In February 2009, Médecins Sans Frontières (MSF) released a report, "Beyond Cholera: Zimbabwe’s worsening crisis," on the humanitarian catastrophe ravaging Zimbabwe. MSF head of mission in Zimbabwe, Rian van de Braak, describes the current situation in the country.

In MSF’s February report, we read that Zimbabwe’s health system was in a state of collapse with a lack of staff and resources. How are things now?

Things have been gradually improving in recent months, with the multi-donor retention scheme helping to bring health workers back to hospitals and clinics. However, there is still a lack of supplies, and many health facilities have begun to ask for fees from patients, making healthcare unaffordable for many.

Since May, the rate of cholera infection has been dropping – does that mean the threat is over?

No, everyone expects cholera to return because the root causes of the outbreak – dilapidated water and sewage systems – have not yet been addressed adequately. Several aid agencies are drilling new boreholes in cholera hotspots to help provide safe drinking water. Addressing the causes [of the epidemic] before the next rainy season will be a race against the clock. We are ready to respond immediately to a further outbreak, with necessary stocks in the country and a contact list of 250 Zimbabwean staff we recruited for the last outbreak. Additionally, we have been distributing cholera- and hygiene kits.

The socio-economic crisis has prevented many people with HIV/AIDS from accessing medical care. How is the situation now?

The problems are still huge. More than 400 people die every day in Zimbabwe of AIDS-related causes. Only about 20 per cent of those in need of ARV treatment are currently obtaining medication.

What about the food situation?

While we had around 150 children in our Therapeutic Feeding Centre in Epworth every day during the peak [hunger] season in December/January, numbers have gone down to 10-15 children a day. However, we remain concerned about malnutrition in Zimbabwean prisons, and have recently expanded our emergency intervention [scheme] for malnourished inmates – which includes activities to help to ensure clean drinking water – to six of the most affected prisons in the Midlands and Mashonaland provinces.

Has your ability to work improved under the new authorities?

In many respects, it has improved substantially [with evidence of increased government cooperation] but it remains to be seen if the remaining barriers for NGOs – such as the lengthy process to receive temporary employment permission for international staff – will be lifted.

In your opinion, what must be done to improve the situation in Zimbabwe?

The population still does not have adequate access to healthcare, people continue to die of AIDS-related illness in outrageously high numbers and the next cholera outbreak is on our doorstep. The donor community should review [its policy in relation to] releasing humanitarian funds and target them as much as possible to the areas most in need. Moreover, the government must further reduce obstacles for international NGOs and [allow them to address the enormous needs] of the Zimbabwean people.

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