IV. The Humanitarian Crisis and the State's Failure to Respond

Zimbabwe is in the midst of an all-encompassing humanitarian crisis that has seen an almost total collapse in the delivery of basic government sanitation, health, and welfare services.

To date the Zimbabwean authorities have demonstrated neither the will nor the capacity to address the crisis and protect Zimbabweans from its consequences. Repressive government and extensive corruption have led directly to an interlinked economic collapse, a humanitarian crisis and growing public desperation. In doing so, the ZANU-PF government has violated the basic rights of Zimbabweans to food, health and clean water.

Statistics from the United Nations Children's Fund (UNICEF) show that Zimbabwe has the world's fourth-highest rate of HIV prevalence and has recently seen an unprecedented reversal of progress on child mortality. For example, mortality rates for children under the age of five have risen from 76 per 1,000 live births in 1990 to 105 per 1,000 live births.[1] UNICEF says that the hardest hit in Zimbabwe are:

populations affected by serious food insecurity, HIV and cholera outbreaks as well as those displaced during the fast-track land reform program, Operation Murambatsvina (OM) and more recent re-evictions.[2] The more chronic vulnerabilities include inadequate access to basic social services, lack of agricultural inputs and disrupted livelihoods.[3]

Maternal mortality has been steadily rising since the mid 1990's, and was at an alarming 880 per 100,000 live births in 2005, the last year for which World Health Organization data is available.[4]

Deaths from cholera in Zimbabwe's main cities and townships are mounting, and health, water and sanitation services have collapsed. The cholera outbreak has left over 39,000 Zimbabweans infected and over 2,000 dead, but is only one of a growing array of healthcare disasters.[5]  For example, 1.3 million Zimbabweans are living with HIV/AIDS, yet only 110,000 of the 480,000 people in urgent need of anti-retro-viral therapy (ART) are currently receiving it.[6]

Because of disruptions in the supply of drugs, food shortages, and transportation difficulties, many of those who do receive ART may not be able to consistently ensure access to their daily medicines, leading to the development of drug resistant HIV strains and treatment failure leading to premature mortality.[7] With collapsing living conditions and the emerging HIV epidemic, Zimbabwe has seen a resurgence in cases of tuberculosis-six times more cases in 2008 than 20 years previously. And cure rates for those put on treatment are just 54 percent.

Food Insecurity

Zimbabwe has suffered from food shortages since 2000 when the Mugabe government embarked on a violent and illegal program of land seizures.[8] An estimated 5.1 million Zimbabweans-half the population-are expected to need food aid in 2009.[9]

Food output in Zimbabwe has deteriorated drastically in the past year. The UN World Food Program (WFP) estimates that maize production in 2008 was 575,000 metric tons-28percent below 2007's historically low level.[10] Maize is Zimbabwe's staple but many villagers interviewed by Human Rights Watch in Mashonaland East, West, Masvingo, Midlands and Manicaland provinces said that they were either living on one meal of sadza (maize meal) a day or on wild fruit.

On October 9, 2008, WFP appealed for US$140 million for vital relief rations in Zimbabwe for the following six months.[11] It estimated a cereal gap for the period April 2008 to March 2009 of 1.2 million tons.

The Crop and Food Supply Assessment Mission (CFSAM-a joint body of the United Nations Food and Agriculture Organization (FAO) and WFP) determined that Zimbabwe's poor main cereal harvest in 2008 was due to a combination of adverse weather conditions, a lack of key agricultural inputs (fertilizer and tractors), crumbling irrigation systems, and disincentives caused by government price controls.[12] 

