http://www.pambazuka.org/images/articles/370/48047zim.jpg Zimbabwe Association of Doctors for Human Rights issued this statement concerning escalating cases of organised violence and torture, and the intimidation of medical personnel.

Since the last report on the 25th of April, our members have reported a dramatic escalation in incidents of organised violence and torture with the number of victims documented in the post election period now standing at over 900. This figure grossly underestimates the number of victims presenting countrywide as the violence is now on such a scale that it is impossible to properly document all cases. There have been 22 confirmed deaths but at least double that number have been reported but are yet to be confirmed. It is alleged that some of those killed have been buried on the orders of state agents before documentation can take place.

There has been a dramatic increase in violence since the beginning of May. In the last 24 hours alone, 30 victims of violence have been treated for limb fractures in Harare hospitals and clinics and supplies of Plaster of Paris bandages are reported to be exhausted in most health centres.

One hospital in Harare has treated an average of 23 victims a day over the last week. On the 8th of May, there were a total 53 more seriously injured patients (13 females and 40 males) admitted to wards in 3 Harare hospitals. These included one 30 year old man on life support in the intensive care unit with severe, irreversible head injuries and a 30 year old man with severe soft tissue injuries to the buttocks and secondary renal failure, also on life support. Both of these patients died later that day. Also admitted was a 3yr old boy with trauma to his R eye from being struck with a rock and a 78 year old man with a fractured lower leg from blunt trauma. One young breast-feeding mother had bilateral fractures of her hands and was unable to hold her baby to feed her. Among the other patients, 20 had defensive, forearm or hand fractures, 5 had leg fractures and 1 fractured ribs. Fourteen patients had severe injuries to the buttocks from blunt trauma which required surgery for the removal of necrotic (dead) tissue. The perpetrators in all cases were alleged by the victims to be war veterans and Zanu PF supporters. Similar patterns of injuries are being reported from other hospitals.

As emphasised in the previous ZADHR reports, the cases documented by our members represent only a fraction of the total number countrywide. ZADHR is concerned that many victims of current violence are not receiving treatment. Numerous incidents of violence are being reported from remote rural areas where there is no access to transport and there are also widespread reports of the injured being denied treatment at health centres where staff have been intimidated and/or are acting under specific instructions from state agents not to treat victims of violence. It was reported from one district (Headlands) that medical care was being provided only if the victim had a letter from the police authorising this. Accounts have also been received of ambulances, sent to collect seriously injured victims, being turned away by war veterans. Under these circumstances, it is likely that many of those with less severe injuries are not seeking medical attention. This seems to be confirmed by increasing reports of victims presenting with complications such as wound infections or infected haematomas which are directly attributable to delayed treatment.

Doctors and nursing staff at rural hospitals are working under conditions of severe stress and many health workers have reported intimidation with some having been specifically instructed by state agents not to treat opposition supporters. These health workers, who, according to some reports are treating up to 60 victims of torture and violence a day, are emotionally traumatised and depressed. One nursing sister treating victims in a rural clinic was observed to be shaking so violently with fear that she was unable to write.

Government spokespersons have repeatedly claimed that they have not received reports of violence or of deaths from the police. However, there is evidence that the police themselves are being intimidated. ZADHR has eyewitness statements that on the 24th of April, at Mayo Police Station in Headlands District, a high-ranking police officer from Harare physically assaulted the Member in Charge, accusing him of being sympathetic to the opposition. The police post had been taking statements from victims and referring them for medical treatment. The Member in Charge was summarily transferred out of the district.

The current pattern of organized torture and violence being perpetrated by state agents in the rural areas of Zimbabwe is similar to that documented prior to the 2002 elections. However, the current violence is dramatically more intensive and unrestrained. The level of brutality and callousness exhibited by the perpetrators is unprecedented and the vicious and cowardly attacks by so called war veterans on women, children and the elderly shames the memory of all true heroes of the liberation struggle.

It has been clearly documented that much of the violence has been specifically directed against members of the opposition party, particularly those who acted as election agents or monitors in the recent elections. Villagers and school teachers from districts where the opposition predominated in the elections have also been targeted even though they have no political affiliations. Without exception, victims treated by our members have identified the perpetrators either as war veterans, armed security force members or Zanu PF youth militia or varying combinations of the three. The few acts of violence attributable to opposition members appear to have been retaliatory or defensive. It is clear from the widespread and coordinated nature of the violence and the consistent pattern of injuries inflicted, that state agents including elements of the security forces are organizing and directing this campaign of terror.

It is now obvious that the intent of the campaign is to secure victory for President Robert Mugabe in a run off election. As in the 2002 election, it may be anticipated that the violence will be halted just prior to the arrival of international election monitors, to create the illusion of a peaceful and fair election, although state agents will maintain an intimadatory presence throughout the rural areas.

ZADHR again appeals for the immediate cessation of acts of violence and for the restoration of the rule of law in Zimbabwe. To this end it calls for:

1) the immediate, large- scale deployment of teams of SADC and other credible international observers to all districts where violence is being reported.

2) attested members of the Zimbabwe Republic Police to assume sole responsibility for the enforcement of law and order, and for the protection of the law be extended to all Zimbabweans irrespective of political affiliation.

3) the immediate withdrawal of all military personnel, both regular and irregular to barracks and the arrest of those war veterans and those posing as war veterans who are instigating violence.

