Zimbabwe Humanitarian Situation Report 31 Aug 2004

GMB Expected to Play Pivotal role in Mobilising Surplus Grain for Re–distribution

The food security outlook for the 2004/05 marketing year continues to be uncertain given the significant divergence in the cereal production estimates. Consistent with recent findings, which highlighted that most households will run out of food from their own production by the beginning of August, Provincial Governors from three provinces are reported to have written to the Minister of Public Service, Labour and Social Welfare to allow NGOs to distribute food aid in their provinces. The Government’s final crop forecast is estimating a maize production of 2.4 million MT whilst the Food and Agriculture Organisation from the aborted Crop and Food Supply Assessment Mission estimated the maize harvest to be around 708,073 MT. According to press reports the Central Statistics Office (CSO) told the parliamentary committee tasked to assess the food situation in the country that maize production for the 2003/04 agricultural season will be at most 1.2 million MT. The country requires approximately 1.6 million MT (based on current population statistics, livestock and other uses) of maize per annum. As a result, GMB is expected to play a pivotal role in mobilising surplus grain for re–distribution.

The Zimbabwean Parliament (August 2004) recently debated on the country’s food security situation. During the debate, the Minister of Public Service, Labour and Social Welfare informed the house that the government was using targeted cash transfers in order to enable vulnerable households to access food. Money being paid to the beneficiaries of public works programme was increased from ZW$5,000 to ZW$60,000 per month to enable beneficiaries to buy maize from GMB at ZW$30,000 per 50kg bag.

The Grain Marketing Board is currently buying maize at ZW$750/kg (ZW$37,500 per 50kg bag) and selling it to rural households involved in the public works programme at ZW$30,000 per 50 kg bag translating to a total subsidy of around ZW$27 billion if the deficit of 177,681MT is provided through GMB. Since GMB is a parastatal, the subsidy will effectively be covered by the Government.

Current monitoring of food security at community level by humanitarian agencies reveals that the percentage of those confirming non-availability of maize has gone up by 10 points in July compared to April 2004. This finding is consistent with the ZimVAC April 2004 report, which predicted that most rural households would exhaust food stocks from own production by July 2004. The same communities ranked GMB as the main source for maize followed by local markets (informal trade) and own production being third. However, GMB maize was reported not available in a number of districts around the country. For the month of July, maize was already scarce in most districts in the southern parts of the country.

Other cereals (Sorghum and Millets), which usually substitute maize in times of stress, are reported not to be available except in the southern regions where a few households still have stocks from own production. This finding is consistent to the April 2004 ZIMVAC suggesting lower production levels of small grain in most areas of the country.

Over 2.3 million people in rural areas need food assistance

According to the Zimbabwe National Vulnerability Assessment Committee (ZimVAC), Approximately of 2.3 million people in the rural areas will not be able to meet their food requirements during the 2004-05 season. This is equivalent to 30% of the total rural population and represents a total cereal gap of 178 000 MT. The greatest proportion of the population predicted to be food insecure is in Matebeleland North (39%) followed by Matebeleland South (34%) whilst the greatest number of food insecure people is in Manicaland and Midlands provinces (see table below).

Table 1: Cereal Deficit/Population that cannot meet the deficit, by Province and Period sorted by % of population in need

The survey noted that most of the households would run out of food from own production by July 2004. Therefore from August 2004 – March 2005 most of the rural population will depend on the market to meet their food requirements, hence access and availability will be critical for the 2004/05 marketing year. The Grain Marketing Board have since increased the price of a 50kg bag of maize from ZW$24 000 to ZW$40 000 (for those not involved in public works programme), this according to the ZimVAC report will result in approximately 40% (3.2 million people) of the rural population being food insecure. The table below shows the percentage of the rural population that would be food insecure under various prices.

% Food Insecure
*price used in the ZimVAC Report

The ZimVAC conclusions were drawn on the assumption that cereals will be available for purchase by those able to afford, therefore for the coming months, it is critical to monitor the availability of cereals on the market, since cereals shortages will result in prices going up and forcing more people to be food insecure.

