Zimbabwe's entire health system has collapsed and the southern African nation, now overwhelmed by cholera, will soon see other epidemics, a worsening Aids crisis and the effects of widespread malnutrition, Médecins Sans Frontières (MSF) said this week.
MSF urged both foreign donors and Zimbabwe's government to do more in light of the crisis, saying that "nonsense" like high government fees had made it difficult for international aid agencies to help.
"You've all heard about the disastrous cholera epidemic," said Dr Christophe Fournier, MSF's international president, who spent four days touring Zimbabwe. "However catastrophic this epidemic is, it is only the most visible manifestation of a much broader crisis in the whole country. Actually the whole public health system in Zimbabwe is down, it has collapsed."
Collapsed infrastructure to blame
Zimbabwe's cholera epidemic - blamed on collapsed water, sanitation and health services - has killed more than 3 600 people and infected 60 000 since August.
There was no immediate comment from the Zimbabwean government to the group's charges.
The next epidemic could be malaria, the group said, because Zimbabwe has been unable to afford preventive measures such as insecticide-treated nets and peak season for malaria is imminent.
Aids expected to worsen
The Aids crisis will worsen, because - in a country where one in five adults carries the virus that causes Aids - people aren't getting medications or health advice.
Zimbabwe has the world's highest inflation rate and faces acute shortages of most goods, but MSF said it has been prevented from doing hunger surveys because the issue is politically sensitive.
But the UN says up to 7 million people, more than half the population, are dependent on foreign food handouts, and MSF is concerned about malnutrition.
Basic health services affected
Zimbabwe's general health collapse has also affected ordinary medical services like prenatal treatment for pregnant women and treatment to ensure that mothers don't pass the Aids virus on to their children.
Fournier, who has worked on medical emergencies around the world for 20 years, said only in Zimbabwe had he "seen this kind of collapse ... in the absence of any conflict, any war."
"A major emergency infusion (of foreign aid) needs to be given to Zimbabwe and it needs to be given now," Fournier said.
The crisis is blamed on economic collapse linked to mismanagement and corruption under President Robert Mugabe's rule. Mugabe remains president under a new unity government. Manuel Lopez, head of MSF's Zimbabwe operations, said he feared international donors would be reluctant to pour funds into a government headed by Mugabe.
Lopez said it can take six months to get a response from immigration authorities to requests to bring in health care specialists, and visas and work permits cost "an incredible amount".
Importing medicines requires paying the government to test each batch, and the group has seen the cost rise from R500 to over R1 000 per batch for the cholera epidemic. "The situation has become very critical," Lopez said. "We cannot continue with this nonsense." - (Donna Bryson/Sapa-AP)
Cholera: nearly 70 000 infected