Celebrating achievements by women in politics


Women in politics in Zimbabwe this week have two major reasons to celebrate; Vice President Joice Mujuru earned her PhD in Philosophy and Senator Sekai Holland assumed the position of Interim party President of the MDC Renewal team.

Although Mai Mujuru is not the first woman in Zimbabwe or in her political party, to earn her PhD, she has shown that with hard work and perseverance a woman can do anything she puts her mind while standing up to patriarchy, something she has been doing for the past 30 odd years. Joice Mujuru has many accolades to her name, a legitimate Liberation War veteran, one of the first women commanders in the ZANLA forces, the youngest cabinet minister in Zimbabwe’s first cabinet, taking the portfolio of Sports, Youth and Recreation, the first female Vice President, and now she can add Doctor to her name.

She graduated with a Doctor of Philosophy degree at the 59th University of Zimbabwe graduation ceremony on September 12, 2014. Mai Mujuru received her undergraduate degree from the Women’s University in Africa as well as a Masters in Strategic Management. She also graduated with a Masters Degree in Entrepreneurial Development from Chinhoyi University of Technology. Mai Mujuru said ‘this should inspire my children and other women to pursue education and empower themselves. It was not easy going to school after independence but I persevered. I am a grandmother, a widow and occupy the second office from the first. I have enormous responsibilities but I worked hard.”

On the other side of the political spectrum Senator Sekai Holland has become the Interim party President of the MDC renewal team. In her statement, released on September 16, Senator Holland said she assumes this position because MDC T has failed to live up to its constitutional principles and ‘violence as a means of control and oppression remains a central feature of the Party with accusations never investigated properly that it emanates from the president’s office.’ She says as a torture survivor she cannot continue to be associated with a party that has made no serious effort to eradicate violence and has failed to institute mechanisms to deal with this, especially where thousands of members have been victims, including the president of the party himself.

Sekai Holland, in the same statement, stated that she is deeply embarrassed by the party’s silence on the president’s attitude and behavior towards women. Patriarchy is still very much alive regardless of all the strides that Zimbabwe has made to empower women in a bid to bring about gender equality. Our Constitution in section 80 (1) states every woman has equal dignity of the person with men and this includes equal opportunities in political, economic and social activities. Both Joice Mujuru and Sekai Holland have shown that success for women in their chosen field and in their own right is attainable and congratulations are in order.

This is an inspiration week for women in Zimbabwe, especially for women in politics, as the Women’s Trust said in their campaign ‘Women Can Do it!’

By
KudakwasheChitsike

The Succession debate reaches new lows.


So the debate over the appointment of Grace Mugabe reaches new constituencies. The National Council of Chiefs has now weighed in and has endorsed her candidacy. This once again reinforces the point made in RAU’s recent report on succession; that the national constitution and the ZANU PF constitution have become inextricably linked. But it raises also the more serious issue about what does the National Council of Chiefs, or least the President of the National council, think that he or they are doing here taking sides in an internal debate within ZANU PF, and, much more seriously, have they read the new constitution at all.

For those traditional leaders that might be in any doubt about how they should be approaching the succession problem, we invite them to consult the constitution, and particularly Section 281. It is very explicit about what they should actually be doing in respect of the succession debate and leadership in ZANU PF.

281       Principles to be observed by traditional leaders

(1)        Traditional leaders must—

(a)        act in accordance with this Constitution and the laws of Zimbabwe;

(b)        observe the customs pertaining to traditional leadership and exercise their functions for the purposes for which the institution of traditional leadership is recognised by this Constitution;  and

(c)         treat all persons within their areas equally and fairly.

(2)        Traditional leaders must not—

            (a)        be members of any political party or in any way participate in partisan politics;

            (b)        act in a partisan manner;

            (c)         further the interests of any political party or cause;  or

            (d)        violate the fundamental rights and freedoms of any person.

