: speak their language, Shona. “It’s not necessarily fluent, but it’s basic English grammar.”
Education levels weren’t all that impressed Hirsch. He felt buoyed by a deep but steady optimism among the people he met.
“Zimbabweans have such a sense of purpose,” he said. “A very upbeat, forward-thinking way. The feeling I got is the country is about to change.” A new government of national unity, where power is now being shared by former political adversaries, may account for that course of hope. And the fact that it’s coupled with a new administration in the United States that may begin to look more favorably on Zimbabwe, has given Hirsh his own dose of hope.
It was a good feeling to fly home with—and just the right antidote for the inevitable stomach bug that gripped Hirsch on the fifth day of the trip and stuck with him all the way back to California.
“Might have been the beef stew,” he said, shrugging off his discomfort—and sounding 100 percent ready for the next trip. “Absolutely I’d like to visit other places and do more.”
]]>My gift, according my father, is that while most people look at a 15-hour flight as torture, I look at is a time to get some rest. And he is right. My flight went by in a flash. I got some reading done, some work done, and slept the rest of the way curled up in my seat with my neck pillow and noise-cancelling earphones (best birthday gift ever).
My first hours in Zimbabwe were filled with contradiction. As I walked out of the airport in Harare I was greeted by clean, cool evening air. I was then welcomed by Oxfam's humanitarian program coordinator, Ransam, with a hug and a joke. But as we drove to my hotel the empty streets were shocking. It was only 10 pm, but there were almost no other cars on the road and very few people walking. We pulled into the hotel and as we walked up to reception the crickets were singing. I could tell, even in the dark, how beautiful the landscape was. But as a sign of the times in Zimbabwe, when I checked in I learned the hotel wanted me to pay cash—in advance—for my room and it preferred US dollars or Euros.
After checking in, I met up with Lyndsay, Oxfam's public figures liaison. She worked to put this trip together and I could tell she wanted it to go well. She has a lot of respect for Emile after their trip to the Congo last year. He gets it, she said, and really wants to learn. As for me, I couldn't wait to meet him and made her knock on his door at 10 p.m. to introduce us. He was tired but cheerful and very excited about the trip. We kept the meeting short: tomorrow would be the car ride to the rural area and we could get acquainted then.
I am always so tired at the end of the day in Mudzi, a region in the northeast part of the country where Oxfam has been working on the cholera outbreak. After a two-hour car ride from Harare we arrived at the Pumpkin Hotel—the only hotel in this region. We settled in (Emile got the suite with the waterbed, and I got the one next door) and had some lunch: Eggs and sadza—a finely ground cornmeal boiled in water.
After lunch, we headed out to look at a bore hole—a narrow well drilled deep into the ground. Mudzi has hundreds of them. They're the source of drinking water for many people in this rural region. This one was a half-hour-drive away on a bumpy, dry road—and when we arrived, we found hundreds of community members waiting for us.
Sitting in two large groups, they had prepared a speech and gifts: beautiful hand-crafted baskets and several large bags of fresh peanuts tied in large burlap bags with "product of USA" stamped on their sides. These bags had been recycled from earlier food distributions. The villagers wanted to show their gratitude for the work Oxfam and our local partner, Single Parents Widow(er)s Support Network, or SPWSN, had done together: teaching communities about hygiene , providing them with basic goods like soap, and repairing their bore holes.
Emile confessed to me that he thought the word was "boar" hole. And why not? if you were not a water engineer or public health person or someone dependent on these holes for water, how would you know what they were? It made me realize how little the developed world knows or understands about those who still fetch water by hand and don't have access to flushing toilets—or even pit latrines.
Back at the meeting, Emile addressed the village, thanking them for their hospitality and acknowledging their strength as a people and as a community. He was nervous and I could tell he had really thought through what he wanted to tell his hosts.
That is why this trip is so important: To get the word out. Yes, the number of cases of cholera might be less each week, but what about next year? How do we stop an outbreak from happening again? This year in this village this outbreak left 25 orphans. This is a staggering number of children who have lost their stability—all because they and their families could not access clean water.
As we drove back to the Pumpkin Hotel, I thought again, with amazement, about how so much devastation can happen in such a beautiful setting, and how the people can keep going with such optimism and positive attitudes. I realized it had been an important day for Emile, too: He was beginning to understand the context of people's lives, how they cope, and the importance of supporting them when their options run out.
We spent another long and dusty day in the field. Today we watched as nearly 2,000 people gathered to learn about cholera. They sang, laughed, and watched plays all about a deadly bacterial disease that can kill a person in a matter of days with diarrhea and vomiting. We listened to health promoters from Oxfam and SPWSN as they talked and sang about feces, and watched as they faked illness and dying—all to teach the audience about cholera.
Emile was amazed at the teams' drama and acting capabilities and at the community's ability to laugh about something so devastating. My favorite part was the singing—so lyrical and powerful. I found myself singing along (not nearly as well, of course) and envious that they could make such beautiful music with nothing but their voices.
We spent the second half of the afternoon driving to a cholera treatment center. The number of cases had finally started to wane but it was hard to know if it was just because the rains had stopped or if all our hard work was paying off. I am sure it was a combination of both—but we will know for sure next year when the rains come again. That is why we are going to continue our work after the outbreak is over: We'll introduce clean water at the level of the household using sand filters. We are going to try and break the cycle of yearly diarrheal outbreaks—lofty goal, but worth shooting for.