As a result of severe food shortages, levels of chronic malnutrition among children under age five have increased, so that 28 percent are chronically malnourished.[13] Hyper-inflation of over 231 million percent has eroded the capacity of families to access the little food available on the market, an especially acute problem for people living in urban areas with no access to land. Maize remains unavailable in most shops. Where it is available on the black market, it is pegged to the US dollar, pricing it out of reach for the average Zimbabwean household. When Human Rights Watch researchers visited Zimbabwe in November the price of a 20 kilogram bucket of maize meal was US$20, unaffordable for most people.[14] Only 6 percent of Zimbabweans are employed in the formal sector[15]. Teachers, for example, earn an average of US$4 per month.[16]

Six local and international agriculturalists told Human Rights Watch that the 2008-9 farming season would fail because many farmers were unable to get seed and fertilizers due to disruption in farming during the 2007-8 season. They presented a picture that placed primary responsibility on the Zimbabwe authorities for the increased food insecurity in the country, citing:

1. Poor agricultural policies that led to the late distribution of farming inputs such as seed and fertilizer by the Zimbabwe authorities;[17] 
2. State-sponsored violence after the general elections in March 2008;
3. Corruption within state-run agricultural institutions such as the Grain and   Marketing Board (GMB) and by ZANU-PF's political elite.

Each of these factors is discussed below. 

Late Distribution of Farming Inputs

Agriculturalists informed Human Rights Watch that the late distribution of farming inputs by the Zimbabwe authorities as a result of poor agricultural policies and corruption was one of the main causes of the decrease in cereal production in the country. Tillage of farms needs to be done before the rains and all preparations should be ready by at least September 1 for rains that normally come between late October and November. An FAO/WFM assessment mission report to Zimbabwe in May 2008 found that the delayed supply of inputs was one of the major factors that affected the productivity of the 2007-8 crops.[18] The assessment mission advised Zimbabwean authorities to ensure that seed was easily accessible by farmers on the open market and made available in a timely manner. However, this did not take place. Late distribution of seed and other farming inputs and unavailability of seed is likely to be a major factor in low maize production next season.

One agriculturalist told Human Rights Watch:

Agricultural production is about the availability of inputs. Seed is always released too late by the government. It gets on the market too late. Yields decline by more than half between November and December planting.[19]

A farmer made the same point to Human Rights Watch:

I benefited from the government Champion Farmer Programme. I was promised 10 bags of Compound D fertilizer, 10 bags of Ammonium Nitrate fertilizer and 50kgs of maize seed but l only got 50kgs of seed. The seed was delivered…on November 18, …too late for this agricultural season…In any case l was already surviving on wild fruits so l had to sell 10 kilograms of that seed and then l washed the treated seed and ground it into maize meal so that my family [could] survive…a few more weeks.[20]

Analysts estimate that the number of Zimbabweans needing food assistance is likely to increase in 2009 due to unavailability of seed and other farming inputs.

State-Sanctioned Post-Election Violence

The protracted violence throughout Zimbabwe in the months after general elections in March 2008 added to food insecurity in the country. Human Rights Watch has collected evidence that shows that state-sponsored groups such as the ZANU-PF sponsored "youth militia" and "war veterans," state security forces, and supporters systematically killed livestock, and destroyed and plundered the homes and food granaries (reserves) of thousands of suspected MDC activists and supporters in order to ensure their displacement and inability to vote.[21] An estimated 36,000 Zimbabweans were displaced by the violence and left in need of food, water, and shelter.[22] Looted food was given to soldiers, youth militia, and ZANU-PF supporters at camps that had been set up throughout the country and used to beat and torture MDC supporters.