Our reading of Section 281 does not reveal any ambiguities in how the National Council of Chiefs should approach the problem: do not say anything, do not endorse anybody at all, let alone the First Lady, and, above all remember, that it is their duty to treat all persons within their areas equally and fairly.

In addition to the provisions of the new constitution is the Traditional Leaders Act [Chapter 29:11],  promulgated before the new constitution, but saying essentially the same things about the non-partisan nature of traditional leadership. Section 46(1) of the Traditional Leaders Act states clearly that in carrying out their duties the traditional leaders must not be “influenced by any considerations of race, tribe, place of origin, creed, gender or political affiliation”. And the duties of chiefs are equally clear in the Act:

  1. a) promoting and upholding cultural values among members of the community under his jurisdiction, particularly the preservation of the extended family and the promotion of traditional family life;
  2. b) carrying out the functions of a Chief in relation to provincial assemblies (see below);
  3. c) nominating persons for appointment as Headmen by the Minister;
  4. d) approving nominations by Headmen of Village Heads for appointment;
  5. e) supervising Headmen and Village Heads in the performance of their duties;
  6. f) discharging any functions conferred upon him in terms of the Customary Law and Local Courts Act;78
  7. g) overseeing the collection by village heads of levies, taxes, rates and charges payable in terms of the Rural District Councils Act;
  8. h) ensuring that Communal Land is allocated in accordance with the Communal Land Act79and to ensure that the requirements of any enactment in force for the use and occupation of communal or resettlement land are observed;
  9. i) maintaining up-to-date registers of names of villages and their inhabitants
  10. j) preventing any unauthorised settlement or use of any land;
  11. k) notifying the Rural District Council of any intended disposal of a homestead and the permanent departure of any inhabitant from his area, and, acting on the advice of the headman, to approve the settlement of any new settler in his area;
  12. l) adjudicating in and resolving disputes relating to land in his area;
  13. m) and ensuring that the land and its natural resources are used and exploited in terms of the law and, in particular, controlling:

(i) over-cultivation; and

(ii) over-grazing; and

(iii)the indiscriminate destruction of flora and fauna; and

(iv) illegal settlements

and generally preventing the degradation, abuse or misuse of land and natural resources in his area;

  1. n) ensuring that no public property, including roads and bridges, telephone and electricity lines, dip tanks and animal health centres, clinics, churches, cattle-sale pens, schools and related establishments, is damaged, destroyed or misused by the inhabitants or their livestock;
  2. o) notifying the Rural District Council for the area concerned, as soon as is reasonably practicable, of the outbreak of any epidemic or prevailing disease, flood or other natural or unnatural disaster affecting the inhabitants, livestock, crops, the land, flora or fauna in his area;
  3. p) liaising with and assisting development committees established in terms of the Rural District Councils Act in all matters relating to the planning and implementation of local development programmes; and
  4. q) under the direction of the District Administrator or the Rural District Council, as the case may be, assisting drought and famine relief agencies in coordinating relief and related matters in his area.

As can been, these duties are all important aspects of rural life, many of which can be the focus of disputes between citizens, and citizens living within the area of jurisdiction of a chief can have the expectation that dispute will be dealt with in a non-partisan and impartial fashion uninfluenced by any considerations of race, tribe, place of origin, creed, gender or political affiliation. So, the constitution and the Traditional Leaders Act are not in conflict, and traditional leaders need to take heed of both, and take the lead in constitutionalism for the sake of those for whom they are responsible.

From “guided democracy” to “guided succession”?


The debate at the SAPES Trust Policy Dialogue Forum on succession last night, 4th September 2014, offered an insight into why Zimbabwe lurches from crisis to crisis, and why the international community (and investors) is so chary about engaging the country. Derek Matyszak, talking about succession in the Presidency, both the national President and the president of ZANU PF, pointed out that the problem with the new (2013) constitution is that, by default, it imports the ZANU PF constitution into the solution for succession. And as he pointed out, and has argued in a detailed analysis, the problems inherent in the ZANU PF constitution may attenuate the crisis. But since “guided democracy” has always been the way in ZANU PF, perhaps we should worry less about what the ZANU PF constitution says, and try to look into the crystal ball about what exactly are Robert Mugabe’s intentions. Will he guide the succession or leave it to his afterlife?

