Investigating Zimbabwe's Cholera Epidemic The non-profit health group Physicians for Human Rights has sent a delegation to Zimbabwe to investigate the cholera outbreak there. They concluded the problem is man-made, and seriously question President Robert Mugabe's role.
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Investigating Zimbabwe's Cholera Epidemic

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Investigating Zimbabwe's Cholera Epidemic

Investigating Zimbabwe's Cholera Epidemic

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NEAL CONAN, host:

By now, most of you will have heard about the cholera epidemic that's already killed 2000 people in Zimbabwe and threatens many more. A non-profit health activist group called Physicians for Human Rights sent a delegation to Zimbabwe last month to assess the situation, and they came to some shocking conclusions - that this is a manmade disaster, a symptom of a much larger problem, that the government of President Robert Mugabe has abdicated its responsibility for the health of Zimbabwe's people and could be guilty of crimes against humanity.

If you have questions about what's happening to the health care system in Zimbabwe, or if you have personal experience with the situation there, give us a call. 800-989-8255 is the phone number; email us, talk@npr.org. You can also join the conversation at our Web site. Go to npr.org and click on Talk of the Nation. Frank Donaghue joins us now from member station WGBH in Boston. He's the CEO of Physicians for Human Rights and was a member of the group that traveled to Zimbabwe in December, his third visit to that country. Thanks very much for joining us today.

Mr. FRANK DONAGHUE (Chief Executive Officer, Physicians for Human Rights): Thanks, Neal. It's great to be here.

CONAN: And how is this a manmade disaster?

Mr. DONAGHUE: Well, clearly, Mr. Mugabe, through his economic policies, the economic collapse of Zimbabwe, has had a causal effect on the whole situation there. There are no longer any hospitals in Zimbabwe. Sewage is literally running through the streets; kids are drinking from sewers. There is basically no medicine for people. Doctors asked, in a protest back on November 18th, for food and medicine for their patients, and Mugabe beat them. And so, it's hard not to - and he's on vacation this month, by the way. It's hard to understand how he and the government of Zimbabwe can see what's happening to their country and allow it to continue. And…

CONAN: I was just going to say, your report says that public hospitals there are closed and have been closed since November.

Mr. DONAGHUE: Completely. I was there and - as you mentioned, in August - and visited the main university hospital. There had been no running water for about a month. There had been no medications. One of the main - head nurse came up to me at the end of the day - of the tour, and she said Frank, we are so - the nurses - we are so hungry, we haven't eaten in three days, and we have no energy to take care of our patients. How do you run a hospital with no toilets or running water?

And so, in November, when the doctors came out and said, help us feed and medicate and take care of our patients, all the hospitals were shut down in the midst of a cholera epidemic. Now, that clearly is a violation of the very responsibility of the government to take care of the health and wellbeing of its people. There are no hospitals. There's private hospitals. A great example - if a woman needs a C-section in Harare, the capital, there are no hospitals to go to; she virtually dies. If she can go to a public - a private hospital, which there's a few, it costs $3,000 cash. Three thousand dollars cash is not - in a country where the average person makes a dollar - lives on a dollar a day, is virtually impossible. And so, what I asked the doctors - what happen if a woman comes and needs a C-section, and she doesn't have the $3,000? He basically said, she dies. And that is over and over again in this country.

CONAN: And when you say $3,000, you mean 3,000 American dollars not...

Mr. DONAGHUE: Three thousand U.S. dollars. Correct.

CONAN: And you also talked with - I think it was a doctor who showed you the pay stub that she got for the entire month of November that amounted to 32 cents American.

Mr. DONAGHUE: That's correct. And remember, because of Mr. Mugabe's policies about withdrawals from the bank, she can't even take that 32 cents out of the bank in one withdrawal. People are literally, Neal, starving in the streets. I think one of the most telling signs of the impact of this cholera epidemic, which indicates how broad it really is - in most - most times there's a cholera epidemic, the fatality rate is somewhere around 1 percent or less.

CONAN: One percent of those infected?

Mr. DONAGHUE: Correct, die. In Zimbabwe, it's well over 5 percent, and in some regions we visited, it's as high as over - a little over 30 percent of the people that get cholera die. And as you know, cholera is quite treatable. One or two days on hydration and sugar and salt and people are back to being healthy. But they have nowhere to go to even get that. There is no water. There's no clean water. And there's no doctors or hospitals to take care of them.

So, to show you that, you know, on average, after a war in a real conflict situation, cholera kills one percent perhaps, and in Zimbabwe, which Mr. Mugabe completely denies there's even a cholera epidemic, over 5 percent of the people are dying, and in some regions - by the way, regions that do not support his election - are dying at a rate of perhaps 30 percent.

