Recently, The New York Times reported on the health care situation in turbulent Zimbabwe. Kathy McCarty, an American nurse working at Chidamoyo Christian Hospital in Zimbabwe reported being paid in peanuts, sacks of grain and other non-monetary forms of compensation. The virtual collapse of Mugabe’s economy and the worthlessness of Zim money have people bartering for medical attention. In turn health care providers turn peanuts and other food products into nutritional meals for sick patients.
The Times article explains, “For many rural Zimbabweans, cash remains so scarce that the 85-bed Chidamoyo Christian Hospital has continued to allow its patients to barter. Studies have found that fees are a major barrier to medical care in rural areas, where most Zimbabweans live.” The decision to barter non-monetary goods, turned medical supplies (food and nutrition for patients) in exchange for medical care creates an innovative and win-win situation for Zimbabwean patients.
During the hyperinflation and collapse of Zimbabwe’s economy in 2008 Chidamoyo kept its doors open as a result of patients providing necessary commodities to medical personnel. The staff of Chidamoyo Christian Hospital continues to barter using thrifty techniques to maximize their medical resources. Medical staff reuse latex gloves after sterilization, filling the gloves with water to ensure hole-free supplies. Nurses use cotton balls found in pill bottles to swab patients’ arms before injections.
Regardless of the imperfect Zimbabwean health system, the United States continues to swim in the chaotic, amoral world of health insurance companies, the never ending problem of lack of access to health care and confusing health care legislation. Luckily for Zimbabweans, they seem to have the whole thing figured out.
For more information, HERE is an interesting video recap!
(Photo Credit: International Foundation of the Red Cross)
This week saw the continued striking of Nigerian doctors as well as empty promises of stretched health ministries and US food aid. Our blog hosted a bright discussion on HIV/AIDS in South Africa highlighting the issues of Gender Based Violence and the use of pornography to influence health behaviors and education. Please let us know what you think in the comments, we’d love to start a conversation! If you are interested in submitting a guest post – submit here.
Marie Musa, 37, is devastated. After the mother of four gave premature birth, her baby boy died a few hours later – because the hospital did not have enough incubators to rescue the infant. In August, the same month that Musa’s baby died in hospital, James Bamie Davies, commissioner of the customs and excise department of Sierra Leone’s National Revenue Authority (NRA), announced in a government gazette an auction of medical appliances, including eight incubators. Only the public outcry that followed the announcement of the auction in the gazette, did the Ministry of Health and Sanitation spring into action and recover the goods.
As Uganda joins the word to mark World Food Day today, Isaac Khisa looks at Uganda’s strides in ensuring that every citizen has at least a meal a day Uganda today joins the rest of the world in celebrating World Food Day but with millions of its population still malnourished. According to United Nations Food and Agriculture Organisations, nine million Ugandans are still facing hunger with many affording only one meal a day. Uganda population is now estimated at 31 million, meaning that about 30 per cent of Ugandans can hardly find something to eat.
About 4 000 children die from diarrhoea in Zimbabwe each year due to poor hygiene and unsafe drinking water, a United Nations senior official said last week. In a speech read on his behalf at the annual commemorations of the Global Hand-Washing Day held in Mutoko last week, Unicef country representative Dr Peter Salama said hand-washing is the single most effective and inexpensive way to prevent diarrhoea.
Two-thirds of the African nation of Benin is underwater, with at least 43 people killed and nearly 100,000 made homeless. Heavy rain began falling at the start of October, and the Rivers Oueme and Mono soon overflowed. Thousands of hectares of land, mostly used for growing rice and other vegetables are now underwater. “Here, the water isn’t going away. We have it up to our knees and now it’s as high as our thighs,” said one resident. “The water, it’s everywhere, and it’s very difficult for people to escape.
Health minister Dr Aaron Motsoaledi will today sign the “real deal” with nine provincial health MECs and eight ministers, giving South Africans a shot at “a long and healthy life”. The Negotiated Service Delivery Agreement (NSDA) gives a frank, but brutal assessment of South Africa’s healthcare system and at the same time commits “not to keep doing things as usual” in finding solutions.