4) the withdrawal of uniforms and arms from all irregular police and army militia not formally attested into the service and not entitled under law to bear arms.

5) the postponement of all run off election activities until the above conditions have been achieved.

Finally, ZADHR again appeals to the international community of health workers, including the Zimbabwe Ministry of Health and Child Welfare and the Zimbabwe Medical Association to bring whatever effective pressure is within their capability to bear on the Government of Zimbabwe to stop these grotesque, cruel and shameful acts of violence, and to be prepared to actively defend their colleagues facing intimidation and physical threat.

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http://www.pambazuka.org/images/articles/365/47598beat.jpgFurther to the two statements ZADHR issued last week we report a further 81 cases of organised violence and torture which have been seen and treated by members of the Association in the three days ending Monday 21 April 2008. This is not a cumulative total – this is the number of cases seen in these 3 days alone. The total number of cases seen since 1 April 2008 is 323. It seems likely that there are substantial numbers of similar cases occurring across the country which have not presented to ZADHR members and are therefore not represented in these figures.

54 of these cases occurred in Harare, Chitungwiza or Epworth, 20 in Glen View alone. 13 more occurred in Mudzi and Murewa, 4 in Mount Darwin, and 6 in different areas of Manicaland.

By far the commonest alleged perpetrators are now the uniformed forces (ZRP and ZNA).

Fourteen (17%) of these 81 patients were women. They include a 7 year old girl who suffered a fracture of her right radius and ulna on falling down while running after her father who was being chased by members of the security forces, and a 10 year old boy with a probable dislocation of the right elbow resulting from being kicked by a soldier who was trying to kick someone else. One 47 year old woman reported being sexually assaulted.

Soft tissue injuries again predominate, with 6 probable fractures. These include the case of a 39 year old man who was abducted from his home at midnight, was beaten and suffered a fractured left ulna, fractured ribs on the left side, and a pneumothorax underlying the rib fractures. A pneumothorax is when air leaks out of the lung through a hole in the lining of the lung, caused for example by a broken rib, and collects in the virtual space between the linings of the lung and the inner surface of the chest wall. It can rapidly threaten life because it may enlarge and cause collapse of the lung itself and distortion of the large blood vessels arising from and draining into the heart. This patient required a tube to be inserted into his chest to prevent that complication.

4 cases of falanga were recorded. Falanga is torture in which the soles of the feet are repeatedly beaten with a hard object such as a baton or bar. There is often severe tissue damage beneath the skin, within the sole of the foot, which never fully heals, resulting in walking being painful for the rest of the victim’s life.

Physical injuries are the most visible. Many of these patients report extreme psychological stress which itself results in both mental and physical symptoms. The stresses reported include many having had their homes and property completely burnt, being forced to roll in muddy or sewage-containing water, running and hiding in ‘the bush’ from fear of assault, being abducted and detained with beatings continuing over several days with no knowledge of when it will end, and having no knowledge of the safety of spouse or children. One 64 year old man presented with full-blown ‘Post-Traumatic Stress Disorder’, the major manifestation of which was his being incapable of speech.

Some of the reported physical and psychological wounds will take a long time and require much care and attention to heal.

 ZADHR condemns the continuing violent assault and torture on Zimbabwean citizens, in particular that allegedly perpetrated by security forces. We continue to appeal to the UN, AU and SADC to engage with the authorities to bring an end to this systematic assault on large numbers of Zimbabweans.

ZADHR further appeals to the Zimbabwe Medical Association, the World Medical Association and other concerned national medical associations to condemn these acts of violence, and engage their Governments in working towards resolution of the crisis in Zimbabwe.

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Statement on World Health Day

The Zimbabwe Association of Doctors for Human Rights calls to attention the state of the public health system. Zimbabwe?s healthcare system, in a known state of crisis, is in need of urgent attention. It is crippled by dilapidated infrastructure, drug shortages, equipment breakdowns, brain drain and costs of healthcare skyrocketing beyond the reach of the majority of Zimbabweans.

Average life expectancy, according to the WHO, has declined from 60 years to 37 years for men and 34 for women during the past decade. Maternal mortality is rising to a level which meets that of the world poorest countries.

ZADHR commends health professionals and health workers in Zimbabwe who have continued to deliver health services in very difficult circumstances and remain committed to the recovery and improvement of the public health system.

ZADHR notes the need for a comprehensive national health plan to replace some of the uncoordinated ad hoc measures that have been put in place to address the crisis in the short term. Such a plan must guarantee that Zimbabwean?s are able to enjoy their right to health. The responsibility for this lies with government in consultation with other stakeholders.

Marking World Health Day, ZADHR calls upon the newly elected Parliament of Zimbabwe, amidst a myriad of challenges ahead of it during its term in office, to prioritise policy interventions to address the public health crisis in Zimbabwe. In doing so ZADHR urges the new Parliament to attend to the following key areas:

- Formulating legislation that protects, respects and fulfils the right to health for all Zimbabweans.

- Providing adequate infrastructure needed for effective and equitable healthcare such as safe running water, adequate sanitation, electricity and transport.

- Taking measures to address shortages of drugs and medical equipment in the short, medium and long term.

- Creating conditions under which good training quality for health professionals is guaranteed and ensure that conditions in which these skills can be retained exist.

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