Health care in Zimbabwe is slowly improving. When the unity government was formed eight months ago few hospitals were operational. "Since then the situation has improved", says Dutch doctor Aad van Geldermalsen, who visits mission hospitals in the rural areas of Zimbabwe.

"Do you see that woman there?" asks nun Rose Tevedzayi. "She was stabbed in her head with a spear by her daughter, who is mentally ill. But such injuries are not very common anymore. Most patients occupying the beds in this hospital have malaria. And we have a lot of people with illnesses related to AIDS, like tuberculosis." The nun walks through the rooms of the Mission Hospital in St. Rupert Chigaro in rural Zimbabwe. The hospital is very isolated in the province of Mashonaland West, west of the capital Harare.

Europe
Sister Rose leads Van Geldermalsen through surgery and treatment rooms. The Dutch doctor wants to see in what state the hospitals' health care is. He works as a policy advisor for the Zimbabwean Ministry of Health and is connected to the Vital Health Services Program (VHSSP) of the European Commission. This programme is supporting health care in Zimbabwe since 2006 with 22.3 million euros. The money is invested in medication, vaccinations, training of medical personnel and extra salary.

Candles
Zimbabwe once had a good health system. But with the political collapse of the country, the state of medical care collapsed with it. Earlier this year the hospital barely functioned. Women in rural areas who wanted to give birth in a clinic had to bring their own candles and water. And medical staff saw their salaries decrease with the hyperinflation of the Zimbabwean Dollar. As a result, many nurses and doctors did not come back to work. Travel expenses often costed more than they earned.

In an article published in the British medical journal The Lancet last month, figures show how health care has deteriorated. Between 1990 and 2006 life expectancy reduced from 62 to 43 years. This was mainly caused by many young adults who died of HIV-related diseases such as tuberculosis. The mortality of mothers in childbirth rose from 168 in 1990 to 725 per 100,000 births in 2007. The number of tuberculosis infections has quadrupled in that period.

Generator
Two newborns lie in a nearly empty room.  One of the children's brother sits beside their cod reading the Bible." Our programme has worked in this hospital," says Van Geldermalsen. "They have a doctor now. And do you see that generator?" he asks. " It's been purchased with the European taxpayers' money."

Sister Rose is aslo pleased with the generator. Electricity is frequently cut off. However, hospital staff is still not always able to use it.  "Gasoline is so expensive. We cannot always use it", Sister rose explains. "We still need to resolve this problem."

Since the new unity government of President Robert Mugabe of ZANU PF and Prime Minister Morgan Tsvangirai of the MDC, there has been some progress made in the country.  There is more humanitarian aid from overseas, aid agencies are able operate more freely and  - the Zimbabwean dollar is banned. Now payments are made in stable currencies like the U.S. dollar and the South African Rand which means that medical staff in Zimbabwe have a proper income again. At St. Rupert's hospital they went back to work.

"The nurses can provide their basic needs again," says Sister Rose. "They no longer come to work hungry." Moreover, the hospital now has eighty percent of the medication we need, she tells me. "That is a step in the right direction. We're just waiting for AIDS drugs. We need that very badly."

Payment maize
"Slowly but surely patients regain their trust in the medical system", says Van Geldermalsen. "Last year there were far fewer patients. Zimbabweans no longer believed in their clinics and hospitals." But although health care is improving, there is a lot to do to get the system back on track. "It is important that money also goes to general medical care. Governmental organizations often have one area which they support, such as HIV / AIDS, but there is little support for general care. This is also very important. We would use money to buy paracetamol for example."

To many patients, visiting the hospital is still very expensive, says sister Rose. One night spent at the hospital with 85 beds costs three U.S. dollars and the same amount goes for a consultation. Especially in rural areas patients do not manage to get their hands on foreign currency. So they do not pay, or if they do it is in kind. Then they come to the hospital with corn, chickens or goats so the nuns and priest have something to eat in that month.