The humanitarian situation in Zimbabwe is deteriorating, with the economic crisis compounding the impacts of erratic rainfall. Severe food insecurity has escalated during the 2018/2019 lean season (October – April), while access to basic services, and particularly healthcare, has become increasingly challenging due to the economic situation.
Nearly 5.3 million people in Zimbabwe are estimated to be in urgent need of humanitarian assistance and protection during the 2018/2019 lean season (October – April) and beyond. This includes nearly 3.8 million people in rural areas, including 2.9 million who are severely food insecure (IPC phase 3 or 4) and a further 900,000 people who are currently receiving humanitarian assistance, without which they would be in IPC phase 3 or above. In addition, 1.5 million people in urban areas, including major towns and secondary cities, are estimated to be facing severe food insecurity, while people in multiple locations across the country are faced with acute shortages of essential medicines. With the ongoing macro-economic crisis, there is a high likelihood that the situation will continue to deteriorate.
In the three areas classified in IPC Phase 4 (Emergency), there is widespread food deprivation, with many people going to sleep hungry and going all day and night without eating. The rural areas of Zimbabwe show a very precarious situation, with 30 per cent of the population experiencing IPC Phase 3 (Crisis) and IPC Phase 4 (Emergency) conditions and about 20 per cent employing emergency coping strategies to access food. The most vulnerable households are experiencing moderate to large energy intake gaps, consuming a diet of very poor quality and engaging in accelerated depletion of assets through unsustainable livelihood coping strategies.
This rise in severe food insecurity has been driven by a combination of factors – including late rainfall, abnormally dry conditions and the worsening economic situation – which are likely to prolong the lean season at least until May. Late and erratic rains have affected agriculture activities, such as land preparation and planting, and the 2019 harvest is likely to be delayed. In addition, infestations of crop pests, including Fall Armyworm and Tuta absoluta, have now spread to all provinces in the country, contributing to reduced crop production. The most vulnerable people reside in drought-prone rural areas, relying exclusively on rain-fed agricultural production for their food consumption and income, and have therefore been hardest-hit by these developments. At the peak of the lean season, these households typically depend on the market for food. However, sharp price rises have resulted in lower purchasing power and inadequate access to food. Staple cereal prices, for instance, increased between 50 per cent and 150 per cent above the five year averages and are expected to further increase across the lean season. In addition, the economic crisis and poor season performance have reduced agricultural-based livelihood opportunities and wages (both in-kind and cash).
At the same time, high livestock deaths have been reported, along with unavailability of pasture, in predominantly cattle ranching districts. There has been a sharp increase of stock feed and agricultural input prices, and the recurrence of livestock disease outbreaks - such as anthrax, foot and mouth disease (FDM) and theileriosis - are further threats to the agricultural season.
People’s capacity to withstand new economic shocks is severely compromised as the country has gone through repeated stresses since 2008. At the heart of the economic problems is a US$17 billion domestic and foreign debt and a $1.8 billion trade deficit that has worsened forex shortages. A rapid snap survey carried out in October 2018 indicated high market volatility, as traders were aligning prices to the black-market exchange rate (RTGS 4:1 USD). The sharp increase in inflation (56.9 per cent in February 2019 year-on-year), and 250 per cent rise in fuel prices are directly impacting on poverty and hunger. Meanwhile, public sector salary payments have not been adjusted to reflect price increases. In October 2018, the government announced a Transitional Stabilization Programme (2018-2020) to implement structural reform to ensure financial stabilization.
These reforms are critical to: address liquidity challenges; stimulate growth and investment to increase revenue collection and foreign exchange generation; and protect social gains. However, their implementation will be met with critical challenges as the country’s protracted fiscal imbalances have undermined any effort to prioritize development spending, including social service provision, undermining poverty reduction efforts. Unemployment rates have been increasing as employment opportunities have continued to diminish. The high and unsustainable debt-to-GDP ratio; high fiscal deficit; cash shortages, and limited availability of foreign exchange are directly impacting on people’s lives; and the persistent shortage of essential goods, including fuel and consumer goods, remain major obstacles for any meaningful economic recovery. The impact of the economic crisis on people’s lives has led to demonstrations, unrest and growing concern regarding human rights violations. There were reports about people killed, injured, detained, and alleged cases of sexual violence.
