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Cablegate: Rapid Deterioration of Social Services in Zimbabwe

This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 03 HARARE 002449

SIPDIS

AID FOR DCHA/FFP LANDIS, CRUMBLY, MUTAMBA, PETERSEN
DCHA/OFDA FOR PRATT, BARTON, KHANDAGLE, MENGHETTI,
BORNS, MARX, HALMRAST-SANCHEZ, MCCONNELL
AFR/SA FOR FLEURET, COPSON, FORT, BAKER, MACNAIRN
STATE/AF FOR RAYNOR, DELISI
PRETORIA FOR DIJKERMAN, HELM, DISKIN, HALE
NAIROBI FOR SMITH, RILEY
LILONGWE FOR RUBEY, SINK
LUSAKA FOR GUNTHER, NIELSON
MAPUTO FOR POLAND, BLISS
MASERU FOR AMB LOFTIS
MBABANE FOR KENNA
GABORONE FOR THOMAS, MULLINS AND DORMAN
ROME FOR FODAG FOR LAVELLE, DAVIS

E.O. 12958: N/A
TAGS: EAID PREL US ZI
SUBJECT: RAPID DETERIORATION OF SOCIAL SERVICES IN ZIMBABWE

-------
SUMMARY
-------

1. As detailed in a recent UN briefing to donors on trends
in Zimbabwe's social sectors, the continuing complex
emergency in Zimbabwe is taking a heavy toll on its
citizens. This cable summarizes UN figures presented at
recent special donor meeting. Crumbling social services are
failing to meet basic demands for health care, education,
water and sanitation. The country is moving rapidly towards
a situation of chronic and widespread poverty. Severe
economic decline, a crippled agricultural sector and
HIV/AIDS exacerbate the problems. US and other donor
contributions help mitigate the symptoms of the crisis and
lay a tentative groundwork for recovery, but the downward
spiral continues.

------------------------
DETERIORATING CONDITIONS
------------------------

2. The United Nations Humanitarian Coordinator recently
briefed international donors on the rapid deterioration of
Zimbabwe's social sectors and its consequences for health,
education, child protection, water and sanitation. The UN
team presented some alarming statistics, summarized below.

3. Zimbabwe is facing macroeconomic instability, reflected
by an "official" inflation rate of over 600%, a decrease in
manufacturing by almost 20%, and rising unemployment in the
formal economy (now over 80%). For most Zimbabweans, these
macroeconomic indicators mean income insecurity and eroded
purchasing power.

4. Overall poverty is increasing. In 2002 (the last year for
which data are available), 80% of the population lived below
the poverty datum line and 69% lived below the food poverty
line. About 36% of the population lived on less than US
$1/day.

5. Life Expectancy is declining rapidly, decreasing from
approximately 60 yrs in 1997 to 35 yrs in 2001.

6. Not only are conditions deteriorating, but information
systems are breaking down as well. Only limited
surveillance data has been available since 2000.

--------------------
HEALTH AND NUTRITION
--------------------

7. Access to health care services in the country has
declined rapidly since the beginning of the GOZ's fast-
track land reform program. Many health care professionals
have joined the continuing widespread "brain drain" and left
the country. According to the United Nations, only 687
medical doctors are still working in Zimbabwe -- a vacancy
rate of 55 percent. Vacancy rates for other key health
professionals are alarming -- 73 percent for dentists, 90
percent for pharmacists, 40 percent for nurses, and 53
percent for environmental health officers. On-going strikes
by health care professionals have further limited their
availability. Several medical doctors have been arrested.

8. The AIDS pandemic continues in Zimbabwe with an HIV/AIDS
infection rate estimated at 24.6% of the sexually active (15-
49) population (CDC/UNAIDS/MOH - 2003). An estimated
1,820,000 Zimbabweans were living with HIV/AIDS in 2003. The
UN reported that an estimated 135,000 adults died from AIDS
during 2003. (According to our figures, an additional 36,000
children died from AIDS this year.) There are an estimated
761,000 AIDS orphans in Zimbabwe (aged 0-14).

9. Acute malnutrition has increased from 1.2% (ZDHS 1988) to
5.0% in 2003, while chronic malnutrition, as measured by
stunting, has increased from 23.3% to 26.5% (projections
based on MOHCW/UNICEF 2003). Approximately 26,000 children
(6-59 months) were severely malnourished at the time of the
survey (MOH/UNICEF - 2003) and the number continues to
increase.

10. In 2002, more than 25 percent of mothers delivered their
babies at home, often without the assistance of a skilled
attendant, due to the high costs of transport and health
care. Maternal mortality has doubled from 300 per 100,000
in 2000 to over 600 per 100,000 in 2003. Mortality of
children under five years old increased from 70/1000 to
150/1000 during the same time period.

11. A current outbreak of cholera within Zimbabwe has
already claimed 17 lives between mid-October and mid-
November, out of 76 cases reported. Other diseases are
increasing. The incidence of tuberculosis rose from just
under 100/100,000 in 1990, to 550/100,000 in 2002. Deaths
due to measles were reported for the first time in five
years. Malaria contributes to about 12 percent of total
outpatient attendees and 15 percent of all admissions, with
over 3,000 deaths in 2001.

12. Essential drugs are becoming scarce. The percentage of
rural health care centers with no remaining stock of
critical drugs is distressing: 69% lacked Erythromycin, 80%
Norflaxine, 29% Penicillin, 28% Ergometrin and 63% Oxytocin.

13. On the bright side, immunization programs are still on-
going and the Ministry of Health and Child Welfare and
partners still maintain high coverage of selected antigens
during National Immunization Days.

---------------
ACCESS TO WATER
---------------

14. One of the most basic of human needs -- clean water --
is getting harder to come by in Zimbabwe. The UN estimates
that between 45-50% of all boreholes in rural Zimbabwe are
non-functional. Others are functioning at vastly reduced
output. The acute shortage of water supply and sanitation
affects 864,000 women and 648,000 children under five years
of age in rural areas, including resettlement areas
(UNICEF/MOH 2002). Rural residents are forced to travel
increasing distances to obtain potable water.

15. USAID and OFDA staff examined several boreholes during a
visit to Zvimba District last week and a visit to Bubi
District the previous week. These visits confirmed the
disrepair of a significant percentage of boreholes. Twisted
barbwire substituted for missing bolts, and wooden sticks
replaced missing metal lynchpins on the "bushpumps". In
several cases, villagers were required to use handpumps for
an hour or more before water would begin to trickle out.

16. In urban areas, chemicals used to purify the water are
in distressingly short supply due to lack of foreign
exchange. This potentially threatens the health of up to 4.6
million urban people.

---------
EDUCATION
---------

17. Education in Zimbabwe is plagued by a lack of basic
infrastructure, lack of teaching and learning materials and
poor sanitation facilities. The number of qualified teachers
is decreasing due to HIV/AIDS, uncompetitive salaries and
working conditions, and emigration of teachers. The number
of school drop-outs is rising.


----------
CONCLUSION
----------

18. UN figures confirm that Zimbabwe is caught in a downward
spiral of increasing poverty. The corrosion of the social
service sector is widespread and the food security crisis is
worsening. Zimbabweans are becoming increasingly dependent
on humanitarian assistance. US and other donor activities
help mitigate the symptoms of the crisis, including
USAID/OFDA's program to rehabilitate boreholes in several
districts, and lay a tentative groundwork for recovery in
some areas. The donors will continue to monitor these
trends and to identify opportunities for additional
mitigation efforts but, without the necessary policy changes
by the GOZ the deterioration will continue. Sullivan

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