Africa's Pol Pot
By Roger Bate

http://www.techcentralstation.com/033005C.html

BULAWAYO, Zimbabwe -- As Zimbabweans prepare to go to the polls on Thursday
and Zimbabwe receives global attention, if only for a few hours, it is
important that the desperate HIV situation there is acknowledged -- if for
no other reason than it is beginning to harm regional AIDS control programs
funded by the US Government and the private sector.

"If I had enough to eat I could take the adult dose", claims Lucy who is one
of the "lucky" Zimbabweans receiving treatment for HIV. Fragile, just able
to lift her arm, I was apparently seeing her at her best in her small shabby
house she shares with too many others in the unbearably poor outskirts of
Zimbabwe's second city, Bulawayo.

Everything is falling to pieces in Bulawayo and especially the health care
system. But while the regional African Presidents see refugees pushing up
their burden of malaria and HIV, they shy from breaking ranks with a fellow
African leader and refuse to condemn Zimbabwe's patent contempt for
democracy. It's time to ask whether aid to the region should be stopped
until these spineless leaders decide to act on the only leader Zimbabwe has
ever known -- his excellency, comrade President Robert Mugabe.

Zimbabwe's rapidly escalating and politically-induced humanitarian disaster,
which has manifested itself in chronic shortages of food, medicine, fuel,
electricity and hard cash, has driven over three million Zimbabweans into
South Africa, Botswana and other neighboring states. In a chilling echo of
what the Khmer Rouge did in Cambodia in the 1970s, Didymus Mutasa, Secretary
of President Mugabe's Zanu-PF government, said: "We would be better off with
only six million people". Prior to the crisis, Zimbabwe's population
estimate was 12 million; today 60 to 70 percent of the country's productive
population is now living elsewhere. Since the World Food Programme (WFP) was
thrown out of the country in December, what food remains is allocated along
political lines, leaving over 5 million malnourished: Secretary Mutasa may
get his wish.

Zimbabwean Health Collapse -- Probably the Worst in the World

According to Amnesty International many refugees are assaulted or raped on
arrival and destitute young women frequently end up as prostitutes. The
refugees know it's going to be very hard, but leaving is still preferable to
staying.

Twenty years ago, life expectancy in Zimbabwe was 58; in 2002 it was 33 and
dropping. The official HIV/AIDS rate in 2002 was about 25 percent (the
highest in the world for any sizeable country), but the real rate is
probably much higher. With no hope for treatment, and little for long term
survival, behavior rapidly worsens. According to one survey, over a third of
Zimbabwean men who are aware they are HIV positive do not tell their
partners they have the disease. And astonishingly 79% of women surveyed said
they would not tell their partner if they had HIV. As one put it to me -
"life is too short here to worry about HIV."

Dr. Mark Dixon from Mpilo Hospital in Bulawayo says that 70 percent of the
patients he treats for any reason carry the HIV virus. A possible
explanation for this extraordinary number is the high incidence of
unprotected sex (usually rape) in Mugabe's youth camps, where sexual power
is used to suppress dissent against the ruling party.

Over 250,000 Zimbabweans now die from AIDS annually. Many sufferers have no
drugs and no future, as they are too sick to travel and seek treatment
abroad. The only good thing about this is that they won't carry the virus
elsewhere. Younger Zimbabweans, who are generally healthy though
malnourished, leave if they possibly can. This is exactly the age group that
carries the highest HIV burden -- estimated by local doctors to be over 40
percent -- and they take the virus with them wherever they go.

To make matters worse, some of the Zimbabwean strains of HIV are probably
resistant to drugs that were used in frequently interrupted trials in
Zimbabwe. In Bulawayo, Lucy's drug regimen has been changed twice in the
past six months, once due to drug shortages, the second due to lack of food,
without which she was unable to take the correct dosage of drugs.

South Africa Takes the Strain, Can Others?