The day started out with a 9 a.m. meeting at the local hospital and a report on new cases. Yesterday, the cholera early warning surveillance system Oxfam put in place with SPWSN detected new cases. For the past several weeks there were only sporadic cases, but yesterday, following a funeral the day before , 19 cases were detected. It was amazing to be there and see our early warning system working—and to learn about the response. All 19 patients were brought to the health center and the response featured bore hole repairs, the delivery of supplies to the health center (including a salt and sugar solution for oral rehydration, disinfectant, tents, and beds) and the launch of a public health education campaign for the affected community. Amazing! By getting the patients to the health center so fast the hope was to avoid more deaths—and more funerals.
As we were listening to the report, I looked over at Emile, who was absorbing all the details and asking thoughtful questions. I was glad he was there so he could return home and share what he had learned about the seriousness of the situation in a way other people might be able to understand.
Oxfam had jumped in to supply ever-scarce fuel and supplies for the response. While everyone hopes this epidemic is winding down, no one was surprised that that there were still cases erupting. The infrastructure in Zimbabwe is so broken down it will take years to build a safe water system for all to use. Our biosand filters—a water treatment method that is used in the household—will provide more long-term protection for families and hopefully prevent diarrhea for them in the coming year.
The filters arrived the other day—thanks to UPS, who shipped them from the US for free—and we swung by the warehouse to look at them: large blue buckets with very little tubing. Their simplicity is amazing. I had drawn a picture for Emile the night before and explained how they worked. When he saw them in person, his eyes lit up: it all came together. I was happy to see someone who was just as excited as me about these blue plastic buckets and their potential to save lives.
We spent the night talking about the trip—all the things we saw and experienced. I pulled out my computer and we had a discussion, using a power point lecture, about the role of evidence in humanitarian response: How do you set up an early warning surveillance? Why is it so complicated? Why is it so important? I could see that Emile was synthesizing all the things he had learned over the past week, putting them together and grasping the complexities that make up Zimbabwe.
I am looking forward to reading what he writes. I am sure I will learn something from him and can't wait.
]]>"The number of people on this planet who suffer from chronic hunger has climbed to almost one billion—one in every six—and it's likely to get worse because of the global economic crisis and climate change," said Raymond C. Offenheiser, president of Oxfam America. "Congress should urgently pass this bill to not only address the ongoing humanitarian crisis, but also lay out long term responses that will reduce the vulnerability of poor people to the kinds of food price shocks we've seen in the last year."
The US approach to food security abroad has been uncoordinated across US agencies. The Global Food Security Act is the first attempt to provide a more comprehensive strategy for the US to address food insecurity abroad, make emergency responses more effective and build long-term food security by investing in agriculture. The legislation improves our emergency response to food crises and provides funding to assist poor countries promote food security and stimulate their rural economies.
"The spotlight may currently be on the financial crisis, but the food crisis is still very real and needs an urgent and coordinated response," said Offenheiser. "Once the world recovers from the global recession, commodity prices will skyrocket again, increasing the ranks of those who go hungry on a daily basis. This legislation begins the process of forging an effective strategy for fighting hunger and poverty."
Food prices on international markets rose dramatically last year and have eased in recent few months, but prices in most developing countries have remained high or continue to increase. For example, five million people are acutely affected by rising food prices in Afghanistan. The cost of cereal in Ethiopia remains drastically higher than at this time last year, and in Zimbabwe, five million people, almost half the country's population, are dependent on food aid.
The Lugar-Casey Global Food Security Act would create a new food security emergency fund for rapid response during crises. The bill also delivers on new investments and partnerships in research and development in agriculture. Perhaps most important, the bill begins to address the lack of clear mission, strategy and coordination among US agencies that has hampered our efforts of fighting poverty and hunger.
"With billions injected into the financial sector over the past few months, the donor community is drawing on empty pockets, but we must see investing in agriculture as part of the long-term solution to food, financial and climate crises," said Offenheiser. "Congress should urgently pass this bill to help us prepare to deal with another major spike in food prices, as well investing in long-term efforts to fight poverty."
]]>Tacked to the outside wall of a government office building in Zimbabwe, the warning served notice to all who could read English that Mudzi district is in the throes of a major public health crisis.
Like wildfire, hot spots of cholera—a waterborne diarrheal disease that can kill quickly if not treated properly-- continued to erupt in late January in this rural northeast region on the border with Mozambique. I heard about the spikes—and the challenge of stopping their spread—at the morning meetings at Kotwa hospital, where aid groups and government health officials gather to coordinate each day’s attack on the disease. Oxfam and its local partner, Single Parents Widow(er)s Support Network, or SPWSnet, are among those responding to the crisis.
Fanning out from the hospital grounds, a small team of nurses, water engineers, and public health promoters hit the road each day, traveling up to two hours to reach the more remote areas where people need everything from clean water to basic information about cholera prevention. And they return each night—sometimes long after dark—to prepare their reports for the next morning.
The news they deliver, along with their statistics, is often unsettling: Reports of people drinking from a stream in which others are washing dirty clothes and dishes; shortages of oral rehydration salts and disinfectant; an ox cart toting a patient who died before reaching a clinic. All of it paints a picture of a country crippled by hyperinflation and failing water and sanitation systems. In Mudzi, less than a third of the households have access to proper latrines, according to one estimate.
Already cholera has sickened close to 85,000 people across Zimbabwe, killing more than 3,900 of them as of Feb. 6. The World Health Organization has called it one of the largest outbreaks ever recorded. And Mudzi, poor and far from central areas of commerce and government activity, has been one of the hardest-hit districts.