Stephen Chan, by contrast, offers the “guided succession” view. He did point out how desperately serious is the interaction between succession (and political settlement) and the economic survival of Zimbabwe. He was at pains to point out that, in order for Zimbabwe to attract the critically needed financial assistance, investors and donors need both clarity about the political security of the nation and economic policies that will ensure stability and growth. These latter do not need a genius macro-economist to tell us what to do, and since the SAPES conference earlier this year, it is clear that all local economists, bankers, and business men know what needs to be done. Little happens because the succession problem just won’t go away, and the political governance of both the present and the future remains uncertain.

However, Chan has an optimistic solution: “guided succession”. Offering the view that Mugabe’s elevation to the senior posts in the AU and SADC is a plan by the wise men in Africa to offer Mugabe a graceful exit (no pun intended), and that succession will be a process not an event. Hence, Mugabe will be inveigled to hand over in two years’ time, leaving the party two years to prepare a candidate for the 2018 elections. The question of which candidate is argued to be largely irrelevant since ZANU PF will easily win this election due to the parlous state of the opposition parties.

In Chan’s view, therefore, the anomalies in the ZANU PF constitution and the potential constitutional crisis that could be produced were Mugabe to die, or be unable to carry out his office, are not important. The party will not fragment, but will produce a successor in some fashion.

However, from Matyszak’s perspective, and Zimbabwean citizens generally, will this succession be “lawful”: will the ZANU PF constitution have been followed? The point here is that we, the citizens of Zimbabwe, have had 34 years, during which constitutionalism has been increasingly abandoned, both because of guided democracy and also because it is frequently just too inconvenient, politically speaking, to adhere explicitly to the constitution and the law. This is one of the reasons why there is no foreign direct investment or donor support for balance of payments: no-one is certain that the rule of law will be followed, and surely the manner of succession can strongly reinforce the rule of law or continue to undermine it.

Thus, clarity about succession is critical to restoring confidence and trust in the government.

Firstly, will ZANU PF follow its own constitution in electing a successor for the presidency? And as a starter it would be nice if more than Derek Matyszak knew what was in that constitution, and citizens could be reassured that ZANU PF has some kind of commitment to constitutionalism by making plain to the country (and everyone else) how they go about electing their leadership in a constitutional manner. A constitution that seems a secret document is not a reassuring basis on which to develop trust, and the possibility of a constitutional crisis, which Derek Matyszak suggests can happen, is not a good advertisement for the future, and for present trust in the Zimbabwe government.

Secondly, whether we like the result of the 2013 elections or not, the fact is that ZANU PF will govern until 2018, and may very well, as Stephen Chan argues, win that election too. It does not seem impossible, therefore, for the party to publicly indicate how succession will take place if it is not going to follow the (sort-of) explicit provisions of their constitution. If they are going to give us “guided succession”, well just give it to us, and then one problem can be solved – the matter of political confidence – and we can move onto the more fundamental problem of restoring the economy and giving citizens their livelihoods back.

But, thirdly, perhaps the issue is really that which Priscilla Misihairabwi-Mushonga pointed out, and is inherent in the immense powers of the presidency. As she pointed out, whatever constitutions say, Robert Mugabe is his own man, keeps his own counsel, makes up his own mind, and this is wholly opaque. Succession depends on what Robert Mugabe wants, and he gives us no clues. Thus, no matter what the national constitution says, no matter what the ZANU PF constitution says, no matter what the wise men of the AU and SADC think, and no matter what the international community wants, we, the Zimbabwean citizenry, wait for him to decide, as he has always done.

