Zimbabwe: Surviving COVID-19
As of 15th April, there were 18 confirmed cases of COVID-19 (coronavirus) and three deaths in Zimbabwe. But there is little doubt that the impending situation in the country is serious, and the government is unable to respond. Ian Scoones, Professorial Fellow at the Institute of Development Studies at the University of Sussex, explains that when thinking about COVID-19 in Zimbabwe, and in Africa more broadly, three dimensions are important – fragility, resilience and inequality.
The conditions for rapid spread of COVID-19, certainly in townships in urban centres, are all there – crowded housing, poor sanitation, lack of water, immune-compromised populations due to HIV and lack of services. For pandemic preparedness planners, this is a recipe for a major disaster.
As people get sick, the ability of the health services to respond is seriously limited. The one infectious disease hospital (Wilkins in Harare) has limited capacity, and apparently no intensive-care ventilation facilities. There are supposedly only 16 ventilator machines in the country. The medical profession is disillusioned and under-paid, and has recently been on a long strike. Many well-qualified doctors have left the country.
State neglect of the health service has been long-running. In the past years it has got worse, and the public system has nearly collapsed. Private providers offer good services to the rich who can pay, but this is limited. And they are not geared up for a public health emergency.
While the Zimbabwean state is clearly highly fragile, there are other aspects of the Zimbabwe setting that give hope. Resilience – the ability to respond to and bounce back from shocks, even transforming the situation along the way – is built by people in networks, embedded in social relations, with values and commitments that go beyond narrow individualism. We see a lot of these characteristics in Zimbabwe.
Over 20 years of economic and political chaos has ensured that food is supplied through informal means, across multiple social networks. If there is nothing in the shops or no fuel at the pumps, then look elsewhere, ring someone up, find an alternative. It is these capacities that are essential for surviving in a pandemic.
The painful lessons of the HIV/AIDS pandemic are imprinted on Zimbabwe’s consciousness: first it was a blame game and then everyone realised this was affecting everyone. Leadership from the health minister, the commitment of front-line health workers and community changes in behaviour turned the tide, and Zimbabwe was one of the first in the region to show declines in the disease. These lessons will be important now; just as in West Africa where the lessons from Ebola will be vital.
Even in the UK, so subsumed in an individualistic culture for generations, the importance of community, connection and solidarity are being rediscovered through ‘mutual aid’ groups. This will be much easier in Zimbabwe and, in the absent of a caring or competent state, will be essential.
While at one level it’s true that viruses respect no borders and affect all people, the consequences are very unevenly felt. Some of this is to do with biology – it is the elderly, for example, who seem to get the worst symptoms – but a lot is to do with deep structural inequalities. Crowded townships (for black African workers), distant from places of work and the suburbs originally reserved for whites, require daily travel on crowded transport networks. This is the perfect setting for contagion. Add to this the crowded nature of such ‘high-density’ townships, and the decline in services, mean that ‘social-distancing’ is impossible. Meanwhile, the edicts of ‘hand-washing’, good hygiene and healthy food are impossible to follow if tap water doesn’t run, people share boreholes and poverty restricts what food can be bought.
It’s probably those in the rural areas who are the most resilient in the face of the COVID-19 crisis. Having food to eat or sell, and solid local networks to draw on, with limited expectations of the state anyway, many have successfully ridden out the roller-coaster ride that has been the Zimbabwean economy.
Of course, as people become very critically ill, this is outside anyone’s ability to respond – and in Zimbabwe this includes the whole health system – so this is why enhancing the ability to stop the spread and building resilience is the essential challenge of the moment. As winter approaches, there is probably very little time.
To read Ian’s complete blog, see Surviving COVID-19: Fragility, Resilience and Inequality in Zimbabwe. Researchers from the Institute for Poverty, Land and Agrarian Studies in South Africa have also recently published a summary of the impacts of the COVID-19 lockdown on poor people’s access to food, and on the formal food economy in the country: Food in the Time of the Coronavirus: Why we Should be Very Very Afraid.