Thursday and Friday I attended many of the Africa focused workshops – most were very exciting and engaging. They really brought the African perspective into the ideas of the US Social Forum and made delegates think about the US role in issues affecting communities on the African continent.
24 Thursday 10am-12pm
African Unity Towards What? (Pan-Africanism & Nationalism is not enough!) by: University of Kmt
I still haven’t exactly figured out this group and what they do. They run the Kmt Press which publishes books and journals, but all of their sessions that I attended were focused on teaching with an African historical perspective. Their missions states that they are dedicated to educating the new generation of African leaders. Interesting that they are in Detroit and I wonder if they know of the Detroit Public School (DPS) Initiative starting in 1992 where Africa was integrated into school curriculums from math to literature.
This People’s Movement Assembly was geared towards bringing African perspectives into the US Social Forum and continue the discussion as preparations are made for the 2011 World Social Forum in Dakar, Senegal. The room was full of delegates from many African countries, Detroit, and US Africa Advocacy groups.
Briggs Bomba, Director of Campaigns at Africa Action, spoke strongly about building solidarity with those most affected in Africa. He said, “corporate led globalization has harshest effects on those in the perifery, the underdeveloped.” He reminded us that all of us the privilege to attend conferences like these and make the policies need to prioritize the communities most affected.
A delegate from South Africa spoke eloquently about the social apartheid of displacement – ideologically, locations, in decision-making and governments; in voting process lack of people power and transformational action, and in the social mainstream. “We cover many issues, but it is the same struggle. We come from different areas, but share common experiences.” (i.e. colonialism)
Some top issues that came out of the PMA:
Militarization in the Congo (DRC)
HIV & STDs from Detroit to Africa
political economy – effects seen in everyday Africa
African defense (defend communities), liberation (not yet liberated), and autonomy
An exciting and dynamic session that really makes me excited for the World Social Forum in Dakar!
This session was an interesting overview of AFRICOM by some leading scholars on the topic of US national security interests in Africa. The attendees were less diverse than the Detroit to Dakar session and most people came to learn more because it looked interesting and had studied Africa to some small degree in the past.
Most interesting was when the discussion turned to private military contractors (PMCs) in Africa responsible for fighting wars in Libera, Southern Sudan, and Somalia. A Ugandan delegate actually talked about being trained by PMCs in Iraq to then return and fight the Lord’s Resistance Army in Northern Uganda. Great to hear the perspective of the Ugandan delegate and Dan Volman as well as to see so many people interested in learning more about African issues!
25 Friday 1-3pm
Power-sharing Deals in Africa: Implications for Democracy – The Case of Zimbabwe & Kenya by: Africa Action
This was by far the most organized session that I attended at the US Social Forum. The Africa Action team did an amazing job of gathering great speakers, formatting the session, and bringing people into the room for the discussion. Many African voices were heard from delegates representing Zimbabwe and Kenya.
In both cases of power-sharing, the speakers agreed that the power-sharing deal was a sigh of relief that stopped the fighting and opened their doors to the international community and economy again. However, they also all recognized that power-sharing was a positive in the short-term, but can be positive as in the case of South Africa when Mandela and de Klerk signed a power sharing deal until the national democratic elections.
Here are some take-aways:
A weak state can and will be manipulated (i.e. Museveni in Uganda – waiting for a similar situation as Kenya and Zimbabwe soon, elections next year)
“The people” are separated from the power – people-centered in needed
Power-sharing allows for lessened tensions and time to create national unity towards something better
Coalition governments show defeat of “people power”
Nyala, Kalma camp, South Darfur - March 2007 (MSF Photo Blog)
The impact of conflict on the environment and then the subsequent, direct effect on human health cannot be overlooked. This internally displaced peoples (IDP) camp in Sudan shows the seriousness of that impact.
