Statement Zimbabwe Association of Doctors for Human Rights - Victims of organised violence and torture continue to flood the health system

It is with the gravest concern that ZADHR reports that patients injured in incidents of violence and torture around Zimbabwe have continued to flood, and nearly overwhelm, the health care system throughout June. ZADHR also remains concerned that many victims of current violence are failing to access treatment due to several restricting factors including limited freedom of movement, no access to transport and the inadequacy to respond to their needs of poorly equipped institutions in outlying areas.

On many occasions it has been difficult or impossible to find beds for those needing hospital admission, including space in 'Intensive Care' for those requiring that level of support and monitoring. It has become necessary to find ad hoc methods to import plaster of paris (for the management of fractures) povidone iodine (betadine) and silver sulphadiazine cream (a basic cheap and effective agent for the treatment of burns) because hospitals have run out of supplies in the face of the extreme demand.

In addition the process of accurately recording, enumerating and analysing the data has been hampered by the risk of harassment from government agencies or those acting in the name of the government. Consequently data for June is not complete to the date of this statement. However the pattern continues of large numbers of soft tissue injuries (nearly 200 documented as being 'severe', i.e. resulting in haematoma or abscess formation, and/or being very extensive), and of fractures (over 50 recorded so far), on a background of larger numbers of cases of medical conditions exacerbated by displacement. There continue to be large numbers of patients presenting with psycho-pathology relating to displacement, loss of family members, and being witness to or victims of severe inflicted trauma. However a remarkable finding is the resilience of the majority of people who have suffered directly or indirectly from this epidemic of violence.

ZADHR wishes to record again the startling brutality of the violence used on increasing numbers of victims some of whom made the allegations below:

- A 57 year old widow living alone was blindfolded and beaten, resulting in severe lacerations to her forehead, bilateral periorbital oedema (swelling around both eyes), multiple linear bruises on her back, buttocks and legs, fractures of her right tibia and fibula (the two bones in the lower leg), with a probable sub-periosteal haematoma (collection of blood under the lining of the bone) of the left tibia.

- An 18 year old boy whose parents support the political party not in favour with his assailants was forced to lie prone and was beaten. He raised his head to protest and was hit in the face with the result that his left eye subsequently required surgical removal.

- A 37 year old woman whose husband was said by her assailants to be campaigning for the political party they did not support was admitted to hospital with a fractured base of her skull, bilateral fractures of the transverse processes of her 6th cervical vertebra (broken neck), and extensive soft tissue injury with haematoma formation on her back.

- A 29 year old man on questioning replied that Yes he did support a particular political party. On his refusal to be handcuffed he was shot in the groin and presented later in hospital with the end of his penis traumatically amputated and considerable extravasation (spreading of blood out of the blood vessels) of blood into his scrotum and upper thigh.

- A 46 year old man suffered fractured 6th and 7th ribs on the right, fractures of his right ulna, left radius and ulna, left fibula, and a comminuted fracture of his left tibia. The attached photograph of the xray of the fracture in his left leg demonstrates the severity of the blow or blows that caused the injury. A difficult surgical fixation with screws and plate was required.

- A 41 year old polling agent was beaten with logs on his back, hands and under his feet resulting in fractures of four of the metatarsal bones in his left foot. The attached photograph of the xray of his foot again visually demonstrates the extreme violence required to cause this injury. Again difficult surgical intervention was required with pins inserted along the lines of the bones to maintain some degree of alignment and stability.

This work can be overwhelming both in terms of volume and also in terms of the shock and emotional distress caused by the repeated exposure to the effects of extreme cruelty. These care-givers also require counselling in order to avert secondary traumatic stress disorder which has already manifested in some individuals.

ZADHR again wishes to commend the large numbers of health workers from admissions officers to specialist surgeons to theatre assistants and all the other cadres who have attended to these patients with consistent dedication to high quality care. We pay this tribute to all working to relieve the suffering and assist the recovery of torture victims on 26 June, UN International Day in Support of Victims of Torture.

ZADHR welcomes the statement issued recently by the Zimbabwe Medical Association (ZiMA) which 'notes with great concern the many incidents of violence that have occurred in different parts of the country and are largely reported to be politically motivated. ZiMA ... would like to condemn in the strongest of terms these acts of violence and urge those involved to stop this brutality.'

We underscore the responsibility resting with the Government of Zimbabwe to protect its citizens from torture and other cruel, inhuman or degrading treatment or punishment. ZADHR calls on the authorities to fulfil this obligation particularly in light of the fact that the Government has the resources at its disposal to halt the violence and maintain peace and order.

ZADHR reiterates its appeals to the UN, AU and SADC to engage with the authorities to bring an end to brutal and systematic violence being carried out on large numbers of Zimbabweans.