‘It’s Like War’

Mugabe has expressed a great deal of anger at foreign officials, saying they ' re exploiting the crisis for political gains. Are you on the receiving end of any of that anger?
Doctors Without Borders has a humanitarian, [non-political] mandate to help people in desperate medical need. But to speak honestly, we've had to plead very hard regarding our humanitarian obligation to do our work. On the other hand, we've treated 75 percent of the cholera cases in this country so far. That's a big number of patients.

In the beginning, government officials were denying and playing down the severity of the crisis. Did they place any pressure on you to portray the epidemic as less severe than it actually was?
Our mandate is to do effective hands-on work of infected patients, so we have to focus on that. But let me answer you this way: Cholera is a completely preventable disease. As in every epidemic, the starting phase is the most decisive part. If you act radically and effectively at the beginning, you can massively reduce the magnitude of the outbreak. In Zimbabwe right now, it is clearly a massive outbreak. Clearly, somewhere in this approach there was a breakdown.

Are you concerned that the political complications that come with foreign countries ' involvement could hinder your ability to deliver treatment and contain the outbreak?
We just have to focus on our medical relief action. Our focus is on the individual facing the consequences of insufficient and ineffective treatment. We can't involve ourselves in politics.

What is it like living with Zimbabwe ' s notorious inflation rate? How does that affect your ability to work there?
The decay of the economy in this country is an enormous challenge. Prices can nearly double within 24 hours. It's even quadrupled within 24 hours. That means personnel from our team who buy commuter passes to go to work in the morning might not have enough money to get home in the evening, because inflation is so aggressive. We also have to pay for local services—materials, water, food—and it's an incredible challenge. If you agree on a price, two hours later you'll need to renegotiate because inflation has already changed that price. We have mobile phones with prepaid accounts that are worth nothing within hours because of the inflation rate, and then we're out there without any functioning means of communication. A very banal thing, but it leads to situations where I cannot send the right number of people to priority locations. Living here is an experience in and of itself.

What has affected you most from your experience in Zimbabwe?
There is enormous stress. You are confronted with situations where hundreds of patients arrive at your treatment center within two hours' time. It's a war-like scenario. Hundreds of people are in life-threatening conditions pleading for you to provide aid, but you have limited resources. It's an enormously stressful situation when everyone has worked at their limit for very long hours, but then a patient who had to travel long distances just to get there dies before you can provide treatment. It's an overwhelming moment when you see kids losing their protection or their lives.

© 2008