Constraints on Urban Food Security Continue

Despite the fact that basic commodities like maize meal and cooking oil are available on the market, accessibility still remains a major problem in urban areas. This has been further compounded by persistently high unemployment levels, low income and high inflation rates. While the downward trend in inflation, sustained so far since January 2004, is a positive development, the rate remains high and continues to eat away the purchasing power of all wage earners and pensioners, the majority of whom have had the real value of their earnings reduced substantially. The annual food inflation reported by the Central Statistics Office stood at 378.4 percent in July 2004, a drop of 52.2 percentage points on the June 2004 rate of 430.6 percent (Figure 1 below).

The monthly expenditure basket for a low income urban household of six, monitored by the Consumer Council of Zimbabwe (CCZ), stood at ZW$1,326,980 in July 2004. Between June and July 2004 the cost of meat went up by 96 percent, that of bread by 17 percent, tea 23 percent and flour 18 percent. The value of all food items in the CCZ basket went up by about nineteen percent while that of non-food went up by thirteen percent between June and July 2004. Over the past twelve months rentals have increased by 650 percent and a significant number of poor households have been priced out of the market. They have been pushed to illegal settlements around the cities and towns. Minimum wages of industrial workers of about ZW$444,000 is enough to cover only 33 percent of the cost of the total CCZ low income household basket for July 2004 (Figure 1).

International Community Conduct Humanitarian Planning Exercise

Over 30 members of the international community took part in a humanitarian planning workshop on 20 July 2004. The UN Country Team (UNCT), humanitarian donors and NGO representatives participated in this one-day exercise, whose objectives were:

  • To undertake a humanitarian situation review;

  • Reach a common understanding on the current humanitarian context;

  • Identify a number of key humanitarian requirements that:

    – Will challenge the existing planning and;

    – Seriously modify the current capacity to address the needs of the vulnerable population.

The analysis and review of the situation was aimed at learning from the successes of the ongoing programme, and minimizing on the gaps on the planning and the implementation of the sectoral initiatives. Core areas were identified as still needing attention. For each, current constraints, challenges, recommendations and opportunities were outlined. Common to all areas was the need to ensure that trust is built between the main partners, to facilitate transparency and information sharing. Key outcomes of the six key humanitarian requirements can be summarised as follows;

1. Access to Vulnerable Populations

Data and information on the situation and of the vulnerable population was highlighted as an ongoing problem. To try to remedy this it was suggested that existing surveillance structures (I.e. ZimVAC and nutrition surveillance) should be strengthened and institutionalised. In addition it was noted that there is a need to build trust among all actors with the government if access to vulnerable populations is to be maintained and increased. Underlying these recommendations was the stated need to reinforce understanding of humanitarian principles at all levels.

2. Promoting access to basic social services

The declining capacity of the public institutions to provide the required resources to support social services was highlighted. It was recommended that there should be some joint identification of priority districts and that the provision of a package of services to these districts, through inter-sectoral planning and delivery should be ensured. It was noted that the continued access to children through targeted school feeding programmes and OVC activities should be siezed as an opportunity to promote access.

3. Accessibility to Food

The need to build a shared understanding and accountability on access to food as an essential human right was highlighted, as a starting point in ensuring food reaches vulnerable populations. As a foundation to this it was noted that a common agreement needs to be reached on the nature and characteristics of the humanitarian situation in both rural and urban areas.

The planning process, which will be conducted in close collaboration with the Government of Zimbabwe, would need to be completed by October/November this year.