But, and here’s a thought, and raised at SAPES by a young mathematician from UZ, why do we citizens always wait for the elites to decide, and what can we do to get clarity? Join ZANU PF and demand a copy of the ZANU PF constitution? Try to use the courts to see whether there is the possibility that we can force ZANU PF into internal constitutionalism? Since the ZANU PF constitution, courtesy of their “overwhelming” victory at the polls in 2013, now is tacitly incorporated into the national constitution, don’t citizens have right to know explicitly what will happen and who will take charge? Or will we just meander along from “guided democracy” to “guided succession” and back to “guided democracy”? And why even bother with elections, just create a dynasty!

Tony Reeler, Senior Researcher

#CSW58- MDG 8: Developing Global Partnership for Development


By Rumbidzai Dube

As the era of the MDGs draws to a close-(2000-2015) – one of the things that need paying attention to is; why did we fail to achieve the milestones? Why did Zimbabwe fall short on so many of the indicators? Central to these questions, is the issue of resources. This is because no policy, however brilliant, cannot be successfully implemented without the required financial and human resources. These resources can be attained where there is a clear fundraising strategy. Usually states fundraise through sustained economic growth in areas such as taxation, trade and consequently decreasing debt.

Zimbabwe has seen a steady growth of the GDP since 2009 recovering from the terrible 2007-2009 period of economic decline. However this growth has not translated into increased income in the home. External debt remains high, pegged at 113 % of the GDP. Overall availability of vital medicines has increased although there is low production of drugs, with CAPS-the leading pharmaceutical company- almost shutting down.  There is general improvement in access to cellular networks and internet with about 20% coverage. 65 in every 1000 people have access to a laptop. However the uptake of ICT’s remains largely centralised to the young and urban population. The lack of ICT legislation continues to hamper access.

What have we done well?

  • The Economic Recovery Programme implemented by former Finance Minister, Tendai Biti, emphasised economic and governance reforms which brought stability and recovery to the economy
  • Overall availability of vital medicines has remained stable because of the local production of drugs, enough to actually export some of the drugs.
  • Our creation and use of technology continues to improve; both mobile penetration and internet usage have significantly increased.
  • We are linked to both the Seacom and the EASSy undersea fibre optic cables, developments that have significantly improved our country’s internet connectivity.

What have we not done well?

  • We have no industry to talk of. Our manufacturing sector is still underproductive because of the many challenges it faces such as electricity load shedding and the liquidity crunch.
  • Domestic policy such as indigenisation and land reform, whose implementation is unclear continue to pose a threat to investment resulting in low foreign direct investment
  • Our proud and arrogant stance in our engagement with the international community continues to alienate possible allies in spearheading economic recovery.
  • The health sector still relies heavily on foreign funding, with our main donors being the Unites States, the European Commission, the United Kingdom and Australia. Our own government has not dedicated enough money to fund our health system.
  • We have not taken full advantage of our membership to regional integration initiatives such as COMESA, SADC and EU-ACP; for instance, we have not utilised the fact that SADC is a Free Trade Area which represents a large market to our goods and produce.
  • Although we are producing and exporting vital medicines, they are still expensive for the average person on the ground; as there is a leaning towards protecting the interests of the pharmaceuticals above those of the patients who are just ordinary citizens
  • We do not have an ICT policy to regulate the ICT industry resulting in stunted growth in that area.

What more can we do?

  • We need to re-engage the international community understanding that we live in a global village where we need allies and partners. Re-engagement should not mean begging, we do not need donations- we need good trade relations in which we bargain for the true value of our goods, both processed and raw.
  • We need an ICT policy to cater to the needs of a constantly changing technology landscape
  • We must learn lessons from the region. Rwanda is a good example, especially where the health system is concerned. In just 19 years Rwanda;
    •  increased its life expectancy from 28 years to 56 years;
    • decreased the size of its population living below the poverty line from 77.8% to 44.9%;
    • decreased child deaths from 18% to 6%;
    • increased the size of the population with health insurance from almost 0% to 90.6%;
    • maternal mortality dropped by 60%;
    • HIV,TB and Malaria deaths decreased by close to 80%;
    • The poorest pay nothing to access health care.