Here, in Mudzi, fear of the disease is palpable. Fist bumps have replaced handshakes as people worry that palm-to-palm contact could transmit cholera. Some people are even afraid to eat, though of course they must, one man tells me.
“We are not settled,” says the man, Wonderful Nyatsuto, as he helps a SPWSnet engineer repair a deep well, known as a bore hole, about a mile and a half from his home. About 15 people in his village have contracted the disease, he says, and a third of those have died. Cases of cholera started to erupt when people began fetching their water from a nearby river after the bore hole stopped functioning. Across Mudzi, many of the region’s 600-plus boreholes no longer work and communities are too poor to repair them. But without a supply of clean water, residents face a growing danger from the disease.
“We are trying to maintain the rules they tell us,” Nyatsuto adds. “Boil water. Clean hands before you eat. Clean the toilet.”
Still, in a region where many locals supplement their meager incomes by panning for gold in a network of streams and drink the contaminated water as they labor, people are continuing to get sick.
But getting to a clinic is no easy matter. Functioning ones are few and far between. Some have no medicines. Others have no medical equipment. And so sick people trudge great distances to get the care they need. Roads are rough, sometimes barely more than tracks through the bush, cars are scarce, and fuel is both dear and hard to find—even for aid workers who have access to outside resources to buy what they need. Sometimes, aid groups have to send vehicles all the way back to Harare, the capital, a two-and-a-half hour drive from the Kotwa hospital, to scrounge for a small supply of fuel that they can port back to keep their trucks in Mudzi running.
One day in late January, 49 patients packed a clinic in Makaha, a ward in Mudzi where cases of cholera were suddenly spiking. A series of tents and one dimly lit concrete room served as wards for people stretched out, limp and mostly silent, on cholera cots—beds with large holes cut in the middle beneath which buckets are placed.
Snaking between the tents and the out buildings was a narrow path of mud bricks powdered, here and there, with flecks of white—the remnants of the dried lime-chloride used to disinfect contaminated surfaces. Mixed with water, a jug of it sat at the exit of the clinic, a reminder to all visitors to give their hands a thorough dousing.
As she finished hosing down an empty cot with the chloride solution, a nurse, her face flat with exhaustion, described some of the misery she had witnessed in the last few days. A mother, six months pregnant and very sick with cholera had managed to get herself to the clinic only to lose her baby. The next day, her husband arrived with their five-year-old son whom he had carried more than 16 kilometers from their home in search of help. Weak with cholera, the boy had died en route. And now the husband was gravely ill, too. The nurse was uncertain whether he would survive.
Behind her, on a shelf, stood a plastic barrel—a mini storage tank for the mixture of oral rehydration salts that were helping to keep the clinic’s patients alive. But the barrel had barely two inches of liquid left in it—nowhere near enough to sustain all those who desperately needed the sugar-and-salt mixture. And there was no more solution anywhere else in the clinic. Fortunately, we had a small supply of rehydration packets in our Oxfam truck and immediately gave them to the nurse. But that’s not all she needed. The clinic had just two doses left of ciprofloxacin, an antibiotic used to treat a variety of bacterial infections including severe cases of diarrhea.
Beyond the tents, was the observation area—a patch of dirt in the shade of a large tree. Here, patients waiting to be admitted slumped on the ground and those who had improved continued to rest before making the journey home. Outside the gate to the clinic, family members huddled around small cooking fires, the smoke curling around them. They were preparing food for the patients inside—a kindness that was also a cause of concern to nurses who feared cholera could soon sweep through the family support network.
Compounding the challenge of treating cholera is the widespread hunger many people in Zimbabwe are now confronting in the months leading up to the next harvest. Hunger has left people weak and more vulnerable to the disease.
The World Food Program plans to feed more than five million people in February, the greatest number in a single month since 2002. But because more people need food, the program is reducing ration size so that it can stretch its stocks far enough to accommodate everyone.
For some families, even coming up with the basics to fight cholera—such as sugar for a rehydration solution—can be daunting. Dutchman Matika tells of having to borrow sugar from a neighbor to make his wife the solution when she came down with cholera. As he speaks, two of his young sons listen intently, their hair tinged with orange—a sign of malnutrition. With 11 children and three wives in his household, Matika says mealie meal—a local staple—is in short supply.
“When you walk around, you see it,” says an aid worker about the malnutrition that has followed on the heels of several poor harvests and that’s affecting people most acutely in the interior of the country. “Poppy tummies. That’s one of the very clear indications. It’s mainly in kids. And you get wasting away in adults.”
But this year, in Mudzi, there are signs the next harvest may be better. While there is never enough fertilizer to guarantee robust crops, the rains during the current wet season have been unusually plentiful. Where corn and sorghum, millet and ground nuts have been planted, green shoots abound—slivers of hope for the future.
]]>On this day, it seemed highly symbolic: a clean sweep. It was a day which many Zimbabweans were praying would bring them change, after months of political deadlock, an ever-worsening economy, and a humanitarian crisis as the country battled its worst-ever cholera epidemic and serious food shortages.
It was the day Morgan Tsvangirai, the country's main opposition leader, was to take office as the country's prime minister in a new unity government.
Tsvangirai won the first round of last year's presidential elections by a small margin. But he withdrew from the run-off, citing violence against his supporters. In September, though, he agreed to a power-sharing arrangement with Zimbabwe's president, Robert Mugabe. However the deal had been stalled for months amid political disagreements.
While there are skeptics who say the new political arrangement is a sell-out and unlikely to achieve much, many Zimbabweans beg to differ. They view the new political arrangement with optimistic caution. Many told me things couldn't get any worse, and that the formation of a new unity government gave them cause to hope again. They believed it could mark the start of change in their country, which has seen thousands killed from cholera—a curable and preventable disease—and where up to seven million people, more than half the population, are dependent on food aid.