On May 13, Augustino Zacarias, the UN Country Team Resident and Humanitarian Coordinator to Zimbabwe, released a statement expressing concern over the politically motivated violence and the rising humanitarian problems. He expressed worries about those who fled their homes-out of fear of reprisals-and lacked food, shelter, and other basic social services, which could trigger unprecedented humanitarian needs.[23] On May 28, UNICEF released a similar statement denouncing the political violence that had "displaced at least 10,000 children" in Zimbabwe, and was "affecting the continued delivery of humanitarian relief to children and their families in parts of the country."[24]

The violence also prevented local farmers from tending their farms and preparing for the 2007-8 planting season. A farm manager in Chegutu, Mashonaland West, told Human Rights Watch, "During the election period just before the run-off, ZANU-PF supporters came and raided the farmworkers' farms and took all of their maize stock. They came on June 18, about 30 of them, all wearing ZANU-PF tee-shirts."[25]

Another farmer in Chegutu told Human Rights Watch that "Instead of spending time on our farms to prepare for the rainy season we were forced [by ZANU-PF] to spend days attending political meetings. The political violence did not help as many of us were forced to flee our homes and leave our farms."[26]

In its June 2008 report on the post election violence, Human Rights Watch highlighted how the government of Zimbabwe bore by far the greatest responsibility for the widespread violence, including looting of property and food reserves, which took place around the country.[27] The report also highlighted how the Zimbabwe police had failed to investigate the thousands of cases of violence perpetrated by ZANU-PF officials, state-sponsored groups, and the security forces, and how not a single perpetrator from these groups had been brought to justice.

The UN's Zimbabwe 2009 Consolidated Appeal Process (CAP) document also found that the impact of humanitarian agencies' long period of absence from the field, partly due to the violence, had a "detrimental impact on the food security situation in 2008 and hindered the collection of first hand information on the real needs of communities and gaps in the humanitarian response."[28]

Corruption and Discriminatory Government Policies on Food

Three economists told Human Rights Watch that protracted and endemic corruption within ZANU-PF has led to a situation of acute economic disparity.[29] They add that a very few individuals have been acquiring vast wealth while the majority of the population (over 90 percent of whom are estimated to be unemployed) continues to face increasingly severe deprivation.

On December 14, 2007, in an address to ZANU-PF's congress, the Governor of the Reserve Bank of Zimbabwe (RBZ), Gideon Gono, accused senior ZANU-PF officials of corruption and stated that the country lost an estimated US$1.7 billion per year "through economic sabotage perpetuated by the few" with the knowledge or complicity of government officials.[30] 

Human Rights Watch has found no evidence that the Zimbabwe authorities are taking any serious steps to address corruption in relation to food insecurity. Conversely, we found that individuals within ZANU-PF have exploited their political connections to secure preferred access to scarce commodities like maize meal and farming inputs for export or for sale locally at exorbitant prices. Endemic corruption has aggravated food insecurity and exacerbated the food shortages. In February 2007, Gideon Gono also accused the country's leadership of encouraging the growth of corruption and cited the "ridiculous" practices of the state's Grain Marketing Board (GMB) as fueling corrupt practices."[31]

Corrupt practices by ZANU-PF officials have also led to severe shortages of seed and other farming inputs such as fertilizer. Many of the government's agricultural policies have benefitted-seemingly by design-the political elite and larger-scale farmers. Agricultural experts and small-scale farmers told Human Rights Watch that official policy and supply of seeds and other inputs were highly politicized and affected by corruption.[32]

The government's most recent policy, the "Champion Farmer Program" (also known as the Master Farmer Program), was supposed to provide seeds, fertilizer and farm implements to farmers with a good farming productivity record.[33] Several farmers who qualify for the program told Human Rights Watch that they believe the program was being used for political purposes and that most of those included in the program were ZANU-PF loyalists. For example, in two Midlands constituencies won by the MDC during the March 2008 general elections, no farmers have benefited from the Champion Farmer Program, even though many qualified.