We have so much potential as a nation. We do not need aid! We have enough resources. If we deal with corruption, work to redistribute our resources equitably ad ensure that everyone, and not just the big fat-fatty cats continue to benefit, the challenge of failing to implement the MDG’s will cease to exist and be another old archive in the history books.

#CSW58 MDG 7: Ensure Environmental Sustainability


By Rumbidzai Dube

The environment is our most valued/priced natural asset because in it exist all the elements that make our lives what they are; air, water, sun, wind, rain, food among others. The conservation of the environment is hence a priority area as failure to conserve it could spell our demise or extinction. Yet, more often than not, the protection of the environment is relegated to the least of our priorities. Even at the global level, recognition that environmental protection is needed is there but the political will to do so is as good as non-existent. The big powers, whose greed and reckless quest to grow their economies is largely responsible for the rut we are in with climate change, refuse to take up responsibility in mitigating further damage and stopping further degradation by reducing their emissions and giving financial assistance to the countries affected by climate change already to adapt to the current climatic trends.

Yet in all this, the poor suffer more. How, one would ask; climate change affects the environment and in doing so poses the biggest human security threat to the poor and the vulnerable. The majority of our women in Zimbabwe live off the land, vana gogo vanorima (women farmers), vana tete vanochera mbambaira (sweet-potato harvesters), madzimai emusika anotengesa maveggie (vendors), makorokoza echidzimai (female gold panners) they all live off the land.

Climate change could bring either droughts or floods. Droughts will mean that the farmers, who depend on consistent and sufficient rains, will be affected. The failure of the rains to come means their failure to produce food (crop failure); which means there will be food insecurity, which will bring hunger, which in turn causes malnutrition. Poor yield means increased poverty and with poverty come health risks. Droughts also mean less water available, the less clean water we have available, the more our chances of being exposed to contaminated water which will result in the contraction of terrible diseases like cholera and typhoid, something that Zimbabwe has already experienced.

Climate change could also mean floods. As the experience of Zimbabwe with the Tokwe-Mukosi disaster illustrated, floods bring many issues: displacement, homelessness, food insecurity, disease, poverty and a general drawback to the development agenda.

Our main energy source in the rural areas, firewood comes from the land and results in the cutting down of trees, the very same forests we need to mitigate against climate change. But what other alternative do they have; gas is expensive, electricity is scarce-and although solar is readily available and can be successfully converted for cooking, it is slow and is hardly a favoured option in many households.

What have we done well?

  • Although in the SADC region, Botswana, Mauritius, Tanzania, Namibia, Zambia, Mozambique, Seychelles, Swaziland, Malawi and Lesotho are doing better than us, we are ranked number 100 in our carbon dioxide emissions. This makes us one of the lowest net emitters of greenhouse gases. One could argue that this is the case because we have no industry to talk about as most of our factories and plants have closed and are largely dysfunctional.
  • However, should we begin boosting our exiting efforts at adopting green energy, this could prove useful in maintaining our emissions really low and preserving our environment.
  • We are producing ethanol fuel which is home-grown and in the process creating jobs, developing our economy and preserving the environment.
  • We are improving our solar technology to reduce the use of wood in rural areas.

What have we not done well and how can we improve?