Later in the day, after being officially sworn into office, Zimbabwe's new prime minister addressed thousands of supporters at a packed showground in Harare.
Some attending told me they'd sold household goods—a TV set; an iron; some clothing—to get enough petrol to come to Harare to listen to Tsvangirai address the crowd as the country's new prime minister.
He promised to end political violence and Zimbabwe's culture of impunity; to work for a society where people were no longer living in fear of reprisals or repression for their views. He said Zimbabwe would not be a pseudo democracy, but a functioning democracy, where the rule of law could be re-established.
A second top priority of the new government, he said, was to tackle the humanitarian crisis, to stem the cholera epidemic which has gripped the country, and to ensure that those who needed food got help—regardless of their political or tribal affiliations.
He also promised to appoint a senior cabinet member to coordinate humanitarian efforts; to remove tax duties for humanitarian food aid, and to organize a food summit to try to ensure that in the future, Zimbabweans would not go hungry again.
And he vowed to stabilize the country's economy—characterized by crippling hyperinflation; to get children back to school, hospitals to reopen, and civil servants to return to work.
All music to the ears of the crowd and—possibly good news for international governments that have said they will carefully monitor change in Zimbabwe before making serious commitments of financial help.
The crowds in the stadium cheered, danced and waved flags. Even a reporter from a government-controlled newspaper seemed happy.
"We used to be dead," he said. "Now we are alive. This is the start of change."
]]>"We hope the government of national unity can prioritize the humanitarian crisis and mobilize all the resources it can to make swift recovery possible while working to bring broader stability to the country," said Oxfam's country director in Zimbabwe, Peter Mutoredzanwa.
Oxfam also urges the new government to create the space for the active engagement of civil society in partnership to rebuild Zimbabwe. Civil society has a critical role to play in the current humanitarian crisis and the longer-term development of the country. Oxfam also asks the new government to ensure that beyond access to basic needs, people's rights to freedom of expression, movement and security are respected and protected.
"We're calling on the new government to remove all constraints and enable our staff and staff of other civil society organizations to be able to carry out their work on the ground freely and effectively" Mutoredzanwa said.
As a direct result of the deteriorating socio-economic conditions in the country, Zimbabwe is currently struggling to control the worst- ever outbreak of cholera in its history, fuelled by the collapse of the country's public health and water systems. The cholera epidemic has claimed more than 3,000 lives, and infected more than 69,000 people. In addition, nearly seven million people, more than half the population, are relying on food hand-outs because of serious food shortages. Seriously weakened, they are more vulnerable and therefore unable to fight cholera.
Hyperinflation and the dollarization of the economy has meant millions have been unable to access basic food staples, increasing the number of people needing food aid in both urban and rural areas.
This year's harvest is predicted to be even worse than last year's and food shortages could continue into 2010. As well as dealing with immediate needs, Oxfam believes the new unity government and donors must examine ways of providing longer-term help, including inputs for farmers to prevent future food emergencies and food insecurity; and ensuring communities have access to clean water.
Oxfam calls for specific attention to be paid to the impact of this tragedy on women and girls—who bear the brunt of the HIV epidemic—are most affected by the deterioration of basic services and the lack of farm inputs.
While several governments have said they will only restore substantial aid to Zimbabwe when there is concrete evidence of political and economic reform, Oxfam urges donors to explore innovative ways to channel emergency resources to people who urgently need help and for existing pledges of aid to be translated into funds on the ground.
Oxfam supports calls for the creation of transparent mechanisms with clear benchmarks, supported by regional bodies like the African Union (AU) and Southern African Development Community (SADC), to monitor the implementation of the power-sharing agreement and policies of the new government. One key benchmark will be an open environment where civil society organizations can freely engage in a wider dialogue with the government as part of longer-term efforts to seek a resolution of Zimbabwe's problems.
]]>The song,"Cholera—Chenjerawo," which translates as "Cholera—Beware," will be played on radio stations across the country every 30 minutes. Performed by a group of musicians calling themselves Artistes for Health, it's the brainchild of some of Zimbabwe's top performers including Tanga Wekwa Sando and Oliver and Sam Mtukudzi who wanted to do something to help stop the rapid spread of the epidemic—the country's largest recorded outbreak. Cholera has now affected every province in Zimbabwe. More than 33,000 suspected cases have been reported and the disease has taken more than 1,600 lives.
The first cholera case was reported in August in a suburb of Harare. This week, at a meeting attended by government ministers, provincial governors, traditional chiefs, health experts, the commander of Zimbabwe's defense forces, diplomats, and the media, the government announced what it called a nationwide blitz to control, cure, and eliminate the disease.
"Information is the greatest tool in fighting this epidemic," declared Dr. Edward Mabhiza, permanent secretary at the Ministry of Health and Child Welfare.
The plan is to recruit as many as 20,000 volunteers to help spread messages about good hygiene. Radio jingles and messages in the papers and on television will be used in the campaign. Pamphlets and posters carrying information on how to prevent cholera are to be distributed everywhere, from beer halls to church entrances, and everyone, from provincial chiefs to soldiers, is being urged to play a part in the national effort.
Theatre groups will be also enlisted. Oxfam is already using drama groups to promote key health messages as it distributes hygiene kits to vulnerable communities across the country.
Using music, theatre, dance and humor, the groups entertain the crowds. But it's entertainment with a message, as the shows also highlight the need for careful hand washing and food hygiene.