CONAN: There is also a shocking statistic you included in your report about the expected age that people can - the age that people can be expected to live to, the life expectancy at birth.

Mr. DONAGHUE: Exactly. It was, about 10 or 12 years ago, roughly 64 years of age. And today, it's rough - it's around 34 years of age. And that statistic alone is startling, but if you look at maternal mortality, that's gone somewhere from about 300 per 100,000 to now 1,100 per 100,000. The statistics keep going on and on and on of how this country's health system has totally collapsed.

CONAN: A health system, you also point out, was previously a model for southern Africa.

Mr. DONAGHUE: Absolutely. It was the pearl of southern Africa, and now, it's the biggest threat to southern Africa. And I think that is the other point that in my meeting with people - I just came back from Johannesburg yesterday - and I think what people now are beginning to understand that Zimbabwe is no longer just a threat - and his regime and what he's done to the health system is no longer a threat to Zimbabwe. The concept of sovereignty is gone when the very security and health of the entire region is at risk. If I can go on and give one example…

CONAN: Please.

Mr. DONAGHUE: I spent a half a day with about 15 women that were HIV-positive. All of them - every one of them - none of them had food that day to eat. We fed them lunch. None of them ate their lunch. They all said they had to take their sandwich home and feed their family, and the woman next to me, I gave my sandwich, she literally broke down because her son who had AIDS hadn't eaten in three days.

But in talking to them more, what they told me is their antiretroviral drugs, which they go to receive once a month, they're now getting about two week's supply. And every month they go, they're getting different drugs. So, one month they might get Kaletra, another month they might get Truvada. And so, what we're creating is actually drug-resistant HIV. We now have drug-resistant TB. We have anthrax in Zimbabwe. We have any variety of diseases that are now going over into Zambia, that are going over into South Africa. Cholera has now - there're cholera cases in Johannesburg itself - coming from Jo-berg.

Good example - I got on a plane yesterday to Chicago - I mean, back to Boston. What am I bringing back from Zimbabwe? What are other people bringing back? This is a global health crisis, and the world and the United Nations and your listeners, speaking Talk of the Nation, need to raise the flag and say, Mr. Mugabe and his regime must be stopped. He threatens certainly southern Africa and beyond.

CONAN: Our guest is Frank Donaghue, the CEO of Physicians for Human Rights. If you'd like to join the conversation, 800-989-8255; email us, talk@npr.org. And let's see if we can go now to Condo(ph), Condo with us from Little Rock, Arkansas.

CONDO (Caller): Ah, yes. I'm from the Ivory Coast originally, and I have seen people, you know, in the open market in the Ivory Coast selling cephalexin, which is an antibiotic, by the unit. So, when I think about that and imagine what's going on in Zimbabwe, that situation must be completely catastrophic. And my point is, as we concentrate so much on trying to get Mr. Mugabe out of office, all these people are dying. There should be a middle way where whatever effort is being made to get rid of Mugabe can also be applied an effort to help the people and prevent them from dying.

And as part of that same - makes your question - I'm posing to you - why is it that I don't hear every time we talk about Zimbabwe that the nature and the origin of those problems they have in Zimbabwe come from the fact that, since they won against the Rhodesian regime, the western nations have literally boycotted and isolated Zimbabwe economically? And that has enormously contributed to the present situation. So, my whole point is, we have to make sure that we do not get so upset and focused on Mugabe and let the people die. We can combine those efforts and save these people's lives.

CONAN: Mr. Mugabe would certainly argue, Frank Donaghue, that sanctions on his country from outsiders, especially Britain, have forced this situation on them - on the country, that this is not his choice, but rather the effect of outsiders.

Mr. DONAGHUE: Certainly he would. But let's not forget that the United States and Britain are the two largest donors to Zimbabwe. We fundamentally keep much of whatever health system was there afloat. Certainly, we're providing all the HIV treatment in Zimbabwe, and Britain is pouring so much money into the health system, as well as food supply, et cetera. So, Mr. Mugabe clearly takes lots of money from countries like United States and Britain.

In fact, when he claimed that we were arrested on our way out of the country, he defined that we were bogus doctors from England and United States. We basically had no Brits with us. We had southern Africans. We thought that was kind of interesting, that they're always the enemy. To Condo, let me just respond to one thing. In our recommendations, of which there's five, I believe, very powerful recommendations - and clearly, the most important, if we like it or not, is that the political impasse has to be stopped. Mugabe - we have to honor the March 29th elections where the MDC takes power.

CONAN: That was the opposition party, yeah.