  • There is increased deforestation. This is because of the increased reliance on firewood for energy both in the rural and urban areas. With increasing power cuts, populations have turned to firewood for cooking. Until we address our energy deficit by increasing and improving electricity supply as well as exploring alternative energy sources such as gas, our forests will continue to deplete.
  • There is increased environmental degradation through veld-fires.
  • The existence of the Environmental Management Agency (EMA) in itself is a positive development. However, this government body is underfunded and is hence plagued by corruption. Anyone can pollute as long as they can pay some in the EMA.
  • There is increased poaching of wildlife in our national parks (especially in Hwange), and again this is being made possible by the rampant corruption in that sector. The lack of resources to patrol the parks makes poaching easier.
  • There is increased desecration of valuable environmental sites such as vleis, sanctuaries and wetlands. This cannot just be a case of ignorance of the need for environmental protection as most of the desecration is sanctioned by government. It is clear the problem is corruption; those who stand to benefit from the building of malls on wetlands or the allocation of residential stands on wetlands are the real culprits that need to be weeded out. (And I am glad that the ugly-Chinese-mall-built-on-the-wetland-is-cracking-up-proving-it-was-built-on-a-wetland).
  • Our water and sanitation situation is pathetic. The housing backlog and the overcrowding in urban areas does not help the situation either. And it must be pointed out that the housing problem is a man-made disaster, a consequence of the demolition of houses by government in Operation Murambatsvina in 2006 and the subsequent failure to replace those destroyed homes.
  • Climate change has begun to show its presence with seasonal changes and drastic changes to our weather patterns. The impact that this has on our environment and our food security is something that has little talked about. We need to increase dialogue around the meaning, cause, consequences and impact of climate change to improve our adaptation strategies.
  • We are destroying our conservancies (such as Save) all for the love of money. Are the diamonds not enough nhaimi?
  • We need to have more public-private partnerships on sustaining the environment. Most environmental degradation affects the public but is caused by corporates accessing resources be it minerals, land or forestry.
  • Above all, this goal needs us to do three things; the first is to deal with Corruption, the second is to deal with corruption and the third to deal with corruption. That green eyed monster called corruption that’s being passed off by those who practise it and being substituted with the s (for sanctions)-word which I dare not pronounce, needs to be dealt with effectively. Until and unless we do that, we are a doomed nation.

#CSW58 MDG 6: Combating HIV/AIDS, Malaria and other diseases


I saw a headline in one of yesterday’s papers which said: “MDC official succumbs to Malaria.” Yes, Malaria, as a disease only becomes topical when it kills a prominent individual. Outside such circumstances, the media pays it very little, if not, no attention. Yet malaria remains one of the biggest health problems our country has to deal with. Did you know that 50% of our population is at risk of Malaria? And, did you also know that 1 in 12 children die before their 5th birthday of Malaria? Do you now see why we must pay malaria as much attention as HIV/AIDS?

Another disease, well known and feared but with hardly any statistics to tell us what it is and how much it has affected our people is cancer. All we know is that the number of death certificates, with the cause of death written down as cancer, are dramatically increasing. Women are being diagnosed with breast and cervical cancer while the number of men with prostate cancer is also increasing. We have many cases of individuals seeking donations to have surgery done on growths in the stomach, jaws, throat abroad and a vast number are also succumbing to lung cancer. Costs of getting cancer treatment are steep, estimated at $500 per session and government no longer subsidises the patients because they says government has no funds.

Typhoid and Cholera are also killing many people. The annoying thing about the scourge of these diseases in Zimbabwe is that it was purely man-made. Yes, I said that! We brought cholera and typhoid unto ourselves through the failure of our government to provide us with clean water and ensure sanitation for its citizens. Meanwhile, the bosses at the municipal councils responsible for collecting our rubbish bins, repairing our sewer pipes and providing us with clean water were always whining that there was not enough money for it while they paid each other $35 000 salaries.

Tuberculosis is also killing many of our people. Fortunately, the drugs are available for free in our public hospitals so once diagnosed; an individual can be helped and healed. Although about 79% of the people treated of TB in 2011 also had HIV/AIDS, 21 % were just cases of TB-something that a lot of people have lost touch with; assuming that only HIV positive individuals can suffer from TB.