In a case in Mashonaland East province, local ZANU-PF officials threatened an official of the Agricultural Technical and Extension Services (AGRITEX)-an Agriculture Ministry department responsible for distributing food and fuel-accusing them of being pro-MDC after distributing inputs to all qualified local farmers whatever their political leaning.[34]

Agriculturalists told Human Rights Watch that the selling of seed on the black market has also affected seed production capacity. As one expert put it:

Inputs imported from outside end up in the hands of the politically well connected that don't put them to good use but sell them on the black market. Seed is now unavailable and farmers can't plant.[35]

Agriculturists and economists say that there has been gross misuse of RBZ funds marked for agricultural production. Human Rights Watch did not find first-hand evidence of this, but 20 small-scale farmers[36] in Mashonaland East, Masvingo, and Midlands provinces reported that the RBZ had diverted subsidized maize seed, fuel, and cheap tractors meant for the Champion Farmer Program to local ZANU-PF officials and governors who then sold them on the black market at high prices. It is unclear how many farmers have benefited from the Champion Farmer Program or related programs and how much the RBZ has actually spent. Zimbabwean officials seldom release figures of RBZ spending on programs.

Local farmers and a senior employee from the state-run Grain Marketing Board informed Human Rights Watch that the GMB has also been involved in corruption. GMB managers appointed by ZANU-PF illegally secure maize from the GMB and sell it on the black market. Some local ZANU-PF officials prevent traders and private persons from moving and selling maize to people at competitive prices.[37]  For example, farmers in Mashonaland East told Human Rights Watch that a ZANU-PF official and former military officer was preventing local businessmen from selling maize locally so that he could sell his own maize, at higher prices, and only to ZANU-PF supporters. This maize was originally stocked by the local GMB distribution center.[38] 

A senior GMB employee told Human Rights Watch that another program funded by the RBZ aimed at small-scale farmers-"Operation Maguta"-had mainly benefited the ZANU-PF elite.[39] According to the GMB official, the seed and stock were also used to buy off war veterans before the March 29, 2008 elections. His claim was substantiated by several farmers in the provinces that Human Rights Watch visited. Farmers and villagers said that the army was put in charge of distributing the program's seed and fertilizer even though, according to agricultural experts, AGRITEX is qualified to do so.[40] Villagers said that instead of distributing the seed and stock to farmers, the army supplied ZANU-PF politicians, who sold them at exorbitant prices on the black market. In its earlier report on the March 29 elections, Human Rights Watch raised concerns about discriminatory practices in the distribution of state-subsidized maize by the GMB.

The Health Crisis

The Cholera Outbreak

The cholera outbreak that started in August 2008 exposed the true decline of healthcare in Zimbabwe. Between 1985 and 1992 no cases of death from cholera were reported in Zimbabwe.[41] Since 1992, as the health and sanitation infrastructure has deteriorated in Zimbabwe, there have been an increasing number of outbreaks. However, deaths from cholera had typically been few, as mortality can be preventedthrough simple treatment-oral, or in severe cases, intravenousrehydration. Typically only one percent-or one person in every 100 infected-dies from cholera.[42] However, in the current outbreak Zimbabwe has seen a mortality rate five to six times higher. On January 12, 2009 the World Health Organization (WHO) reported over 39,000 cholera cases in Zimbabwe and over 2,000 deaths.[43] The actual figures may be higher due to the incapacity of Zimbabwe's health services to document cases.

One international health expert told Human Rights Watch that "The cholera outbreak is an indication of the general collapse in the health system. This… outbreak is [such as] we have never seen in Zimbabwe."[44]

According to health experts, the high mortality in the current outbreak is exacerbated by severe malnutrition and high rates of HIV prevalence.[45]

While exploding only in the past few months, Zimbabwean authorities had been aware of the potential for a massive cholera epidemic for nearly a year. In December 2007, 459 cases of cholera were reported in two high-density suburbs of Harare and 11 people died from cholera and more than 300 were hospitalized in Bulawayo.[46] Repeated calls to address the epidemic and to ensure that municipal water sources were properly treated were unaddressed by the government.

