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Guest BSR: Zimbabwe - strategies against Covid-19

April 16, 2020

News of the tragic loss of a well-known broadcaster to Covid-19 three weeks ago tore public opinion in Zimbabwe. Thirty-year-old Zororo Makamba, the second person to have tested positive to the coronavirus in the country, died tragically at Harare’s Wilkins hospital. A day after this tragedy, we learnt from the family that the hospital did not have ventilators – but when the family secured one, the hospital still did not have a functional electrical socket.

 

Makamba’s tragic death highlights the dangers of a decaying and underfunded public health system and the need for urgent action by President Emmerson Mnangagwa in concert with his political opponents to avoid an unspeakable loss of human life from Covid-19:

 

First, and foremost, the government must lead in marshalling every available resource to identify cases, prevent transmission, protect health-workers and provide state-of-the-art health-care for every Zimbabwean citizen, rich or poor, who contracts Covid-19. Announcing and enforcing quarantines will not prevent the spread of this pandemic in the absence of comprehensive public health measures. 

 

The Covid-19 tragedy has exposed extreme governmental negligence toward public institutions and services and the folly of State divestiture from providing public goods and services. For pandemic-preparedness planners, Zimbabwe is the ultimate nightmare, with crowded housing, poor sanitation, lack of clean water, and a significant proportion of the population still immuno-compromised due to HIV/AIDS. A once robust health system is now so run down that even basic diagnostics are often done in South Africa. Zimbabwe has fewer than 20 ventilators.

 

Meanwhile, a small wealthy elite that relishes in excess has been able to rely on their wealth to charter flights to exclusive private hospitals outside Zimbabwe, including South Africa, Singapore, China and Dubai, avoiding Zimbabwe’s dismal health system. Now, however, travel restrictions due to Covid-19 have curtailed this option. 

 

But rather than dedicate their resources into rapidly strengthening public health, some wealthy residents are hastily financing construction of an exclusive hospital for their use during the crisis. If this comes to pass, it will surely strain an already fragile relationship between those in power and everyone else who must struggle alone. The general public, for whom poor public services and infrastructure pose a direct threat, have protested and spoken out against the decadence and poor governance. But the elites have turned a blind eye. 

 

In the past, Zimbabweans have managed to make ends meet in the face of difficulty. They persevered through the HIV/AIDs, Cholera and Malaria crisis. But without a complete shift in government priorities, Covid-19 may prove too large to fathom. 

 

Many of the poor will find it impossible to adhere to recommended social distancing or basic hygiene rules, in some cases because their living space is crammed, in others because livelihoods depend on daily hustling for food and other resources. Life is excruciatingly difficult, with average wage for civil servants at less than $500 a month, while a domestic worker earns less than $75 a month. Much of the population is self-employed or underemployed in an economy that has become predominantly informal. 

 

Half-way measures could lead to our downfall. Yet, as bleak as the situation on the ground appears, we cannot despair. Rather, Zimbabweans must insist on action. We shall not now fail to rise to the challenge of rebuilding a healthy, thriving society and stronger nation. 

 

The President’s Choice

 

President Mnangagwa must first recognise the extent of the crisis the country is facing: an unprecedented burden of the disease and the social and economic devastation that may follow. Facing this reality, he must seize opportunities to minimise the impact, and gain the international support that Zimbabwe so desperately needs. Even so, it is a race against time. Although there are now only a handful of known cases, testing has barely begun. If the experience of other countries is a guide, it is already spreading through communities.

 

The hope for countries like Zimbabwe is to get ahead of the pandemic, through testing and slowing transmission, while improving the ability of society to cope and adapt. That means improving our hospital facilities and enabling social-distancing measures. 

 

The President has taken an important step to control the pandemic by putting the country in lockdown. But this measure alone is inadequate, and even dangerous, in the absence of strategy for tracking, tracing and isolating cases as well as ensuring that people have enough food and water to survive the lockdown. So, the President should implement four key policies.

 

First, he must establish a Public Health Advisory body, comprising health and policy experts from across government including agriculture, women and child welfare services who will advise on strategy. Responding to the Covid-19 crisis is a public health emergency that cannot be run by politicians alone. In addition to advising on strategy, that body must identify the most urgent and effective fixes to Zimbabwe’s dilapidated hospital-care infrastructure. 

 

Second, Zimbabwe must invest human-power and money in expanding hospital capacity. The President should consider deploying the Zimbabwean military to build this new infrastructure. Emphasis should be put on upgrading hospital facilities, as well as ensuring adequate testing kits and personal health equipment are available to medics and other first responders.

 

The country can be smart about new medical technology, including procurement of new diagnostics, treatments as they are developed and ventilators. The President can look to initiatives such as the Zimbabwean Kufema Project recently set up to build open source ventilators. Within a week, the project had come up with several prototypes and attracted over 600 volunteers. 

 

Third, the priorities for Zimbabwe must change immediately. The government has taken important steps in that direction by announcing that it will divert budgets towards healthcare.  But now, the President must ensure that the benefits of that investment are accessible to all Zimbabweans regardless of class or income. A significant swathe of the Zimbabwean economy is ‘informal.’ For them, social distancing is not a viable medium to long term option. Most informal traders’ live hand to mouth and face a stark choice between starving to death or exposure to Covid-19. It is this group of people that immediately requires more help. 

 

Finally, the options for the economy are limited. Even in the best of times, the Zimbabwe government lacks the financial resources to implement meaningful change. It is difficult to see how the Zimbabwean government can help its people without a serious injection of external support, including from Zimbabweans living abroad. 

 

To address this, President Mnangagwa must instigate a new and shared vision for the country that reignites hope for the people and confidence in external funding partners. He needs to reach across the aisle and initiate meaningful dialogue with his political opponents. Together, the President and his political opponents should immediately re-engage with bilateral and multilateral donors to support a comprehensive response to Covid-19 and negotiate with the US government and Europe for suspension of sanctions and resumption of effective business and humanitarian relations. 

 

Honouring Zororo and others like him

 

As Zimbabweans work together to reconstruct our families, societies and economies following the current shut-down, the tragedies that have befallen Covid-19 victims must offer solid direction. A new national vision by Zimbabweans of all walks of life, rich and poor, must replace the current dysfunctional discourse regarding Zimbabwe’s future.

 

Let us place at its heart a new basic bargain: each Zimbabwean, regardless of post-code or stature, deserves the right to a decent and dignified life and care. If we work towards that shared dream, then surely, we can fight and defeat Covid-19 – and build a Zimbabwe that works for all.   

 

 

'Maxwell Gomera is a Senior fellow of Aspen New Voices. He is a Zimbabwean living in the UK and an expert in public policy on nature and agriculture. He has written for many outlets including The Independent, World Economic Forum, Project Syndicate, Stanford Social Innovation Review, The New African, The Mail and Guardian amongst others. Twitter: @GomeraM Email: maxwell.gomera@gmail.com 

 

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