Food and Nutrition Surveillance Planning under way

Plans for setting up a pilot sentinel site food and nutrition surveillance are under way and data collection is scheduled to start in 10 districts by November 2004. The Task Force on Nutrition Surveillance has agreed on the guidelines, while the training notes and data collection tools are now in place. Training of nutrition assistants, district and provincial nutritionists on data collection and management will start in October. The training will also include field-work to ensure that the quality of data collection is comprehensive and reliable. To ensure good data management and analysis, the Task Force on Food and Nutrition Surveillance is being chaired by the Central Statistic Office (CSO) and co-chaired by the Department of Epidemiology under the auspices of the Food and Nutrition Council. The Task Force which has adopted a multi-sectoral approach to nutrition information collection and management includes the Ministry of Health and Child Welfare, Ministry of Local Government, the Ministry of Lands and Agriculture, the Ministry of Social Welfare, UNICEF, WFP, FAO, WHO and representatives from two NGOs, specifically Save the Children UK and CAFOD.

Currently, UNICEF is supporting the recruitment process of two consultants that will be based in the Food and Nutrition Council, and one consultant based in the Ministry of Health and Child Welfare to manage the surveillance system. In addition, 10 data managers are being recruited and will be deployed to each province. Initially, data collection will begin in 10 sentinel sites in 10 districts and then be expanded to the entire country to ensure that there is a comprehensive nutritional surveillance system in place.

Global Fund Round Four HIV and AIDS Proposal: Update

The Zimbabwe Country Coordinating Mechanism (CCM) for the Global Fund to fight AIDS, Tuberculosis and Malaria (Global Fund) formally submitted an appeal against a decision of the Global Fund not to fund the Zimbabwe HIV and AIDS fourth round proposal on 16 August 2004. This proposal, worth US$218 million, was primarily aimed at scaling up the provision of ART to 80,000 people, increasing the availability, quality and access to qualifying testing and counselling services, strengthening and expanding the national programme of PMTCT and generally enhancing the capacity of the health system to deliver a comprehensive response to HIV and AIDS.

The Global Fund Technical Review Panel (TRP) TRP identified the following weaknesses with the HIV and AIDS component of the Zimbabwe Fourth Round proposal:

1. Doubts were expressed about existing capacity and whether the speed of capacity development as outlined in the proposal would allow the realisation of targets;

2. Uncertainty was expressed over whether direct referral to ART services will be provided through VCT/Education/Support sites;

3. Lack of information over whom funds will be given to for which activities;

4. No plan presented which domestic or international organisations will implement the major training programmes for both medical and non medical personnel;

5. Sub-recipients not specified (NGOs, FBOs - Faith Based Organisations - CBOs, private sector) – it was outlined that this is crucial in the current Zimbabwean context;

6. Problems of skills gaps of proposed Principal Recipients was identified but has since been remedied through the appointment of UNDP as temporary principal recipient agents.

In response and through the appeal letter and accompanying documentation, the Minister for Health and Child Welfare, in his capacity as the chairperson of the Zimbabwe CCM outlined the following points:

It was argued that the weaknesses cited were mostly matters for clarification which could not be adequately addressed in the proposal, mostly due to limitations imposed by the guidelines and proposal form itself. In addition some of the issues raised in the TRP comments were indeed already elaborated upon in the proposal and its attachments

It was also felt that some concerns appear to have been applied more strictly to Zimbabwe than other countries. An example cited was doubt on the country’s capacity to meet targets for patients on ART, even where these were substantially lower than some approved proposals in a similar context.

The Ministry of Health highlighted the need to address this matter urgently particularly in light of the continuous negative effects of the disease on the socio-economic welfare of the population. Failure to adequately address the escalating crisis on HIV and AIDS in Zimbabwe is likely to impact on regional efforts to mitigate the effects of HIV, the minister noted.

In a statement issued on the 9th of September the UN Humanitarian Coordinator underlines the disappointment that has been felt by the UN regarding the decision of the Board of the Global Fund to Fight, AIDS, Tuberculosis and Malaria (GFATM) to not approve Zimbabwe’s Fourth Round Proposals. He welcomed the appeal that has been submitted and underlined the need to respect the appeal process.

The UN has been working closely with the Government and other partners to secure signature of the grant agreement for the proposal that the country put to the GFATM nearly two years ago under the First Round. He said “The UN remains confident that with continued dedication and perseverance by all parties concerned this agreement will be signed shortly and implementation can start immediately thereafter”.