In response to a lack of water purification chemicals and electrical shortages, the national water board cut off all water supplies to Harare residents in early December 2008.[47] However, the Zimbabwe authorities failed to anticipate the consequences. While capacity to respond may have been undermined by a lack of medical and financial resources, health experts say the authorities initially refused to acknowledge the true extent of the cholera crisis and the urgent need to respond.[48]

Despite an alarming increase in cholera deaths, infections and their locations, the government did not immediately appeal for international help and initially refused to declare the outbreak an emergency. One international health expert told Human Rights Watch: "By the time the government called us in to assist, over 200 people had been infected in just one…Harare…suburb. A faster response may have prevented the spread of the disease."[49]

On December 4, 2008, four months after the start of the current outbreak in Harare, ZANU-PF Health Minister David Parirenyatwa declared the outbreak a national emergency.[50] But on December 11 Mugabe claimed the crisis was over, ignoring international humanitarian and WHO data, which showed a sharp increase in infections and deaths.[51] 

A Failing Health System

Many district hospitals and municipal clinics in Zimbabwe are currently either closed or operating at minimum capacity. Other aggravating factors include dilapidated infrastructure, equipment failures, and a "brain drain" of medical professionals.[52] As a result, ordinary Zimbabweans cannot access basic healthcare. The cholera outbreak has been aggravated by the closure in November of Harare's two main public hospitals, Parirenyatwa and Harare, and a shortage of drugs and medical personnel.[53] 

The main victims of the health crisis are the elderly, children, women and the chronically ill, including people living with HIV/AIDS.[54]The crisis is such that in November 2008, UNICEF moved into a 120-day emergency mode, focusing on the cholera outbreak and providing emergency health care to children.[55]

On November 20 the Zimbabwe Association of Doctors for Human Rights (ZADHR), a local human rights NGO, expressed grave concerns about the impact on maternal health of the closure of two government maternity hospitals in greater Harare.[56] Since 1994, mortality has increased among mothers from 283 to more than 1,100 deaths per 100,000 live births.[57] ZADHR said that about 3,000 women a month were giving birth in public hospitals in Harare, with between 250 and 300 needing lifesaving caesarean sections.[58] The closure of the maternity hospitals will result in many poor women being denied emergency treatment,[59] and may further contribute to the already rising maternal mortality rates. Private hospitals charge for their services in foreign currency, pricing out most Zimbabweans.

The authorities have treated health workers protesting the decline in Zimbabwe's health system harshly. On November 18, heavily armed riot police prevented a group of health workers from petitioning the Minister of Health and Child Welfare. The workers were demanding that the government restore accessible and affordable healthcare. Police initially forced the health workers to protest within the grounds of Parirenyatwa Hospital, but after four hours the police entered the hospital grounds and forcibly dispersed the workers, assaulting several.[60]

Official Restrictions on the Operations of Humanitarian Agencies

The work of local and international humanitarian organizations has been hampered by a difficult economic environment and political interference in their operations. Relations between humanitarian agencies and ZANU-PF have been poor for several years. The latter has repeatedly accused NGOs in Zimbabwe, including humanitarian organizations, of supporting the MDC and working with western donors to overthrow the government. According to the UN's 2009 Consolidated Appeal Process (CAP) for Zimbabwe, violence and government restrictions have prevented humanitarian activities. The CAP document stated:  

A protracted election period, from March through August, essentially put the country on hold for six months, during which time election violence and government restrictions halted most humanitarian field activities. Half a year of critical humanitarian service delivery in support of food security, clean water, health, and education services was lost, and the impact of this is likely to continue into 2009.[61]

Such political interference has not only stifled the operations of humanitarian organizations, it has significantly worsened the humanitarian situation itself and compounded the suffering of Zimbabweans. On June 4, 2008 the Minister of Public Service, Labour and Social Welfare wrote all NGOs and private voluntary organizations and announced a full suspension of all their field operations.[62] Earlier, Minister of Local Government Ignatius Chombo had accused local and international humanitarian agencies of breaching their registration terms and conditions. Chombo accused some NGOs of using food distribution programs to support the MDC.[63] According to The Zimbabwe Times, on June 15, while addressing a campaign rally in Silobela, Mugabe accused NGOs of using food handouts to overthrow the government.[64]