Everyone in the global health sector is writing about the incredible reach of SMS technologies working for health in developing countries, and rightly so. Hope Phones has partnered with FrontlineSMS to provide old cell phones to communities in need through SMSmedic partner organizations. More: Your Old Phone Can Change the World
A service that I just recently came across is one that is not being as widely talked about. TeleMed is different from FrontlineSMS: Medic because it connects local health care workers directly to patients in need via SMS technology. SMS: Medic is focused on health infrastructure. TeleMed does not have a website up yet, but is definitely one to watch:
The other big talk within global health is whether Paul Farmer will take a job within the US government. Some have expressed great hope for potential reform others voice their plea with him to continue his incredible community based work outside the bureaucracies. My opinion is that Partners in Health has developed into a strong organization and does not depend on Paul Farmer to further their work. If he wants to take on the inefficiencies and inadequacies of the US government and global health, then all the more power to him.
Broken promises abound as the economic crisis deepens and the right to health falters, but activists are coming together to ensure that funding for health and HIV are not cut. International donors are expected to slash budgets for health due to the economic crisis and health experts fear that this will lead to, “less food security and quality of nutrition, which will in turn put more stress on already weak health systems.” Paula Akugizibwe, regional treatment literacy and advocacy coordinator of Windhoek-based AIDS and Rights Alliance for Southern Africa (ARASA) in Namibia demanded, “We need to ensure that African lives do not become a silent casualty of the global financial downturn. Our lives are not cheap or expendable. We expect health to be prioritised over weapons, sports and lavish politics.” Tanzania was the first sub-Saharan country to announce a 25 percent cut of its annual HIV/AIDS budget. Other budget cut impacts: Guinea: Medicines Running Out
On Wednesday, the Livingstone High Court was supposed to hear a ground breaking case about whether mandatory testing for HIV and discrimination solely on the basis of HIV status is constitutional in Zambia. Unfortunately two days later news came that the trial was postponed until mid-July. Be sure to keep watching this story. More: Trial postponed until 15 July
Mara Gordon writes on Change.org’s Global Health Blog about a direct campaign in Tanzania discussing behavior change. “This campaign is partially paid for by the President’s Emergency Plan for AIDS Relief, U.S. government money to fight HIV that’s notoriously had lots of conservative strings attached. Had I seen this ad a year ago, I probably would have dismissed it as unrealistic abstinence-only propaganda. But behavior change works. Behavior change – in combination with access to condoms, comprehensive sexual education, open discussion about HIV and sexually transmitted infections in general, all that good liberal stuff.” More: Changing Human Behaviors: Sexual and Social
During a course on Africa’s environmental history I wrote about the need for changing human behavior in both the sexual and social arena to make a real impact in HIV prevalence. The major social change is the response from Western institutions and organizations in how they talk about HIV/AIDS and Africa while seeking to change sexual behavior. Lesotho: Cultural Beliefs Threaten Prevention of Mother-Child HIV Transmission
Health workers note an encouraging response to the PMTCT program. The number of facilities providing PMTCT has risen from nine in 2004 to 166 by the end of 2008. The number of women who received PMTCT and subsequent antiretroviral (ARV) treatment increased from 421 in 2004 to about 5,000 by end of last year, according to 2009 National AIDS Council statistics. “The primary health care coordinator at St. James Mantsonyane Mission Hospital, Khanyane Mabitso, says stigma and cultural beliefs make it difficult for medical personnel to follow up on HIV-positive mothers and their babies.”
Many advances have been made in health. Some argue that these advances have been dwarfed by the HIV/AIDS epidemic, the economic crisis, or the failures of African governments. The WHO report shows that the only statistic with concrete results was the number of children dying before the age of five. Is this a solid example of the failure of big plans and blanket goals for development?
The Anti-Corruption Committee report provides a number of recommendations for reform all focused on improving the health care delivery services in Sierra Leone and eliminating the risk of corrupt practices in the health services across the country. More on health service scale-up: Chad: Paving the Way for Better Obstetric Care
Government meetings with UNICEF to help scale-up of health services for better obstetric care across the country.
