HARARE, 20 January 2009 (IRIN) - Zimbabwe's defunct health system and the growing humanitarian crisis have had a devastating impact on the lives of children, particularly those who are orphaned or vulnerable, and UN officials have warned that child mortality rates will continue to rise.

UNICEF executive director Ann Veneman, who visited Zimbabwe recently, told journalists that children's access to health care and other preventative measures have been made difficult by the collapse of the health services system, the cholera epidemic, the closure of government hospitals, and the economic and food crises.

With at least 1.3 million orphans in the country, Zimbabwe has a higher number of orphans, in proportion to its population of 13 million, than any other country in the world, according to UNICEF.

Life has become even more precarious for children living with HIV, as they have had nowhere to turn for treatment of opportunistic infections since health workers at government referral hospitals downed tools in October 2008 in protest over the deteriorating working conditions and poor salaries.

About 120,000 children are in need of antiretroviral drugs, but only 9 percent are receiving their medication from the government-run programme. The drugs should be fetched every month, but the HIV/AIDS clinics have closed, so getting the drugs has become extremely difficult.

Access to the life-prolonging medication can depend on whether or not the overworked senior staff still working at the hospitals have decided to open the clinics.

"The fact that children have no access to HIV/AIDS treatment services because hospitals are closed or AIDS clinics are closed is a big issue for us," Veneman noted.

"What happens when they get pneumonia and they don't have access to antibiotics? We all know that pneumonia is one the biggest killers of children under five, while children living with HIV are particularly vulnerable to this disease - and other diseases - because of their compromised immune systems," she added.

According to UNICEF about 41 percent of child deaths are AIDS-related; with limited access to health care and HIV/AIDS treatment services, child mortality rates will keep rising. About 1.7 million people are living with HIV in Zimbabwe, of which and approximately 160 000 are children.

The work boycott led to the closure of at least three referral hospitals in the capital, Harare, leaving patients in need of medical care stranded. To help get health personnel back to work, Veneman announced that UNICEF would make available US$5 million for salaries and incentives.

Veneman also expressed concern about the effects of the deteriorating health system on maternal health. As a result of the boycott by health workers, the programme to prevent mother-to-child transmission of HIV has also suffered a setback.

Women have struggled to be admitted to deliver their babies in state hospitals, and are not being adequately monitored. Most Zimbabweans cannot afford the high cost of obstetric care in private sector institutions.

Without treatment or other interventions, 15 percent to 30 percent of babies born to HIV-positive mothers will become infected with HIV during pregnancy and delivery. A further five percent to 20 percent will become infected through breastfeeding.

The minister of health and child welfare, Dr David Parirenyatwa, told IRIN/PlusNews that government was doing the best it could to address the problems in the health sector.

"We are currently working with donors on the ground to address problems in the health sector," he said. "However, the economic crisis continues to make life very difficult for us, but we are doing our best."

st/kn/he

© IRIN. All rights reserved. More humanitarian news and analysis: http://www.IRINnews.org

IRIN news