Rising child malnutrition signals impact of poverty/AIDS

As food prices continue to escalate in Zimbabwe, the number of children suffering from severe malnutrition has increased in suburbs around the capital, Harare, according to aid workers. But they do not rule out that the spike could be linked to HIV/AIDS, in a country with one of the worst prevalence rates in the world. New Hope Zimbabwe (NHZ), a local NGO providing community assistance, said it recorded 50 cases of severe malnutrition every week in Epworth, one of the capital's poorest suburbs. In Dzivarasekwa and Highfields, townships within a 20km radius of Harare, it was seeing 20 to 30 cases every week. "Epworth has the worst cases in Zimbabwe, as most of the poor live in that area. It was also the worst hit by Operation Murambatsvina ['Drive out Filth']. Most of the people's livelihoods were destroyed - people are now out of work and their small businesses are now deemed illegal, and parents are dying from HIV/AIDS," said Pastor Elfas Zadzagomo, NHZ executive director. The Zimbabwean government said the operation was aimed at clearing slums and flushing out criminals, but left more than 700,000 people homeless or without a livelihood in the winter of 2005. National malnutrition statistics are hard to access in Zimbabwe. But according to the UN Children's Fund (UNICEF), there is a strong association between severe malnutrition and HIV/AIDS; around 70 percent of children admitted to hospital for severe malnutrition in Zimbabwe are also HIV positive. Life is tough for an HIV-positive baby in Zimbabwe's poor suburbs, and often short: parents do not have enough food; hospitals do not have a reliable supply of antiretroviral (ARV) drugs. With inflation at 913 percent, people are being squeezed by steeply rising prices for everyday essentials and shortages of medication, including the ARVs that help keep AIDS at bay. Last week the official Herald newspaper reported that the parastatal National Pharmaceutical Company (Natpharm), which supplies drugs to all state-run hospitals and clinics, had less than a month's supply of ARVs in stock because of the lack of foreign currency to purchase them. Charles Mwaramba, acting managing director of Natpharm, told a parliamentary portfolio committee on health and child welfare that the Reserve Bank of Zimbabwe (RBZ) had allocated just US$106,000 to the company between January and March, against a required $7.4 million. Joyce Magunda, an Epworth resident in her thirties with a two-week-old baby girl and three other children, was among the thousands affected by Murambatsvina. Before the campaign she worked at a crèche in the city. Now unemployed, she has been struggling to rebuild her home and her life, and relies on the vegetable patch outside her wood and corrugated iron shack to feed her family. A frail and careworn Magunda said she did not have enough breast milk for the infant and fed her maizemeal porridge - totally inappropriate for a baby - at regular intervals. "At least she sleeps then and does not cry of hunger all the time." According NHZ, most of Harare's street children come from Epworth. Aid workers said poverty and the loss of parents were forcing them to seek refuge in urban streets. On the outer limits of Epworth, Dolly and Tony Maulana, a poor farming couple in their fifties, are attempting to stem the flow of children to the streets of Harare by giving them a shot at education and food. The couple, with a few years of primary schooling between them and 10 children of their own to support, pooled their meagre resources to build a three-room school out of mud, cement and bricks in 2002. "Our children should stay here. Our people are poor, they do not have money for the school fees and they do not have enough to feed the children, but we must have our children with us and not let them starve in the city," said Tony Maulana. The centre provides free primary education and some senior schooling to 1,400 children. They also grow maize and vegetables, which they share with the school children, 11 volunteer teachers from the community and their neighbours. "The children do not have enough food - there are many orphans with nothing to eat; we are seeing our neighbours go without food, so we help," said Dolly Maulana. NHZ is trying to source funds to start a nutrition programme at the school. Children's agencies like UNICEF advocate community-based therapeutic care in a programme that treats severely malnourished children in their homes, as part of a larger programme to help vulnerable neighborhoods. However, UNICEF has been unable to raise even 30 percent of the required funding of about $900,000, spread over a period of two years, which would help it implement this critical programme in pre-designated rural areas of Zimbabwe and key urban districts. According to UNICEF's Representative in Zimbabwe, Dr Festo Kavishe, "Community-based nutrition care programmes are the logical way forward, treating children with severe malnutrition at an earlier stage before complications occur. With Zimbabwe's high rates of HIV, rising orphan numbers and growing stress on the family and health systems, I cannot understand why such a good proposal remains so desperately underfunded." The government accuses Western donors of applying "sanctions" on Zimbabwe over its land redistribution programme launched in 2000, in which commercial farms were seized, often violently, by supporters of the ruling party.