Zimbabwe is also battling disease outbreaks, acute forex shortages in the health sector and stock outs of essential medicines. In 2018, Zimbabwe recorded the second largest cholera outbreak in its recent history. The disease rapidly spread mainly around two suburbs of Harare city since September, and by early January 2019 more than 10,000 cases including 65 deaths across the country have been reported. The country is also battling a typhoid fever outbreak, which has affected Harare and Gweru cities since 2017, with more than 6,100 cases reported and 17 deaths since the outbreak began. The country also has a high level of HIV prevalence, affecting more than 13 per cent of the population. In the face of rising needs, Zimbabwe’s healthcare budget is chronically underfunded and stocks of essential medicines, diagnostics and supplies have been depleted due to foreign currency shortages. Many private pharmaceutical suppliers now only accept United States dollars and have dramatically increased their pricing. As a result, many people are unable to pay for basic health services, including vulnerable people living with chronic conditions such as tuberculosis and HIV, and refugees. Drought-induced migration in search of food may further compound the health situation as it could reduce the coverage of key immunization activities, which increases the risk of additional disease outbreaks.
Malnutrition could rise in the months ahead due to increasing food insecurity, economic strain and unavailability and unaffordability of basic food commodities. The nutrition status of children in Zimbabwe showed a marked improvement in 2017, with global acute malnutrition (GAM) rates reducing to 2.5 per cent and severe acute malnutrition (SAM) to 0.2 per cent. However, the confluence of risks in the months ahead is likely to reverse some of these gains, especially in 25 drought-prone districts identified by the nutrition sector. Children under age 5 will be worst-affected, along with people living with chronic illnesses such as HIV. It is anticipated that more than 72,200 children could be affected by acute malnutrition (25,280 SAM and 46,948 MAM) in all districts in the country between now and May 2019. In addition, 360,000 young children aged 0 to 23 months, nearly 906,000 children aged 6 to 59 months and nearly 575,400 pregnant and lactating women with elevated nutrition needs or vulnerability in 24 districts are likely to be affected by food insecurity.
Decreasing access to clean and safe water in both rural and urban areas is heightening the risk of disease and malnutrition. Only 49.4 per cent of water points across the country (mainly hand pumps) are fully functional, according to the October 2018 report from the Rural WASH Information Management System (RWIMS). Urban areas continue to suffer from overloaded and ageing water and sewage infrastructure, with intermittent water supply of an average of 12 hours per day, according to the most recent Service-Level Benchmarking (SLB) survey. The situation is compounded by the economic situation, which is limiting access to foreign exchange by urban local authorities to procure water treatment chemicals. An estimated 780,000 people remain at risk of WASH-related disease outbreaks, including cholera and typhoid, due to inadequate access to safe water. Poor rains have increased the burden of fetching water for children and women, forcing them to travel longer distances and exposing them to the risk of violence and abuse. Access to safe water also remains a challenge for the 20,000 refugees in Zimbabwe.
Increasing food insecurity and poor access to hygiene, sanitation and water will particularly impact people living with HIV. Lack of food has a direct impact on the ability of people living with HIV to take their medicines, as the drugs cannot be taken on an empty stomach and also increase the feeling of hunger. People living with HIV with food insecurity run the risk of malnutrition and ill health. Lack of access to safe water and sanitation can have dire consequences for people living with HIV. Episodes of severe diarrhoea, cholera or other gastro-intestinal infections can accelerate the progression to AIDS, if untreated. Rising food insecurity and the growing economic crisis pose unique protection risks for women and girls. Girls are particularly vulnerable to family separation, early marriage, teenage pregnancy, domestic violence and extreme coping mechanisms during times of household stress, including transactional sex. The risk of exposure to domestic violence and intimate partner violence are also expected to increase as a consequence of heightened family tensions caused by crop damages and income losses. Poor rains have increased the likelihood of drought-induced displacement, as affected people consider moving to urban and peri-urban areas in search of jobs and food. Rural-urban migrants often end up in severely overcrowded city slums, which lack basic services, such as proper drainage systems, safe drinking water and proper sanitation. Migration due to hunger also increases the risk of sexual violence, exploitation, abuse and early and unwanted pregnancy. Meanwhile, restrictions on employment, the encampment policy and limited livelihood activities leave refugees and asylum seekers dependent on the humanitarian assistance for food.
Lack of food, water scarcity and deteriorating access to livelihoods will impact the education of school age children, especially girls. School dropout is reportedly already rising, as families prioritize food, performance of households’ chores and casual labour over school attendance. Families with constrained budgets will prioritize food over school fees. For girls, in particular, school dropout can lead to family separation, child labour and early marriage. During the 2015-2016 El Niño-induced drought, there was also a reported increase in cases of teenage pregnancy, impacting girls’ school attendance, and the pattern could be repeated if the situation does not change.