Speaking at a gala reception in Washington marking the beginning of “Africa Week,” Carson said: “Most of the Obama administration’s Africa team is in place, and we are gearing up. We will continue to build on and strengthen the strong bipartisan consensus in Congress and among the people of America that has motivated U.S. policy towards Africa. Over the next four years, we will be focusing our efforts on strengthening democracy, promoting sustainable development, resolving or mitigating conflict, and dealing with transnational issues such as climate change and agriculture,” he pledged. While Obama has built a great team, the White House has yet to announce any Africa Policy, greater control and influence for the Bureau of African Affairs, or take any serious (or effective) action for the continent. More: Tanzania: Obama, Kikwete Meet in Oval Office on Africa’s Conflicts
Zimbabwe owes the World Bank and the African Development Bank more than $1bn, how much potential does renewed aid really hold for the country. If the debt is not forgiven there will be no way the country will be able to rebuild necessary infrastructures for health, water, etc. There are countless case studies to show this historical fact. It must also be noted that Western sanctions were a huge detriment to a country in need, maybe this marks a turnaround?
“No weapons” MSF in Nasir, Upper Nile State, South Sudan
More: A Tale of Two Refrigerators
Fighting has renewed in southern Sudan, but its not just between militant groups – aid groups fall victim to needless fighting as well. Diane Bennet writes on William Easterly’s Aid Watch blog about the 2001 peace in Sudan and how it was a ripe time to treat disease and build health infrastructure. Unfortunately internal bureaucracy and politics became the largest hurdle.
Oxfam International has released a report [access here] “challenging the myths about private health care in developing countries.” The report emphasizes the role that private health care can play in developing countries, but reminds us that there is no way a scale-up of private health services will reach poor people in need. Key recommendations are to increase funding for free universal health care infrastructure, rejecting ineffective practices of the past, and combining efforts to fuel effective initiatives – sounds a lot like SCOUT BANANA
Revolutionizing access to health knowledge, the efforts of the Mobile Health Alliance (mHealth), supported by the Rockefeller Foundation, the UN Foundation, and Vodafone Foundation are making a mark across the African continent boasting 51 existing or to-be-implemented programs in 26 countries around the world. Harnessing the potential of growing technology in ‘developing’ countries for the purpose of health can only signal a major shift in access to health care across Africa.
It appears that Obama’s administration is stacked in the favor of Africa and in favor of better international development practices all around. With Susan Rice serving as Ambassador to the UN action against genocide may be bolstered, Gayle Smith more likely than not will be tapped as USAID Director, she was a major proponent of the HELP Commission creating a cabinet level position for foreign aid, and a well known name among insiders and outsiders in African affairs, Johnnie Carson, is expected to be named head of the Bureau of African Affairs of the State Department. The future of US relations in Africa has incredible potential and hope to change.
As a massive cholera outbreak tears across the country, medical staff have returned to their posts, but the nature of their strike, that began in 2008 over poor working conditions and wages, is now “more like a sit-in.” In a country so crippled by Western exploitation and resulting politics, a strike of the health workers in the face of a rampant disease outbreak does not bode well for a vulnerable population.
More: Too Much Cholera, Too Little Food Over 80,000 Zimbabweans Infected with Cholera
Imagine the potential of the US’ military might if it was dedicated to coordinating naval and health care workers from 13 countries to bring aid and health services to communities in need. This becomes a reality with the African Partnership Station Initiative and Project Handclasp. I can only dream of a day where initiatives like this are more a norm than a surprising gesture of good will.
One of the most innovative programs that I have read most recently is the work the Dutch based Gender and Water Alliance which is employing women to make soap as well educate and use it to increase hygiene and combat preventable diseases. Health benefits, a source of income and empowering women!