Mr. DONAGHUE: Correct. But the second recommendation, which is really the most radical, and even the United Nations and others have now turned to us in the last 48 hours and said, we really want to dialogue more about that, is that Mr. Mugabe must yield control of health services and water supply and sanitation and disease surveillance, and the United Nations, using its power, must go in and basically, if you will, create a receivership - take over those systems and provide a consortium of organizations and non-government organizations to basically supply those functions until a viable, responsible government is in place. And to your point, Condo, I think that that will resolve the problem of taking care of people and keeping them alive while the political struggle goes on.

And our third recommendation, of course, is that United Nations, again, with its authorized power, should call on the International Criminal Court to gather further charges - and investigate rather and gather further evidence for crimes against humanity against Mr. Mugabe. So, I don't think we're just pointing the finger. I do think we have some real concrete recommendations to keep the people alive. And in fact, one of them is to call on Mr. Obama - Mr. Obama to convene a summit on AIDS and tuberculosis and other infectious disease in the region and help resolve and come up with some immediate remedies.

CONAN: Condo, thanks very much for the phone call. Appreciate it. We're talking about the health crisis in Zimbabwe with Fred Donaghue of Physicians for Human Rights. You're listening to Talk of the Nation from NPR News. And let's talk with Lee, Lee with us from Golconda, Illinois.

LEE (Caller): Yes.

CONAN: Go ahead, please.

LEE: Hello?

CONAN: Yes, you're on the air. Go ahead, please.

LEE: Yes, I just have a comment, not a question. I lived in Zimbabwe when it was still Rhodesia, in the early '60s, and I'm somewhat amused at the reaction to the European nations that boycotted the Rhodesian government, wanting us to turn the country over to Mugabe and his - I can't remember what his associate's name was. There was two parties at the time.

CONAN: Well, his party is ZANU-PF, yes.

LEE: Beg your pardon?

CONAN: His party is ZANU-PF.

LEE: Yes, but there was another gentleman that was his cohort in that party, I believe.

CONAN: Well, go ahead.

LEE: And anyway, the boycott that went on and finally - especially by Great Britain, I might add - basically just stopped the Rhodesian government and turned it over to the people that are now running it.

CONAN: Well that's...

LEE: That's my comment.

CONAN: OK, the legacy of colonialism.

LEE: Yes.

CONAN: Yeah. OK, Lee. Thanks very much. As you look ahead, how long would it take, do you think, to get - you could not get the United Nations to go ahead and take over this health system of Zimbabwe and its - the water system and sanitation, that sort of thing - as a receivership without the cooperation of the Zimbabwean government. They might very well see this is a violation of sovereignty.

Mr. DONAGHUE: Well, they absolutely will. I mean, there's no question. But - not go get into all the legal...

CONAN: Yes.

Mr. DONAGHUE: Words but the Article 39 of the Charter - let's remember that Zimbabwe, for the last 20 years, has signed on to covenants and conventions with the United Nations and the world, and they are in violation of those covenants. Therefore, in violation of those, they have - there are some procedures that can be taken against them for breaking those covenants. And one - you know, one is the protection of the right to health and the right to life for the people of Zimbabwe. That's clearly at risk. And so, Mr. Mugabe can held the task on that. But now that this is no longer - and I believe, and I think we believe and our report will indicate - this is not a sovereignty issue, as I said. This is now a threat to the very region - to the health and the security of all south Africa. And so...

CONAN: And I don't mean to cut you off, but we have little time.

Mr. DONAGHUE: Yeah, I'm sorry.

CONAN: Are you finding the political will for this kind of intervention?

Mr. DONAGHUE: Well, I think - as I said, I was in Jo-berg yesterday, and I met with some officials of the South African government. And I think that people are increasingly aware that, yes, I think that they are feeling now in Zambia and South Africa that they no longer can tolerate what's going on, and that they need to step up to a leadership role, which they too have not done heretofore. But I think the message that's coming loud and clear, and the response to this report alone, is saying, you know, we really do need to rise to the occasion. This is the first human rights report from in the country in the last year, from Physicians for Human Rights. We've made radical recommendations in the past in Sudan - calling it genocide - Bosnia. And I think our radical recommendations will take feet, and I think people will listen.

CONAN: Frank Donaghue, thanks very much for your time today. Appreciate it.

Mr. DONAGHUE: Neal, thank you so much for letting us tell the story.

CONAN: And by the way, the other man's name in the early part of Zimbabwean independence was Joshua Nkomo. So, we thank our researchers here on the staff for that. Frank Donaghue, CEO of Physicians for Human Rights, they've just published a report on Zimbabwe's health crisis. You can download that report and look at photos from Zimbabwe at our Web site. That's at npr.org. Just click on Talk of the Nation. Ira Flatow and Science Friday will be here tomorrow. We'll see you again on Monday. Have a great weekend everybody. This is Talk of the Nation from NPR News. I'm Neal Conan in Washington.

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