Yet even the government, which acknowledges there is still some way to go before it can declare the epidemic under control, concedes that it needs more than educational messages to fight the cholera epidemic.
The country's sewage systems have broken down. Rubbish is no longer collected and piles up rotting on streets. Hyperinflation has caused many health workers to stay away from work, unable to live on their salaries which are paid in rapidly devaluing Zimbabwean dollars. More boreholes need to be drilled to provide clean water sources for communities. And many Zimbabweans are struggling to feed themselves.
There are worries that the epidemic could spike with the approach of the peak season of heavy rains which could spread contamination to shallow wells. There are also concerns about flooding and the movement of infected people within Zimbabwe and to other neighboring countries.
Education, though, can go a long way. And the call for action to mobilize the nation is an important step forward.
]]>2008 was an especially grim year in Zimbabwe—and prospects for the coming year seem little better. The fact that Zimbabweans were celebrating the new year at all might seem surprising. But many people, or at least those with some money living in the cities, were in the mood to party, if only for a night and to forget their worries.
Zimbabwe is gripped by economic collapse. Hyperinflation, the worst in the world, has seen prices skyrocketing, making it hard for many to access food and fuel. Last month, the country's central bank introduced a 10 billion Zimbabwean dollar banknote, but its actual worth, about $10 US dollars on the black market, is rapidly decreasing day by day. Most shops now only accept foreign currency not Zimbabwean notes.
On top of the economic meltdown, which has seen doctors, teachers, and most government staffers staying away from work because their pay in local Zimbabwean dollars won't even cover their crippling transport costs, there is a serious and worsening humanitarian crisis.
A cholera outbreak in August has now affected more than 30,000 people, and claimed the lives of more than 1,600 people, with cases now being reported across every province in the country.
Cholera is an easily preventable and treatable waterborne disease. But its spread in Zimbabwe is being fuelled by the collapse of health, sanitation, and water services. There are limited medical supplies and many don't have access to clean drinking water or proper sanitation. The onset of heavy rains this month is worsening an already alarming situation.
A second humanitarian crisis, still under-reported, is the worsening malnutrition and food shortages. There have been several years of failed harvests; a serious shortage of seeds and fertilizers; and driving hunger is forcing many to eat seeds instead of planting them for next year's crops.
The UN has warned that around five million people, more than half of the population, will soon rely on food aid.
The country is also facing political deadlock. Efforts to form a power-sharing government between the ZANU-PF party of President Robert Mugabe, who has been in power since 1980, and the opposition Movement for Democratic Change, have stalled.
I got a somber insight into many of the problems the country was facing as I visited Kadoma city in central Zimbabwe, about 112 miles west of the capital, Harare.
Oxfam has been working in the area, drilling wells so that communities can access safe drinking water, distributing hygiene kits, and undertaking health promotion work.
The health authorities have reported nearly a thousand cholera cases since mid November, with 29 deaths. Unofficial statistics put the figure even higher.
Two people had died that day; and I was shown a tent containing the wrapped corpses of seven bodies, several of which had lain there for several days and were swelling. Fuel shortages and rocketing prices meant that there were no vehicles available to take the bodies to the local cemetery.
"Things aren't stabilizing," said one nurse. "They're getting worse. We're seeing more patients every day."
With early access to treatment—intravenous fluids and oral rehydration—patients can recover quickly and be discharged within days.
But a visit to a nearby housing estate—described as a cholera "time bomb" by a senior health official—made clear why the epidemic is sweeping across the country.
The sewage system had broken down, and residents were disposing of human and other waste in the narrow lanes around their homes.
Those images haunted me as I sat in the jazz bar that night. Zimbabweans might have little to celebrate, other than surviving another difficult year; but they are still pinning their hopes that the coming year might bring some change for the better.
]]>Like many elderly and retired people, 70-year-old Mapatsi Tsuro spends his days in the garden tending to his crop of vegetables. But for Tsuro this is no leisurely pastime, rather it is a matter of survival. When he should be enjoying his golden years with the support of the family he raised, he now has to feed and care for eight grandchildren, following the untimely deaths of his three children.
Tsuro lives in Chicomba in eastern Zimbabwe, but his plight is common to millions of rural families in the region with the world's highest HIV infection rate and the greatest number of AIDS-related deaths. In Zimbabwe 1.7 million of the population of 13-million are infected with HIV/AIDS and Almost 900,000 of those infected are women.
Behind the alarming statistics lies human tragedy. The hardship for those infected and their families begins long before they die. Stigma, fear and despair often follow a HIV-positive diagnosis. The loss of income and support when a breadwinner or caregiver becomes ill, and the diversion of household resources to provide care increases the burden on family members, particularly children caring for terminally ill parents. Many only leave behind the trauma of bereavement and orphans.
Almost one in four children in Zimbabwe, 1.1 million, are now orphaned by AIDS. This number continues to grow as HIV and AIDS dramatically increases the vulnerability of children. The majority of the country's orphans are absorbed by the elderly in rural Zimbabwean households, a group which is barely coping with the extreme economic and social conditions in the country.
Oxfam America is supporting the Single Parents Widows Support Network (SPWSN) to improve the security of vulnerable groups by providing for their immediate nutritional needs, building sustainable livelihoods and enhancing the resilience of communities. Since 2002 Oxfam has been responding to the ongoing food security crisis in Zimbabwe through a livelihoods support program in the Seke, Mudzi, and Chikomba districts of Mashonaland East Province. The program provides seeds, fertilizers, primary health kits and on-going support to some 10,000 vulnerable households.
