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Neglected health crisis on farms
PlusNews
May 13, 2009

http://www.plusnews.org/report.aspx?ReportID=84366

It is harvest time in Zimbabwe's northern Mashonaland Central Province, but the only thing growing on most of the farms around Bindura, the provincial capital, is tall grass.

"This area used to be the breadbasket of the region," said Zivei Kabungaidze, provincial coordinator of the Farm Orphan Support Trust (FOST), a local NGO that assists orphans and vulnerable children in farming communities. "Only about five out of 100 farms are still growing commercially."

A small percentage of farm workers received plots and most lost their jobs when formerly white-owned commercial farms were redistributed during President Robert Mugabe's fast-track land reform programme that began in 2000.

Those who have remained on the farms mainly survive by piece-work and gold panning, but living standards have plummeted and basic social services like farm schools and clinics no longer exist. "Life is very difficult in farm communities," said Kabungaidze, and HIV/AIDS is making the lives of the children FOST supports even harder.

At Umzi Farm outside Bindura, a few small plots of maize and vegetables grown by former farm workers and their families compete with the grass, but Maria Macuculi's* plot is completely overgrown.

Like many former farm workers allotted land, she cannot afford seed and fertiliser to cultivate it. These days, she also lacks the strength to carry water from the river about a kilometre away.

Macuculi, who like many former farm workers is originally from Mozambique, learned she was HIV positive after losing her husband to tuberculosis (TB) four years ago. She has been getting free antiretroviral drugs (ARVs) at a clinic in nearby Glendale for the past three years, but she often struggles to find food to take with them. "At times I go to bed without having any food, and then I don't take my ARVs."

The UN Children's Fund (UNICEF) helps local NGOs like FOST to support vulnerable farm children with school and medical fees, home visits by trained community members, and skills training for older children, but political violence in recent years has made NGOs and donors reluctant to venture onto resettled farms with much needed food aid.

"We've not been able to raise funding to provide food to our home-based care patients, and it is a problem for many of them to take medication when they don't have a balanced diet," said Godfrey Magaramombe, director of Farm Community Trust of Zimbabwe, another NGO funded by UNICEF.

Mercy Dimbi* has lived on Umzi farm since she was a girl, when her father started working there. She and her daughter, Esther*, 9, have been on ARVs since 2002, but Esther still has continuous headaches and bouts of flu, and Dimbi looks weak and undernourished.

She has attended some of the FOST training on livelihood development but does not have the strength to work the land, so she knits jerseys for her neighbours in exchange for maize and sends her daughter, 14, to look for firewood to sell. None of her three children and one grandchild is in school.

A national farm health programme run by the Ministry of Health and Child Welfare used to train community members to provide basic health services, but it stopped when the land reform programme began and most farm clinics closed. "Many people don't have money for public transport to travel to hospitals," said Magaramombe, whose organisation is among several NGOs trying to fill the gap by training their own community health workers.

Esther, also a resident of Umzi Farm, is the second wife of former farm worker Antonio Fanuel, who has TB. He says he was tested for HIV but never learned the result because he could not afford to return to the hospital. Esther is underweight and suffers from chest pains, while her 18-month-old child has diarrhoea, but she has no money to go to the hospital for TB or HIV tests.

"The Farm Health Programme is one of those services that must come back to life, especially with everything that happened during the land reform programme," said Dr Henry Madzorera, a member of the former opposition Movement for Democratic Change and health minister in Zimbabwe's new unity government.

In the short term, the ministry plans to use mobile clinics and village health workers to provide farm communities with basic health services and health education but, eventually, said Madzorera, "We must have a clinic within a five kilometre radius of every settlement."

*Not their real names

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