The Zimbabwe authorities have failed to provide any evidence to support their allegations that NGOs were in breach of their registration terms and conditions or conducting discriminatory practices in their food distribution programs. In any case, under Zimbabwe's laws regulating the operations of NGOs, the Ministry of Public Service, Labour and Social Welfare does not have the powers to order the suspension of NGOs.[65] This raises concerns that the suspension was an attempt to prevent NGOs from witnessing and reporting on the state-sponsored violence that was taking place in the rural parts of the country at the time. It also significantly affected the ability of the NGOs to assist the poor and destitute.

The suspension limited the ability of humanitarian agencies to determine the true extent of the food crisis, and assess the future needs of the population. It obliged them to delay responding to the food crisis until after the authorities lifted the formal ban in September 2008. The agencies were therefore forced to conduct registration and verification exercises at the same time as distributing food. Humanitarian agency representatives told Human Rights Watch that this had put a strain on their ability to reach all those in need:

The suspension was the period [that] we should have [been able to use] for…registration and verification. The numbers of needy skyrocketed because the crisis was only attended to at the last minute. Our food aid was in South Africa …Because we were suspended we couldn't bring it in. It takes [time] to move 10,000 tons of food. It also cost us money to keep the food in South Africa because we had to [rent] extra warehouses.[66]

Attempts by ZANU-PF to Interfere in Food Aid Distribution

Despite the formal lifting of the ban, restrictions on the operations of humanitarian agencies remain. The terms of a new Memorandum of Understanding signed between local and international humanitarian agencies and the ZANU-PF authorities say that if the agencies wish to operate in a specific area, they must first get permission and sign a written agreement with local government structures setting the terms for the distribution.[67] 

While such a request by the government may seem reasonable, local government and party structures in Zimbabwe have attempted to use this requirement to control and impede the efforts of humanitarian agencies to assess needs and provide much needed food and other assistance to Zimbabweans. The requirements have also left the delivery of humanitarian assistance open to manipulation by government agents and ZANU-PF officials.Representatives from a number of NGOs told Human Rights Watch that banning restrictions continue to be enforced in some localities by ZANU-PF officials, "war veterans" and traditional leaders.

Local authorities and chiefs have also tried to interfere directly in humanitarian agencies' food distribution. ZANU-PF officials in at least two areas insisted that food aid should be distributed exclusively through their local structures. Two NGOs independently told Human Rights Watch that the Governor of Masvingo province was insisting that someone from ZANU-PF must accompany all humanitarian agencies or they would not be able to distribute food.[68]

In another case, in Gokwe, Midlands, one humanitarian NGO was unable to distribute food because ZANU-PF officials and militia continued to patrol the area and demand that food be distributed through them.[69] Representatives from the particular NGOs informed Human Rights Watch that they had raised the issue with the government but their concerns were not addressed. The NGOs expressed reluctance to raise the situation with donors because they feared expulsion from the country or the renewed suspension on their operations.

Government Non-Issuance of Employment Permits for International NGO Staff

The Zimbabwe government has also hampered the work of international humanitarian organizations by unnecessarily denying foreign staff employment permits and extensions of permits. Representatives of four such agencies interviewed by Human Rights Watch said that since the lifting of the aid suspension, the Zimbabwe authorities have refused to issue new employment permits or extend the employment permits for some international staff without presenting any valid reasons for doing so.[70] 

The non-issuance of employment permits appears to be another government tactic to try to control and restrict the activities of humanitarian organizations. One NGO representative told Human Rights Watch:

I have just been informed that a key food aid staff member's employment permit will not be extended. The appeal will take more than four months. But this is a key person. This is someone that we really need for their expertise.[71]

Another added, "There are a lot of stumbling blocks and hurdles that the authorities put in our way. The work permit issue is just another one of them."[72]