The supply of summer grain and legume seeds ensures that communities are able to sustain food production and build seed reserves. Over 60 community and individual nutritional gardens have also been established to grow vegetable during the winter months. The gardens ensure sufficient household food and the nutrition vital for maintaining health. Surplus crops provide some income for immediate needs such as health and education. The vulnerable groups receiving support include women-headed households, child-headed households, and households caring for orphans and the chronically ill, especially those affected by HIV/AIDS.
Neighboring South Africa is the site of the world's highest HIV infections, but also the country with the most people on ARV treatment. The National Strategic Plan aims to extend treatment to 80% of those with Aids by 2011. The plan also recognizes that Community Based Organizations (CBOs) and Non Governmental Organizations (NGOs) form an essential part of the integrated approach needed to address HIV/AIDS issues at community level.
Oxfam America's partner, The AIDS Consortium (AC) is one of the largest umbrella organizations in South Africa with a network of over 1000 affiliates. Members include CBOs and individuals motivated to meet the needs of the communities they live in. They offer a wide variety of services ranging from support groups for people living with aids (PLWA), job creation projects, home-based care (HBC), feeding schemes and orphan support, to national advocacy campaigns and large-scale treatment services.
"Community-based care workers are the unsung hero's of our country in the fight against AIDS and for community development," says AC executive director Denise Hunt, "with very limited resources they are forging ahead and making a huge contribution on the ground."
The AIDS Consortium represents the NGO sector on the South African National AIDS Council (SANAC). Here it is working with government and the private sector to formalize and increase the role of civil society. Hunt believes, "The only way we are going to meet the access to treatment targets are through dramatic shifts in how health care is delivered. Community care workers are in a position to play an expanded role and we are pressing SANAC to secure the finances, training and resources which will enable them enhance to their skills and contribution to service delivery."
Dr Liz Floyd, the head of Gauteng Multisectoral AIDS Unit, agrees that a more significant role for organizations is needed to meet the increasing demand for HBC and other support services.
"Government is developing a decentralized strategy for health care. It is very important to spread the resources to a network of mass-based care workers on the ground in communities in order to build community capacity to respond to and reach the people who need it," says Dr Floyd.
AC founder and Patron, Supreme Court Judge Edwin Cameron, is one of the few public figures to have openly declared his sexual orientation and positive HIV status. He points out that the epidemic is likely to be around for a long time and that community groups are vital to ensure an adequate response for PLWA. "We don't have a cure, but we do have manageable treatment," says Judge Cameron. "The public sector program is good but it is not reaching enough people. Community-based workers can bridge the gap between where we are now and where we need to be."
]]>I was traveling with Ransam Mariga, Oxfam's program officer in Zimbabwe, and Bridget Masaraure and her colleagues Grace Tambo and Helen Dhliwayo from the Single Parents and Widows Support Network, our partner in Zimbabwe. Our mission that day in December was to visit a few of the 6,000 families that had received a package of seeds and other assistance, part of an agriculture recovery project designed to help them grow some food during the approaching rainy season.
Our first stop was Beatrice Masuku's household. Her homestead consisted of several small brick and mud buildings with corrugated iron or thatched roofs spread in a rough circle around a yard of baked dirt. We crowded under the shade of a tree and settled onto a few chairs and a mat. As we began to talk, several children peeked out from behind one of the small buildings, laughing in delight at the sight of the unexpected visitors.
The Masukus have eight children, and had taken in five orphans, children of Beatrice's brother. The family of 15 makes a living by farming and selling what they can of their crops. The children look after other people's cattle. It's not an easy life, made more difficult by erratic rainfall and Zimbabwe's continuing economic woes.
Beatrice Masuku brought out bags of seed to show us what she'd received, making several trips between her granary and our shady tree: plastic bags and packets of millet, pumpkin, kale, bean, and sorghum seeds filled her arms.
In previous years, when the family hadn't received seeds and times were difficult, she explained to us that she had to ask neighbors for seeds. "People would look around and see if they had any extra seed in their granaries," Masuku said. "They would sometimes not have any seeds or any money to give us." If that happened, she would go work in someone else's fields in exchange for seeds or money, and do whatever job they wanted—and she would then have to work in her own fields as well.
We followed Masuku out of the compound and down a dirt path that led to the family's fields. She showed us where she had already planted the groundnut (peanut) seeds that came in the seed package. The rest of her fields were already prepared for planting the other seeds. She explained that she is waiting until the seasonal rains begin before she plants the rest.
Farmers in most parts of Zimbabwe have no choice but to wait for rain. Few have any other means of irrigating crops. In recent years the rains have been extremely erratic, with too much rain that washes away soils followed by extended droughts. Lack of rain is now a brutal counterpoint to the economic crisis. When taken together it is very hard for most farmers to make ends meet, particularly those with chronically ill family members or caring for orphaned children.
Masuku says that the seeds she received from Oxfam and the Single Parents organization, plus a little she saved from last year's harvest, will allow the family to manage well over the year ahead—if the rains begin soon. She expressed hope that the first pumpkins would be ready soon so that the family can use the pumpkin leaves as an accompaniment for their maize meal, or sadza, the staple food in Zimbabwe.
After returning to the compound we said goodbye and piled back into the car. The group continued on to several other households as part of our monitoring of the Oxfam agricultural recovery project.
