An in-depth Study on the impacts of Operation Murambatsvina 5. CONCLUSIONS 5.1 Trauma Firstly, it is clear that our findings both extend and amplify the previous findings. On these findings, there can be little doubt that Operation Murambatsvina has had devastating effects on the mental health of those affected. It is clear that this is not due to the Operation alone, but that the organized violence and torture of the past 5 years or so has had the cumulative effect seen in the consequences of Operation Murambatsvina. The overall morbidity is enormous – conservatively about 800,000 persons – and reflective of the situation seen in a “complex emergency”. It is noteworthy that the UN Special Envoy alludes to such a situation in her report, and the response of the United Nations subsequently reinforces that Zimbabwe has become a “complex emergency”. Certainly our findings suggest a picture commensurate with a war rather than a time of peace. It is important here to point out that we are talking about “clinically significant disorders”; that is, psychological disorders that ordinarily would require the attention of mental health professionals and that are unlikely to heal without such attention. Combined with the effects of the destruction of their homes and their livelihoods, it is even more improbable that these people will heal unaided, and there is a pressing need to develop effective psychological assistance for this population. Our data do not allow us to specify the types of psychological disorder suffered by the population, and hence there is a pressing need for good clinical follow-up. This is imperative, since some conditions, such as depressive disorders, have higher risk than others, and the risk of suicide and para-suicide must be quickly countered, especially in the situation of high adversity that most sufferers find themselves. 5.2 HIV/AIDS Again our findings extend and amplify previous findings. As our findings show, those suffering from HIV/AIDS have lost access to quality care, medical treatment, medications, nutritional support, and many have no support at all. The HIV/AIDS group was also much more likely to be suffering from a clinically significant psychological disorder. All of this was avoidable with proper planning by the Government of Zimbabwe, but no provision has been made at all, and, worse than this, there are many reports indicating that the authorities are even obstructive to attempts to assist. This is wholly unacceptable. We wish here to make two points. Firstly, that people’s lives are at risk is not acceptable, and it is clear that those suffering from HIV/AIDS have been placed now in a situation of multiple risks. This requires an emergency response from local and international groups, irrespective of whether the Zimbabwe Government accepts this or not. Secondly, there must be serious concern for the effects in the long-term on morbidity due to HIV/AIDS. The risk of treatment-resistant HIV must now be seen as highly probable, and transmission a reality given the hazardous behaviours now reported in this group. The 26