We have been doing well in our fight with HIV/AIDS. Infections reduced from 30% in 2000 to 15% in 2011. However it is worrying to note that HIV/AIDS affects more women than men as prevalence is 6% higher among women (18% prevalence) than men (12% prevalence). And so it is perplexing to understand why some people JUST don’t get what we mean when we speak of the feminisation of HIV/AIDS, or the need for addressing gender relations in ending HIV/AIDS. Can she negotiate for safe sex [with her HIV positive partner]? Can she say no to sex with her [HIV positive] husband? How many of the women will get HIV/AIDS from their [HIV positive] husband in that polygamous marriage? How many of the women will contract the disease from that serial rapist? And so the nature of the relationships [where women have less power] determines the risk [higher] of getting HIV/AIDS and reflects in the prevalence [higher among women].

What have we done well?

  • HIV/AIDS testing has significantly improved. It takes less time to get tested and the counselling services have improved.
  • The roll out of the Anti-Retro Viral Treatment (ART) has been largely successful, with free drugs being provided for patients in public hospitals.
  • The successful implementation of the Prevention of Mother to Child Transmission (PMTCT) has helped reduce new infections in children.
  • The availability of malaria and tuberculosis (TB) drugs for free in public hospitals has helped the fight against both diseases.

What have we not done?

  • We only have 2 public hospitals treating cancer – Mpilo Hospital in Bulawayo and Parirenyatwa in Harare.
  • These hospitals have very little in the form of radiation therapy equipment, drugs and manpower in the form of specialists.
  • We have not opened our eyes to the reality of the increase in cancer detections enough to take steps to prevent its outbreak.

What more can we do?

  • We need to allocate more funds to addressing all these diseases. Relying on external partners’ support is unreliable and risky and as proved by the withdrawal of funds by the Global Fund, the plug on such funds can be pulled off any minute. Government must adequately budget so that donor funds become surplus, not the core.
  • More focus needs to be paid to dealing with cancer as cancer deaths are on the increase. Further, awareness efforts on what causes cancer and how it can be cured need to be scaled up.
  • Above and beyond the policy and practice, we need to address our ethos as a people. The reality of the high HIV infections among women lies in unequal gender relations where women are unable to negotiate for safe sex. Without addressing these gender relations, women will remain vulnerable.
  • We must address corruption; Salary-gate is part of the reason why people died of cholera and typhoid. Those who sanctioned and those who took fat salaries home while some poor people drank infected and dirty water to their death bed have blood on their hands.

#CSW58-MDG 5: Promoting Maternal Health


By Rumbidzai Dube

When I reflect on the risk and sacrifices that women make in this world, it makes me wonder when, why and how it came to be that in many parts of the world, they are regarded as second class citizens. What am I saying?

According to the Zimbabwe Demographic Health Survey (ZDHS) of 2011, at least 10 women die every day due to pregnancy-related complications. Did you hear that, 10 women die every day while giving birth to children, some of them sons, who will then turn on their mothers, sisters, aunts, nieces and cousins and treat them as second class citizens. Isn’t that ironic?

Millennium Development Goal 5 is definitely one of the goals that Zimbabwe will not be able to meet. With maternal deaths estimated to be above 960 deaths for every 100 000 live births, the target of reducing maternal deaths by three quarters can remain an aspiration for now. Given that the 960 deaths are official statistics, which God knows how accurate they are, with the way our government is out of touch with the issues on the ground on so many levels, the rate is possibly even higher.

Let us assume for a minute that these statistics in fact are right, I am still perplexed by the worrying trend that factors such as education, class, location and age are no longer critical in determining who is affected. Uneducated and educated, poor and rich, rural and urban, and older and younger women are all dying in child birth. Clearly there are nuances to the problem and successfully dealing with maternal health needs exploring these. For instance, cases of celebrities who passed on in child birth, grabbed the headlines, raising the need for a more concerted effort into addressing the issue of maternal mortality.

What are some of these nuances?

