Global Policy Forum

By Ignatius Banda

Judith Moyo is unable to give her child enough food. She has to bring her 18-month-old daughter to a council clinic for check-ups every month because of what nurses call her ‘‘slow development''.

‘‘I give her isitshwala leftovers from the previous night,'' 33-year-old Moyo says as she tries to keep the child quiet. Isitshwala is a staple thick porridge prepared from maize meal. The fourth of the United Nations' Millennium Development Goals (MDGs) seeks a two-third reduction in the deaths of children under five by 2015. But the issues related to the first MDG, the eradication of extreme poverty and hunger, will push the reduction of child mortality in Zimbabwe beyond the target date of 2015. Despite President Robert Mugabe's declaration in Zimbabwe's first MDG progress report in 2004 that the country was achieving success in the implementation of the goals, the continued lack of access to basic services makes this unlikely.

The World Health Organisation's estimates for 2004 put the under-five mortality rate in Zimbabwe at 129 per 1,000 live births. This has meant a sharp increase since 1990 when infant mortality was estimated at 80 per 1,000 live births. In 2000, it stood at 117 per 1,000 live births. The United Nations Children's Fund reports that while Zimbabwe saw a decline in infant mortality in the early 1990s, numbers have risen steadily after 2000 as health delivery services declined amid growing international isolation. Zimbabwe therefore remains one of a few countries to reverse the gains made during the early years of independence.

Apart from Moyo, other women at the government clinic also admit that they cannot provide enough sustenance for their newborns because of escalating food costs. Selina Zulu makes regular visits to the clinic. She used to give her older children, who have since finished their primary education, supplements like peanut butter. But now she cannot do the same for her three-year-old son because of escalating prices.

‘‘Things have changed so fast. We have had to turn to feeding our children food which we know is not good for them,'' she said amid nodding from other women gathered at the clinic. A nurse at the clinic says a number of children under five have been put on supplementary feeding. They are getting rations from the United States Agency for International Development (USAID). ‘‘Many of the children have been given the anti-measles jab, but they remain poorly fed. This is our main worry,'' says Helen Dube, a nurse monitoring the feeding and vaccination.

Zimbabwe's economic decline has led to the breakdown of the country's health delivery system. Health care is now characterised by acute shortages of drugs and skilled personnel. This has affected levels of measles immunisation, which is one of the indicators for MDG 4. In the 2004 progress report, the Zimbabwe government promised that 90 percent of infants will be vaccinated against measles by 2015.

But Stanford Matenda, a researcher and chairperson of the National University of Science and Technology's Journalism School in Bulawayo, says the economic decline has made it virtually impossible for the country to realise this goal. ‘‘I do not see us achieving it.'' ‘‘Just recently, government acknowledged that nurses were not going to work. The same goes for medical doctors. Children do not have access to food, care or medication, so it will be difficult to attain these targets,'' argues Matenda.

‘‘When parents are experiencing severe economic and psychological hardships, it will also be quite difficult for children to be healthy,'' he concludes. Recently, Deputy Minister of Health and Child Welfare Edwin Muguti told striking doctors that the government had no money to meet their demands for salary adjustments. The lack of resources to meet service delivery needs will also affect remote rural areas. According to health officials in the western border town of Plumtree, the measles vaccination programme has been slowed down by the unavailability of medicine and medical personnel.

Gertrude Chisale of Plumtree Hospital's documentation centre says there has been a steady rise in the number of deaths from measles as the government hospital struggles with resources. ‘‘This year alone, we have had at least 15 deaths of children under five and we expect the number to rise if the situation continues,'' Chisale tells IPS. ‘‘We used to have motorcycles for staff to travel to remote rural areas to do vaccinations. This has been stopped because government says there is no money for fuel or for the maintenance of these bikes,'' says Chisale. Matenda hopes that international assistance will become available to help vulnerable groups such as newborn babies.