The other households had stories similar to that of the Masukus: families who have taken in orphans, some of whom are affected by chronic illness and HIV/AIDS, and all struggling to survive in a country with an inflation rate of almost 1,600 percent. The declining economy means that sometimes there are shortages of everything farmers need, and other times the prices are so high that average farmers cannot afford to buy the seeds, fertilizer, fuel, and other basic inputs to run a farm. It is a serious situation in a country dependent on agriculture.
As we sat in one compound, again under a shady tree, members of the Kanjere family of 10 told us how they occasionally receive food aid but that the delivery is sporadic—sometimes they receive nothing. However, one woman in this household talked enthusiastically about the seeds and fertilizer that came from Oxfam and Single Parents. The seeds were the best types for the dry region, she explained, and because the variety of seeds in the package help them to grow vegetables as well as grains like sorghum. The pumpkins, beans, and kale fill an important gap in the period before other grains can be harvested: "In two months we will fend for ourselves," she told us.
As we drove out of the compound, the family members returned to their seats in the doorway of their house and under the tree. Fields already prepared, there was nothing to do but wait for the rains to begin.
We ended the day with a visit to a community garden funded by Oxfam America. Community gardens help families grow vegetables in the winter season, providing enough food to survive until they can plant, grow, and harvest their next crop. The gardens require less intensive labor, which benefits those who are not physically strong, and the vegetables grown in the gardens are both nutritious and a source of income.
The garden is surrounded by a thick "fence" of prickly branches and, inside, there are many rows of long, even beds. We were visiting after most of the vegetables had been harvested for the season so many of the beds had only sparse vegetation, but the plants that remained were bright green against the dark soil.
Each garden member is given several rows to plant, and seeds for green beans, butternut squash, kale, onions, cabbage, and carrots. We stood on the packed dirt paths that divided the beds, under the hot sun, and talked to members of the garden. Each of the women and one young man we met had a difficult story to tell: being widowed, having sick children to care for, or taking care of orphaned siblings. One young ma's parents died when he was younger, leaving him in charge of his siblings. "I used to be a child heading a family, but now I am older and look after seven orphans," he said. "It's tough to look after so many orphans, and I mostly use this garden to support the children." By the end of last winter his beds were full of onions which he hoped to sell after they matured.
The garden members told us that although much of what they grew was eaten to supplement the families' staple food, sadza, they were also able to sell some vegetables. They used the income for school fees, purchase of other foods, medical expenses, and to pay for the grinding of maize. "Things are better than before because I could sell my harvest," said a young mother of two.
Since women are typically the ones interested in participating in community gardens in Zimbabwe, I asked the young man why he was a member. His response was very honest: "I am interested in gardening because of the hard times. I have a lot on my shoulders and am gardening because I have no other choice. I would rather have money to start my own business, but I also need the garden."
Emily Farr is the deployable humanitarian officer for Oxfam America in Boston. She works primarily on Oxfam's programs in Africa.
]]>Such lingering hard-line attitudes led to widespread political violence during the 2000 and 2002 elections in Zimbabwe. A 2000 human rights report described a typical incident: A truck transporting people to a party meeting was run off the road and attacked by members of another political group armed with AK-47s and iron bars. While most of the victims of the attack fled, two were trapped in the truck when it was firebombed, and died on the road moments later.
Thankfully, today there is considerably less political violence, and one of the groups that has made change possible is the Zimbabwe Civic Education Trust (ZIMCET). According to director David Chimhini, the organization, founded in 2000, helped eliminate much of the violence in just a couple of years. With funds from Oxfam America, ZIMCET established a network of local "peace committees" that have brought political opponents together to learn about nonviolent conflict resolution.
These peace committees are led both by members of the ruling ZANU-PF political party and their opponents in the Movement for Democratic Change (MDC). ZIMCET overcame the climate of distrust by keeping the focus on peace—something neither side could oppose. ZIMCET also cultivated strong relationships with local leaders, who encouraged the new peace committees.
One peace committee created a sports league for youth, many of whom were out of school and lacked employment, which made it easy to get caught up in violence. Another committee concentrated on cultural events. But ZIMCET's main accomplishment has been to help people acknowledge their mistakes and learn to forgive one another. "Our peace committees help people change their attitude towards each other," Chimhini says. "They now say 'Never again'! We will never beat or kill just for an election."
The process has not been easy. Tina Malowa was a much-feared political operative, but after attending training sessions with ZIMCET, her perspective changed. "Sometimes I sit down and think about all the violence and at times I find myself sobbing because I know I did some evil things. Things that I really regret to this day." Her transformation has been both personal and political: "I realized that my thinking was all wrong. In democratic societies, there is bound to be an opposition party."
Beside her, at a meeting in ZIMCET's Harare office, sits Simon Mapuvire, MDC district secretary for Manicaland. Mapuvire has also come a long way. "I was beating ZANU-PF people and I was directing people to beat others," he said candidly. "Then ZIMCET taught me that I was just beating my brothers and sisters. Now Tina is my friend and we work together, and I have thrown away that evil element in my head."
]]>It is a stark example of the impact of HIV and AIDS on rural Zimbabwe. In addition to her own 10 children, Mrs. Nyuwani, 48, and her recently disable husband took in another dozen children. "The 12 came here because their parents passed away and they were living as street children. So my husband I brought them here," she said. "Six are of my late sister, others are my brother-and sister-in-law's kids, and the grandchildren of my sister."
This would be a tremendous challenge for anyone. But Nyuwani has a thoughtful, peaceful air about her as she takes a deep breath and describes how the family copes: "At first it was disturbing, because I thought about where to get food for all these children," she said. "But now I am used to looking after them? I treat them all the same, and share the food equally."