  • We simply do not have enough trained health professionals to deal with the delivery of our babies. Our nurses left and we are not doing much to motivate those who remained behind to remain in our service and to be motivated at work.
  • The private health-care system has not been effectively regulated. Just in the past year I have had 2 friends and a relative who have had nasty encounters with private health practitioners. The first friend went to a reputable women’s health centre where she was told she had a growth in her uterus and needed to have her uterus cleaned. Fortunately for her, she chose not to do that and sought a second opinion. Guess what-the supposed ‘growth’ in her uterus was a baby. And to think these people have advanced machines for scans and all that other fancy stuff!!

Another friend elected to deliver her baby through a Caesarean and informed her gynaecologist of her choice. However, he kept pushing the dates for the performance of the Caesarean forward, in what she feared was an attempt to create complications in her delivery, leading to her increased stay in hospital and increased bill=more money for the doctor.

My other relative had had two babies, delivered through normal births without any complications. However for her third baby, the doctor dramatically chose to ‘induce’ her labour prematurely. She could not understand why he did so when her labour was not delayed and her pregnancy was advancing normally. Eventually she found out why when the bill came with a breakdown of:

  1. Costs for inducing labour
  2. Costs for delivering the baby
  3. Costs for doing the ‘stitches’ on the mother
  4. Costs of medication to clean the wounds

She also complained that the same doctor had developed a reputation of forcing women whose babies he delivered to have more ‘stitches’  or proclaim non-existent complications requiring caesarean delivery because doing so meant he would charge more for sewing them back together and performing the surgery. It seems the love for money far exceeds the observance of medical ethics these days.

What have we done well?

  • Our implementation of the Prevention of Mother to Child Transmission programme (PMTCT) has significantly reduced cases of HIV/AIDS infections in children at birth. HIV testing has improved and the responsibility lies with the mothers to choose life for their children.
  • The adoption of the National Campaign to Accelerate the Reduction of Maternal Mortality (NCARMM) directly corresponding with the African Union (AU) Campaign on the Accelerated Reduction of Maternal Mortality in Africa in itself is an important development as it affirms government’s recognition that maternal mortality is a serious problem that needs addressing.

What have we not done well?

Government admits that most maternal deaths are a result of time taken to seek healthcare because of ignorance or lack of funds to pay for hospital care; time needed to reach a healthcare because hospitals are too far and there is no easily accessible transport to and from the health facility or the cost to do so is high and unaffordable and time taken to access care at the health facility-where there is generally an air of neglect of women in health-care facilities by highly unmotivated nurses.

Generally health services are inaccessible particularly in rural areas where hospitals and clinics are not within easy reach and the transport networks to the major clinics and hospitals are not easily accessible. Increasingly, the service in hospitals, particularly public/government hospitals, has deteriorated and has become poor. Pregnant women suffer neglect in hospitals resulting in some avoidable losses and deaths. Socio-economic challenges, related with the current economic environment significantly impact women’s access to medical services as they cannot afford to pay the user fees. There has been reduced uptake of contraception for inexplicable reasons.

What more can we do?

  • We need to adequately fund all our health institutions. Although a government policy stating that women should not pay user fees exists, it is impractical. If clinics do not make women pay, then they will not have the gloves, medication and swabs to attend to the women at child birth. Until and unless government adequately funds these facilities then the assertions that user fees have been scrapped will remain what they are; mere rhetoric!!
  • We must address religious and traditional practices that deny women access to medical facilities or that delay until patients are in critical condition. Zvitsidzo (Apostolic sects’ version of maternal wards), located in bushes in the middle of nowhere, secretive and denying access to the public, are an example of how maternal care is being compromised. Because of the veil of secrecy that these sects throw over these spaces, it is not clear how many women actually die and whether there are any complications that women have to live with for the rest of their lives for failing to give birth in certified maternal health care facilities.
  • We must maintain our reliable supply of contraception BUT we must find out, through comprehensive research, why there is reduced uptake of contraceptives.
  • We must take measures to motivate our nurses to do their jobs effectively. Without the necessary incentives, women will continue to lose their lives in avoidable circumstances.