As a part of the efforts of the Zimbabwe Government to respond to the pandemic the Ministry of Health has revealed through the local press that the Reserve bank of Zimbabwe will be releasing US$1million per month for the ARV roll-out programme. The funds will facilitate expansion of the program to three referral hospitals namely Parirenyatwa, Chitungwiza and United Bulawayo Hospitals by the end of September 2004. The Ministry also intends to introduce ARVs at provincial hospitals which will go a long way in meeting the needs of affected people in rural areas who may not have adequate resources to travel to major referral centres in large cities. The challenge still remains of mobilising adequate resources to meet the 3 by 5 target of providing access to treatment for 171,000 Zimbabwean by December 2005.

Facing the Future Together - Consultative Workshop on Women, Girls and HIV/AIDS in Zimbabwe

On 5-6 August 2004, 75 participants from government, the National AIDS Council, people living with HIV and AIDS, civil society, the donor community and UN agencies gathered to launch the national and regional reports of the UN Secretary General’s Task Force on Women, Girls and HIV/AIDS and participate in a workshop to plan follow up to these reports.

The workshop was organised by UNIFEM, UNAIDS, UNICEF, UNFPA and the Ministry of Youth Development, Gender and Employment Creation and focused on six issues covered by the SG’s Task Force:

1) HIV prevention among young women and girls
2) Girls’ education
3) Violence against women and girls
4) Property and inheritance rights of women and girls
5) The role of women and girls as caregivers.
6) Access to care and treatment for girls and women

The workshop started the process of development of a national action plan on women, girls and HIV/AIDS, and reached consensus on coordination mechanisms and leadership roles for implementation of the plan. Participants agreed to the establishment of a Steering Committee led by the National AIDS Council and the Ministry of Youth Development, Gender and Employment Creation, with support from UNIFEM and the Zimbabwe AIDS Network and with participation of a wide range of stakeholders from government ministries, civil society organizations, UN agencies and donors. The terms of reference of the steering committee and the roles of the various players will be clarified during the first steering committee meeting, to be held before mid-September. Sub committees will be formed to address the six focus issues as well as resource mobilisation. A consultant will be hired by UNAIDS to finalise the action plan based on the outcomes of the workshop, under the supervision of the steering committee and its subcommittees.

Reproductive Health Assessment Planned

Maternal mortality rates have increased dramatically in the last fifteen years. According to the 1999 Demographic and Health Survey for Zimbabwe (DHS) figures had risen from 293 per 100,000 live births in 1994 to 695 per 100,000 live births and are now expected to be even higher. The results of a joint Ministry of Health and Child Welfare and World Health Organization Rapid Assessment of Access to Health Services in hard to reach areas, conducted in November 2003, indicate that much more needs to be done to address and ensure the adequate provision of reproductive and maternal health. The assessment found that more than 80% of the communities had to travel more than five kilometres to the nearest health facility. Although antenatal care was high, delivery in health facilities was low. Only 54% of the health facilities visited had nurse midwives and there were general inadequate supply of essential obstetric drugs.

The Assessment made a number of recommendations including more focus on community based initiatives, such as more training of traditional midwives, and strengthening the reproductive health care services management as well as addressing institutional capacity.

The Ministry of Health and Child Welfare, with technical and financial support from UNICEF, WHO and UNFPA have conducted a comprehensive obstetric health assessment to better understand the situation in the country and be able to better determine key areas of intervention. The data has been collected and the results are expected to be available by the end of the year.

The UN Country Team Visits Mlibizi Minefield

From 5-6 August, 2004 the Government of Zimbabwe, represented by the Ministries of Defence and Foreign Affairs alongside the UN Country Team, represented by UNDP, FAO, WHO, UNICEF and UNHCR jointly visited mined areas along the Mlibizi minefield in Victoria Falls. The field visit, which was organised by the government, was preceded by a comprehensive overview of the landmine problem in the country, with particular reference to its humanitarian and socioeconomic effects. The field trip included visiting both cleared and un-cleared sections of the minefield and observing demonstrations of the de-mining process and mine detonation/destruction.