South Africa, with its 42 million people, is perhaps big enough and rich
enough to accommodate the Zimbabwean influx. Other countries are not so well
placed. According to figures from nongovernmental organizations working in
the region, Botswana, with just over a million people, now probably hosts
more than 200,000 illegal Zimbabwean immigrants. And that allows for the
thousands who are unofficially deported from Botswana back to Zimbabwe every
week (official figures talk of only 2,500 per month, but NGOs say it's far
higher).The permanent and temporary influx has caused terrible strains,
leading to conflict, rape, and the possibility of increasing the HIV rate
from an already staggering 38 percent.

The HIV infection rate in Zambia and Mozambique is worsening. Official
figures say it's 16.5% and 12.2% respectively, but neither country has the
level of border control enjoyed by Botswana and hundreds of thousands of
HIV-positive Zimbabweans may well be entering both countries.

According to Michael Biemba, the Livingstone council AIDS coordinator, HIV
rates are 55% in Livingstone (the closest Zambian town to Zimbabwe) and this
is partly due to the influx of prostitutes from Zimbabwe. There are fights
breaking out between local sex workers and the influx of desperate
Zimbabweans who are undercutting their prices. AIDS rates in close by Katima
Mulilo in Namibia and Kasane in Botswana are also high and rising, and
Zimbabwean sex workers are largely to blame there, too. One Zambian doctor
monitoring AIDS in this border region said that rates of over 60% were not
unusual. Given the lag for HIV to take its fatal toll, the Zimbabwean influx
into the entirety of its neighboring states will take time to really show
its worst effects, but the worst is what we should expect.

An Old Foe Returns -- Malaria Again

Although HIV is the main concern, malaria rates in the region are set to
rise as well. In 2004 Zimbabwe's underfunded health department managed to
cover just 3.4% of buildings designated to be sprayed with insecticides.
Exact malaria rates are unknown but likely to be soaring; the child death
rate is extremely high, due to the shortages of drugs. Meanwhile at a
malaria rally my colleague Richard Tren attended in November, the health
minister was more interested in attacking the opposition MDC party than in
combating malaria. His chant "Down with the MDC; Down with Mosquitoes" was
half-heartedly taken up by a shocked audience expecting a health speech.

The Limpopo Province in South Africa forms the Southern border of Zimbabwe.
Its health department has excellent data, and Dr. Philip Kruger says that
January's malaria rate in the Province was five times higher than last year,
and "Zimbabweans are a likely cause."

Despite the impact on the region, few non-Zimbabweans, especially political
leaders, will openly criticize Mugabe. This leaves a vacuum the
international community is loathe to fill. Tom Woods of the State Department
told me that the "US would not hold the region hostage over Zimbabwe." But
he agrees that an African solution is required, such as occurred recently in
Togo, and only South African president Thabo Mbeki has the clout to provide
it.

While Mbeki continues with his strategy of "quiet diplomacy", the corpses of
those who die of AIDS related diseases and kwashiorkor -- caused by acute
malnutrition -- continue to pile up in Zimbabwe's mortuaries. Also piling up
are the bodies of murder victims since there are no longer any qualified
personnel left in the country to conduct forensic post mortem examinations.
Until the pathology tests are done, relatives of the victims cannot bury
their dead.

With Western help, an exit strategy for Mugabe could be devised and the rule
of law returned to Zimbabwe. But to achieve this aim the international
community must speak with one voice.

Carole Bellamy, head of UNICEF, last week asked for more aid for Zimbabwe.
This is the wrong signal to be sending regional leaders who will use any
sign of Northern weakness to vacillate over Mugabe. Bellamy must know that
the aid will not be used to save lives of the poor but will be used
politically. Mugabe only knows about power and protecting it, aid and soft
words have not worked, tough talk from the Sate Department, backed up by
action from the region, is what is required. Lucy's life and that of
millions of fellow Africans hinges on political will to push change in this
outpost of tyranny.