Dr Manuel Lopez, head of the MSF mission in Zimbabwe, described the raging epidemic in Zimbabwe as ‘€œthe tip of the iceberg’€.

‘€œExperience has taught us that in a high prevalence HIV setting where there is malnutrition and food shortages and a recent epidemic outbreak such as cholera and poor vaccination, all kinds of infectious outbreaks can be expected’€, said Lopez.    

‘€œIf another major health problem were to hit Zimbabwe today, the situation could be disastrous as the public health system has completely collapsed’€, added MSF President, Dr Christophe Fournier.

‘€œMost public hospitals and clinics are either closed or empty, there is also a shortage of drugs and medical equipment, medical staff are not showing up because they haven’€™t been paid and patients cannot afford hospital or clinic fees. As a result they don’€™t go to health facilities. Staff shortages have forced many women to have their babies at home as there are no midwives to help with their deliveries’€, he continued.  

The country, with an estimated population of 12.8 million people in 2001, is also grappling with a serious AIDS epidemic. About one in five adults has HIV. With health services shutting down, there is no follow up for the 200 000 patients on antiretroviral treatment. This poses ‘€œa risk of a drug-resistant epidemic in the country’€, Fournier said.

People’€™s vulnerability to AIDS and other health conditions is compounded by malnutrition, according to a study published recently by UNICEF. About seven million Zimbabweans are in need of food aid. Food insecurity, in particular, has led to an extraordinary exodus in the last several years of an estimated three million Zimbabweans fleeing to neighbouring countries, such as South Africa.