It is estimated that about 3 million blast anti-personnel mines and over 200,000 above surface anti-personnel mines were laid. There are a total of 6 minefields, which stretch for approximately 700km along the northern and eastern borders of Zimbabwe, covering an area of 210 square kilometres, of which about 40% have already been cleared. Landmines and other unexploded ordinances (UXO) pose both an immediate threat to life and limb, as well as an obstacle to sustainable development. There is no accurate information regarding mine and UXO related victims and accidents, and as a result it is difficult to determine the level of ‘humanitarian emergency’ related to land mines. However, since independence over 810 fatal cases have been reported of which 16 injury cases occurred from 2003 to date. These statistics are only a small proportion of the actual incidences as most are not reported.

In addition to the threat to human life a significant number of livestock and game are also killed and maimed each year. To the rural communities, the loss of livestock, including cattle, goats and donkeys, is a heavy socio-economic blow. Additionally, the presence of landmines have also cut off rural communities from their customary lands and thus blocked access to water sources (waterholes, streams, and rivers), agricultural fields, pastures and forests. The minefields have also compromised the eradication of tsetse flies and foot and mouth diseases, as the eradication teams are unable to reach some of the most affected areas as they are mined.

The government is currently clearing the Victoria Falls Mlibizi minefield and about 213.2km have been cleared so far, with only 6.8km remaining. The government is seeking support from the UN and other partners to increase the level of Demining, Victim Assistance, and Mine Risk Awareness for communities living adjacent to mined areas.

Health Update

Clinical malaria

The Ministry of Health and Child Welfare (MoH&CW) report on Epidemic Prone Diseases, Deaths and Public Health Events noted a continuous decline in malaria cases. The number of cases reported for week 33 was 12407 which are 3% less than cases reported for week 32. There were 10 deaths for week 33 compared to 11 deaths recorded for week 32. Kwe Kwe district in the Midlands province and Hwange in Matebeleland north had the highest number of reported cases with 887 and 858 cases respectively. For week 32, Kwe Kwe district reported 987 cases while Hwange had 1152 cases. However, no deaths were reported for Hwange and Kwe Kwe for week 33. Cumulative figures now stand at 558644 and 977 deaths. At the end of week 33, the Case Fatality Rate (CFR) was 0.17% compared to 0.17 for week 32.

Malaria prevention campaigns are continuing in all affected districts.

Other common diseases

There were no suspected cases of cholera for week 32 and 33. Cumulative cholera cases still stand at 116 and 9 deaths with a CFR of 7.8%.

Reported cases of common diarrhoea continue to rise with 3312 cases for week 33 compared to 3219 cases for week 32. However, there was a marked decrease of 50% in reported deaths from a high figure of 18 for week 32 to 9 for week 33.Manicaland province had the highest number of reported cases (492). Harare central continues to record the highest umber of deaths with 5 for week 33 and 9 for week 32. Cumulative figures for diarrhoea now stand at 12738 and 438 deaths (CFR: 0.34%).

The environmental health department is currently engaged in water and sanitation projects with the intention of reducing cases of diarrhoea in all provinces. Health education and case management are also being intensified in the affected areas particularly in rural clinics.

The weekly Disease Surveillance System reported six suspected cases of measles from Midlands province (3), Matebeleland South (2) and Harare city (1). National trend as reported by MoH&CW reflect more positive cases of measles than for the last two years, 2002 and 2003. In order to control the disease, the MoH&CW is promoting intensive surveillance activities in all provinces.

UN Humanitarian Coordinator

Contributions from GoZ, NGOs, International Organizations, or private sector groups are welcome

Articles for publication in the next Situation Report should be submitted by 15th October 2004 to our office at the email address: Zimrelief.info@undp.org