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The mobile doctors who have kept Aids at bay in a crumbling state
Riders for Health in Zimbabwe has become a model for Africa, but economic meltdown means that outside help is urgently needed
It comes as a shock to find that almost the only part of Zimbabwe’s
Government still functioning is the health system in the country’s remote,
deprived rural areas.
It functions so well, says Victor Nyamandi, a senior Health Ministry
official for the Makoni district 170 kilometres (105 miles) east of the
capital, Harare, that the monitoring system ensures that tuberculosis
medication is taken by every patient to whom it is prescribed.
Cholera has been kept away from the district’s 300,000 people, who live in
scattered villages connected by rutted tracks in the rolling landscape, for
seven years. They have not seen a case of measles for more than three years.
Measles immunisation days in any part of the district receive a 90 per cent
attendance. Even the white-robed, crook-wielding Vapostori (Apostolic) sect, whose religion abhors Western medicine, are having their children immunised.
“It’s undoubtedly the best health structure in Africa,” said the
paediatrician Greg Powell, chairman of the Zimbabwe Child Protection
Society. It was functioning in the bush far better than in the urban areas,
where hospitals have been overwhelmed by national infrastructural failure,
he added.
The system could not work without a highly mobile corps of dedicated health
workers who stay in constant contact with rural communities, using a fleet
of tough, reliable motorbikes. “Three quarters of the ministry’s vehicles
are managed by Riders for Health,” Mr Nyamandi said. “They are the key to
our success. We cannot do without them.”
Starting before independence in 1980, and accelerating dramatically
afterwards, health authorities created a unique and almost self-contained
system of primary preventive healthcare among the country’s unsophisticated
rural communities, which had been devastated regularly by disease.
