As food shortages across Zimbabwe continue to worsen, HIV/AIDS support groups have raised the alarm over rising malnutrition and the high incidence of HIV/AIDS related deaths in urban centres.
Matabeleland AIDS Council (MAC) director, Andrew Moyo, told IRIN that the critical food situation had led to the deaths of many people who would have survived, had they had access to a healthy diet. MAC works with 90 HIV/AIDS support groups throughout Bulawayo, Zimbabwe's second city.
Moyo added that the demise of the Zimbabwe National Network for People Living with AIDS (ZNNP) two years ago had compounded problems for HIV-positive people trying to cope with the food crisis.
"Our findings from the city of Bulawayo are that most of the AIDS support groups have crumbled. This has made it even more difficult for the ill to get support from the National Aids Council (NAC) - in fact, a lot of them are dying quietly under the most deplorable of circumstances," said Moyo.
Sukoluhle Ndlovu, the overall coordinator of the support groups still operating under the guidance of MAC, said food donations were inadequate to cater for the number of people needing assistance.
"We have about 1,000 people on our registers - but the food donations we get cater for only 600 people. Each family receives a monthly allocation of 25 kg of mealie meal, 4 kg of beans, 750 ml of cooking oil, and 25 kg of nutrimeal porridge. We also have another scheme that supplies porridge only, for 125 people, but a lot of people are still left out of these programmes because of limited supplies, or because they are not registered with us," she told IRIN.
Ndlovu said HIV-positive people in most of the city's western surbubs were not registered with any of the support groups or community-based organisations that have access to donations.
"A lot of people are dying at home. I have spoken to many ill people who said they had no access to any assistance. However, there are other ... suburbs ... where some people reported that they do get porridge from some well-wishers, but the overall picture is that of despair," she said.
Home-based caregivers have complained of the lack of support from relatives of those living with the disease.
"There is a disturbing pattern that is emerging in the city. Maybe it is because of the harsh economic situation, but most people are now abandoning their sick relatives. In most cases we find that the terminally ill person has relatives in the neighbourhood or within the city, but those relatives neither visit the patient, nor send them any form of assistance," said Nozinhle Mthimkhulu, co-ordinator of a number of community based care-givers.
"The traditional African extended family, which used to care for even the most distant of cousins, is under severe strain because of the burden of AIDS. The ill are left to ill-equipped caregivers, who do not even have the painkillers to sooth the general daily pains [HIV] positive people complain about," she added.
Commenting on the situation in other urban centres in Zimbabwe, Blessing Chebundo, chairman of the parliamentary portfolio committee on public health and child welfare, said his committee had made "appalling findings" when it visited public hospitals, clinics and HIV-positive persons receiving home-based care.
"The plight of HIV-positive people is appalling to say the least. The same picture prevails throughout the country. Despite their efforts and goodwill, home-based caregivers are slowly being rendered ineffective by the lack of drugs and equipment. In fact, they are a very important component of the care for the sick, because they take over where everyone has failed. But that support is declining, and home-based caregivers now lack even the gloves for handling the terminally ill," said Chebundo.
The World Food Programme (WFP) with a number of its implementing partners, is currently working on a report detailing the effects of food shortages in all the country's urban centres.
Zimbabwe's health care services have been strained to breaking point by the lack of manpower, drug shortages, and infrastructure and equipment falling into disrepair, all as a result of the current economic crisis.
The country's allocation for health diminished from 12.7 percent of the national budget in 2002 to 8.33 percent in 2003.