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Bartering for Health: Zimbabwe's Desperate Deterioration

Zimbabwe's poor are now bartering food for medical services

Long plagued by crippling debt, astronomical inflation, famine, and a collapsed economy, Zimbabwe, once one of Africa's wealthiest countries and a net exporter of foods, minerals, and numerous goods, is now among its poorest.

Most observers and Zimbabweans, if they didn't fear reprisal for saying so, would place the blame for the deterioration squarely on the country's despotic president, Robert Mugabe, who has held on to power since he helped lead the country to independence from Britain in 1980. Among Africa's wealthiest men, with untold millions stashed away in Swiss bank accounts, Mugabe not only has siphoned off much of the country's vast wealth from diamonds and gold, while threatening opponents and critics, but has also, for decades now, held the nation hostage to his own well-documented psychosis.

So desperate was the U.N. and world community for Mugabe to stand down, recent revelations by WikiLeaks make clear, that Kofi Annan himself, then U.N. Secretary General, is reported to have offered Mugabe "a lucrative retirement package in an overseas haven if he stood down as Zimbabwe's president." The extraordinary offer apparently was made to give Mugabe an incentive to exit the political stage voluntarily, perhaps on the assumption that he retained some concern about his legacy. But Mugabe apparently turned down the offer a day later, and now, with elections looming next month and, with them, the near-certainty of more widespread electoral fraud, he is running for yet another term.

The news of bartering with such lucrative offers, with one who has already stolen so much from his people, comes amid a report in the New York Times two days ago that a hospital not far from Harare, the nation's capital, has turned to bartering medical treatment for goats, sheep, sunflower seeds, and even peanuts, as its patients have so little cash on hand.

The Times article, "Zimbabwe's Poor Barter Goods for Health Care," comes six years after a similar report in the same newspaper, "With Health System in Tatters, Zimbabwe Stands Defenseless," which detailed the plight of another poorly stocked Zimbabwean hospital that was trying to fight an outbreak of cholera without even bleach or salt.

"Only a decade ago," Michael Wines reported in 2004, "Zimbabwe's public health system was, with South Africa's, head and shoulders above those of most of the 40-odd other nations of sub-Saharan Africa. But in a weeklong trip through eastern and central Zimbabwe, both to cities and to remote towns like Binga [housing the hospital in question], it was apparent that health care--like the rest of Zimbabwe's economic and social fabric--is dissolving."

"Three years of economic free fall and inflation, now averaging 620 percent a year, have left Zimbabwe desperately short of even basic drugs and medical equipment, pushing a once robust network of hospitals and hundreds of rural clinics close to ruin."

Reporting two days ago on the other Zimbabwean hospital (in Chidamoyo), Celia Dugger gave an even-bleaker update to the already desperate situation: "The hospital, along with countless Zimbabweans, turned to barter in earnest in 2008 when inflation peaked at what the International Monetary Fund estimates was an astonishing 500 billion percent, wiping out life savings, making even trillion-dollar notes worthless and propelling the health and education systems into a vertiginous collapse."

When Zimbabwe replaced its currency with the U.S. dollar, inflation fell from the stratosphere, but dollars are now so scare there, including because Mugabe has had to make a large repayment to the IMF that the country could ill-afford, that bartering has replaced currency transactions among many of the nation's poorest.

Adds Dugger, "A recent United Nations report suggests how far Zimbabwe has to go. It is still poorer than any of the 183 countries the United Nations has income data for. It is also one of only three countries in the world to be worse off now on combined measures of health, education and income than it was 40 years ago, the United Nations found."

If this seems like a tale of inevitability, think again. In 1988, when I taught for a year in Zimbabwe, one of a large network of teachers, engineers, nurses, and doctors who were proud to contribute to the newly independent country, the prosperous nation boasted an excellent infrastructure, with light industry, mines, extensive tourism, and productive farms that exported food across the continent. The country was also (amazing to recall) a political example to its southern neighbor, South Africa, which was still under apartheid rule, with Nelson Mandela also in prison. Back then, Zimbabwe was dedicated to spending a third of its GDP on improving its schools, with a national press also established to print and distribute textbooks to as many city and rural schools as possible.

The upswing in the country's fortunes was impressive and infectious. Seven of my best A-level students went on to study at the University of Zimbabwe, then a thriving institution, if one already critical of the president for his refusal to permit a third candidate to run against him. Mugabe's response to the university's dissent was to close it, expelling literally every student, before encouraging those to reapply who could bring themselves to promise allegiance to his increasingly draconian policies.

Still, as tempting as it is to lay all of the blame for Zimbabwe's collapse at Mugabe's door, another key reason for the country's rapid deterioration is the brutal sanctions that Western economies and the U.N. have inflicted on the country. Supposedly targeting only corrupt elements within ZANU-PF, the country's leading political party, with a view to squeezing Mugabe out of power, the sanctions have instead made the economy implode while Mugabe is still firmly in office. As Tawanda Hondora editorialized on last year, "Zimbabwe's economic woes are the direct result of a concerted and systematic campaign to effect regime change through an economic implosion."

"That Mugabe is an evil, brutal dictator that needs to be removed from office is not in doubt," Hondora continued, after going into considerable detail about what the sanctions are supposed to accomplish and how they are in fact hurting the innocent. "It is however immoral to cause the removal of Mugabe from office by precipitating the collapse of a developing, only recently independent, now famine-ravished African country through an economic sanctions regime."

"The US introduced economic sanctions on Zimbabwe through the Zimbabwe Democracy and Economic Recovery Act, 2001 (ZIDERA)," she reminds us. "Through this enactment Zimbabwe's access to finance and credit facilities was effectively incinerated. . . . At the stroke of a pen, Zimbabwe's access to international credit markets was blocked. And relying purely on barter trade, and trade, mining, agricultural concessions, and on exports-generated foreign currency, Zimbabwe's economy has been slowly but surely asphyxiated."

"It is apparent," she adds, that "some of the most powerful countries in the world have put in place measures to bring about the downfall of Mr. Mugabe by orchestrating the economic collapse of Zimbabwe. [But] it is wrong to conflate Zimbabwe with the personality of Mugabe. They are two distinct entities. It [also] cannot be right to say that economic support will be provided to the country once its leader is out of power. . . . No matter how evil a dictator Mugabe is, it cannot be right to force his downfall by killing off the country's fledgling economy, by erasing the gains made after 1980, and worsening the AIDS and unemployment crisis."

Reluctantly, given Mugabe's appalling record, I have to agree. Although the sanctions were obviously well-intended, they have not been as precise and targeted as many would like to believe. They have instead caused the country's economy to implode, with the result, as we've seen from recent reports, that the poor in Zimbabwe are now forced to barter their livelihood--sheep, goats, and food for their families--if they're to receive medical treatment, including for emergencies.

I personally abhor what Mugabe has done to Zimbabwe and would like to see him put on trial at the Hague for his gross abuse of human rights. But it can't be right to make a once-prosperous nation suffer in this way, on the clearly mistaken notion that it will convince a megalomaniac to release his stranglehold on the country. "Is it not true," asks Hondora, "that an economically independent people are much more likely to vote or rebel against a brutal dictator?"

The question could of course be asked with Cuba, North Korea, and several other countries in mind. It's a question, however, that poses considerable urgency for Zimbabwe and its people, who are desperate for change but still, years after fighting for their independence, living beholden to a tyrant.

December 25 election update: "Fears Growing of Mugabe's Iron Grip over Zimbabwe."

Christopher Lane, Ph.D., teaches literature and intellectual history at Northwestern University and is the author of Shyness: How Normal Behavior Became a Sickness. more...

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