Survival comes down to just that: food. Nyuwani has seven hectares (about 17 acres) of farmland at her disposal, and is an experienced farmer. "I manage all this by farming, and the older kids help in the fields," she said. "During the rainy season there is a lot of work to be done, because I have to tend to the crops and the children as well."
Lack of cash and time to look for farming supplies like seeds and fertilizer make it extremely difficult for Nyuwani to plant and harvest enough to sustain the family. These constraints and the number of AIDS orphans on the Nyuwani homestead made her a candidate for the seed distribution project implemented by the Single Parents and Widows Support Network, in partnership with Oxfam America. Single Parents gave Nyuwani some seeds in November 2005, and by the end of May 2006 she had a decent harvest: she estimated growing about 500 kilograms (1,100 pounds) of groundnuts, 100 kilograms (440 pounds) of corn, and 250 kilograms (550 pounds) of sorghum.
This was an improvement over previous years when lack of seeds as well as rain diminished the agricultural yield for the Nyumanis. But the food won't last forever. "I got a better harvest this year, but it won't last until the next season since I have such a big family," Nyuwani said. "For us to survive, to the next [growing] season, two of my daughters will pan for gold in river beds near here. We will also cut back on our meals to one or two a day. We will eat sadza [corn meal] and okra—that's what we have here—no tea, no sugar, no bread. During this [rainy] season we also have some pumpkins and cow peas, but we don't usually eat them apart from the rainy season."
Oxfam America and the Single Parents and Widow Support Network are exploring possibilities for a winter garden project that would help families grow vegetables over the winter. This would help bridge the food deficit many families will be experiencing before the end of the next growing season, and improve nutrition for families taking care of chronically ill people.
For now, the food is sustaining the homestead. "I appreciate the seeds I got from Single Parents," Nyuwani said. "I was very happy with the sorghum and maize seeds I received. I am also happy with the groundnuts."
In addition to improving their diet, groundnuts are also an economic opportunity for a family low on cash with a lot of kids who need to go to school. "If you can grow more of these to sell some, you can get some money," Nyuwani said. "Some of the children were chased away from school due to lack of school fees, but I sold some groundnuts and paid for six who are now at school."
]]>September is the end of winter in Zimbabwe. After four years of erratic rains and low yields, many farmers were desperate as they headed into another growing season. Most had no money to buy seeds, fuel, or fertilizer—or if they did these essential farming supplies were simply not available due to the economic crisis gripping Zimbabwe.
Many families in Mudzi were caring for people living with HIV and AIDS, which is infecting more than 20 percent of Zimbabwe's population. This took away the time they needed to travel in search of seeds to plant and grow corn.
"For the last five years, few had been able to produce a crop," Mariga said. "People were surviving on wild fruits, and they did not have access to any grains or other sources of food."
Mariga, Oxfam America's humanitarian program officer, had no time to waste. He immediately started working with representatives from a local development organization called Single Parents and Widows Support Network, carrying out a rapid assessment of the most vulnerable families. Coordinating with special committees comprised of local volunteers, Oxfam and Single Parents surveyed the population in Mudzi and identified 5,000 families that needed help the most.
"Our criteria prioritized families with chronically ill family members," Mariga said, "Households taking care of more than two or three orphans, women-headed households, child-headed households, and those with older grandparents taking care of the young."
"Mudzi is a dry area of Zimbabwe," Mariga explained on a visit the following May. "It only gets between 300 and 350 millimeters (1.2 to 1.5 inches) of rain during the growing season. It's not ideal for agriculture and there are a lot of people living here who have to scrounge for a living, and grow what crops they can."
In consultation with farmers, Oxfam and Single Parents devised an agricultural support program that would get families the seeds they needed to plant before the rains started in November. The priority was on drought-resistant small grains like sorghum, as well as corn, pumpkins, and groundnuts (peanuts).
It was a race against time: Oxfam America and Single Parents procured the seeds and distributed them to the 5,000 project participants just in time for the rains. Suddenly, the most vulnerable families had a glimmer of hope.
"The seed package was really well received by the farmers," Mariga said. "They had something to grow, they would not have to scrounge for money to buy these inputs, and they could use their money for school fees, and health care for those who are chronically ill."
By the middle of April, the results were clear: farmers grew substantially more than in previous years, and would have more food to eat in the coming winter. "Our final round of monitoring indicated that about 40 percent of the participants harvested a crop that would sustain them until December," Mariga said. "Another 20 percent will have food until the next harvest in May 2007. This is a milestone for an area that has not been able to produce much in the way of crops for the last four to five years—it is a real achievement."
Bridget Masarauru, the program director for Single Parents, said that the agriculture program is making a big difference for the people they work with in Mudzi. In the previous years of low rainfall, Masarauru said it was common to see people faint during community meetings as the lack of food caught up with them. "People can now confidently say that they can have two or three meals a day, at least during the rainy season," Masarauru said. "This is something really tangible we can do."
David Kanjere, the elected councilor for Masahwa ward in Mudzi, was enthusiastic about the seed program. On a late-May tour of Masahwa, the second-largest ward in Mudzi with more than 24,000 people, Kanjere said this year's harvest was significantly larger thanks to the seeds and a bit of rain. "People started harvesting last month, and they are still harvesting now. Right now, people's lives are changing with this yield."
Oxfam and Single Parents are now turning their attention to helping farmers in Mudzi to store their seeds for the next season, and create ways for them to sell or exchange seeds and make them more widely available to other farmers. They will also look at ways to help the minority of participants who had trouble maximizing the potential of their seed basket in the 2005-2006 growing season.
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