Supposedly the global food crisis of last year is over! Agricultural experts from Africa and Asia are saying that we are no longer in a food crisis and that there needs to be an increased production of rice in Africa in order to keep the food crisis at bay. In my opinion, as long as we continue our unsustainable and capitalist practices that commodify a basic human need, we will remain in a global food crisis affecting both the US and Africa.
More: Rwanda: Food Production Up, Thanks to Green Revolution
Thankfully the increase is not due to the ‘Green Revolution,’ but instead to increase in practices that are focused on protecting the environment.
Years of controversy seem to have brought the blame down on the South African Treasury. With an extensive bureaucracy, it is no wonder that the ARV roll-out program has taken much longer than it should – as many die without the proper medications. While the numbers of people enrolled in the ARV program has increased significantly there still exists a problematic policy of access. Access hinges on wealth, CD4 count, and location. To access the government’s ARV program your CD4 count has to be less than 300, which is at a point where you are already very vulnerable. This creates an issue of sustained treatment because it forces an irregular regimen. If your CD4 count is above 300, you will have to pay. Many cannot pay and if you live far from a government hospital access is just that much more difficult because of taxi fare and time sacrificed for travel. It seems the health and wellbeing of its citizens is not a high budget priority of the South African government.
More: Rapid HIV evolution avoids attacks
Much like the flu virus, HIV mutates and evolves in response to treatments. This really exposes the South African ARV program as highly ineffective. Duncan discusses HIV/AIDS in Morocco
Little known to the world, the HIV/AIDS crisis grows in Morocco.
The current condition of Zimbabwe is undeniably complicated and rapt with controversy. Robert Mugabe, Zimbabwe’s only president since the country became independent of white rule in the early 1980s, was once hailed as a hero and held up as an example of excellent leadership to other newly-independent African nations. Now, as the rate of inflation in Zimbabwe continues to skyrocket and a cholera epidemic appears to be ravaging rural communities, many are calling Mugabe an inadequate dictator who’s unwillingness to accept new leadership may lead to his country’s demise.
Unfortunately, the current situation in Zimbabwe is anything but clean-cut. The country’s complicated colonial history continues to influence Mugabe’s political posturing and decision-making. Mugabe argues that the United States and the United Kingdom are executing a form of post-colonialism via sanctions levied against himself and companions in his political party, ZANU-PF (Zimbabwe African National Union – Patriotic Front). He argues that these sanctions are the primary cause of deteriorating social and economic conditions in Zimbabwe. He also boldly claims that the U.S. and U.K. regularly generate false data regarding the health of Zimbabwe’s citizens, most recently in the case of a cholera epidemic that Save the Children, a British NGO, claims has taken the lives of 1,111 among 20,581 cases since August 2008. Mugabe and his supporters have suggested that this data is an attempt by the West to usurp his democratically-appointed powers.
On the flip-side, the United States and the United Kingdom have issued repeated calls for Mugabe to relinquish his presidential powers in wake of Zimbabwe’s current social and economic crises. Many in both countries have accused Mugabe and ZANU-PF of influencing Zimbabwe’s most recent election through violence and intimidation. Supporters of the opposing MDC (Movement for Democratic Change), led by former presidential candidate and current prime minister Morgan Tsvangirai, have narrated stories of abuse and “reeducation” in camps operated by ZANU-PF. Similarly, as the apparent cholera epidemic continues to spiral out of control and child malnutrition worsens, the U.S. and U.K. cite that Mugabe is killing his own people through stubbornness.
The situation in Zimbabwe is complicated. These brief descriptions barely scratch the surface of the country’s multi-layered complexities. Nonetheless, we at SCOUT BANANA believe that the current conditions of Zimbabwe offer an excellent opportunity for education on multiple topics, including international health, development, post-colonialism, and globalization.
To offer a further introduction to Zimbabwe, I’d like to direct you to the BBC’s Country Profile. As you move to this site, I’d encourage you to examine the information offered there with a critical eye. What might appear fair and balanced is often rife with bias.
Good luck and please continue to check scoutbanana.org for updates.