HARARE, 8 January 2009 (IRIN) - Tongai Chinamano*, 35, of Hopley Farm on the outskirts of the capital, Harare describes being HIV positive in Zimbabwe as a death sentence.

Chinamano was diagnosed with Kaposi's sarcoma, a type of skin cancer common in people living with HIV, in June 2008. The doctor who attended to him recommended that he immediately begin radiotherapy to treat the large painful lesions on his legs, but he has yet to receive any treatment.

Chinamano visited Parirenyatwa hospital - one of the country's largest referral hospitals and the only public hospital in the country that offers radiotherapy - shortly after being diagnosed, only to be told that all 18 of the hospital's radiotherapy machines were broken.

He returned to the hospital every week for three months, but the machines were still not repaired.

"I spent a lot of my pension money on transport to Parirenyatwa with the hope that I would one day receive good news," Chinamano told IRIN/PlusNews. "The cancer is eating into my leg bit by bit and the pain is unbearable."

By October, Chinamano was unable to walk without a walking stick. Desperate for treatment, he went to Parirenyatwa hospital once again. This time he was told that although one of the machines had been repaired, there was no one to attend to him as the doctors and nurses were on strike. Chinamano says he slumped against a tree outside the hospital and wept uncontrollably while his wife looked on helplessly.

"I cried with no shame that day because I was hurting inside," he recalled. "All I wanted to do that day was to just die; I felt I had suffered enough."

Chinamano's story resonates with many people in Zimbabwe who, confronted with illness and the high cost of medical care in the private sector, are struggling to get even the most basic services through the country's collapsed public health sector.

The health worker strike led to the virtual closure of three hospitals in the Harare area - Harare Central, Chitungwiza and Parirenyatwa - all of which have clinics that dispense anti-retroviral drugs (ARVs) and treatment for HIV-related opportunistic infections.

The health workers argue that it is futile for them to return to work just to "watch patients die" because there are no drugs, no medicines and essential medical equipment is not functioning.

"As health workers we greatly sympathise with the suffering of the people but even if we opened the hospitals, in the state that they are in we wouldn't be able to do much for [patients]," said President of the Zimbabwe Hospital Doctors Association, Dr Amon Siveregi. "Our hospitals have become death traps."

"All we want is just to make things right, we do not enjoy the situation," he added. "We are very disappointed that government is not taking the health crisis seriously."

For many Zimbabweans, getting medical treatment now depends on having a relative who is a nurse or doctor or on having enough foreign currency to access treatment through the private sector. Patients can expect to pay as much as US$200 for a consultation and a prescription at a private clinic, an amount that few people can afford in a country with runaway inflation and 80 percent unemployment.

AIDS activist, Sebastian Chinhaire called on the Zimbabwean government to admit its failures and request assistance from the international donor community to resuscitate the country's health delivery system.

"While other African countries with better performing economies are rejoicing at the advent of life-saving ARVs and a better life for their HIV-positive populations, we have nothing here to celebrate," he told IRIN/PlusNews. "It is all just misery, death and pain."

Minister of Health and Child Welfare, Dr David Parirenyatwa said that government was doing its best "under the circumstances".

"We are trying to talk to the donor community about bailing us out in the health sector," he told IRIN/PlusNews. "It's not that we have no concern."

For a number of years, health service delivery at many of Zimbabwe's government hospitals has been in decline due to under-funding and poor health worker salaries that have seen many experienced health professionals leave the country for greener pastures.

*Not his real name

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