ActionAid International Southern Africa Partnership Programme (SAPP-Zimbabwe) 3.4.10 Lost health facilities Council clinics and hospitals are dotted throughout the country. However, manpower, drugs and equipment have been limiting to the provision of good health facilities. About a third of households surveyed reported they had lost access to their traditional health facilities as a result of the operation. This was more evident in Mutare recording a high proportion of 43% followed by Bulawayo (31%) and Kariba (24%). Minimal disruption occurred in Beitbridge (4%) and Victoria Falls (5%). In addition to community based care, chronically ill persons with a deterioration in their health at times need to access clinics and hospital. Currently, from the survey results a high of 45% reporting that they were not accessing health facilities as a consequence of the Operation. 3.3.11 Increased vulnerability for children, orphans (OVCs) and women In a disaster (natural or man made in this case) children and women are more vulnerable to abuse and exploitation. It is saddening to note that 35% of the interviewed homesteads acknowledged that women and children had become more vulnerable to abuse as a consequence of the Operation. Results from analysis show that respondents from Harare, Bulawayo, Mutare, Kariba, Beitbridge and Victoria registered, 37%, 28%, 55%, 24%, 12% and 9% respectively. Statistics recorded for Mutare on women dignity and safety is strikingly similar to those of those that expressed increased vulnerability of children, orphans and women (57% vs. 55%). Forty five percent (45%) of households hosting orphans acknowledged increased vulnerability for OVCs and women. Furthermore, a high proportion of these were from female-headed households. A major potential problem is sexual exploitation as women try to fend for children and in some cases adopt risky coping mechanisms. As earlier highlighted, the majority of child headed households are girls. This not only reinforces the earlier statement that they are increasingly becoming vulnerable. 3.3.12 Loss of Quality Care - Home Based Care (HBC) As earlier highlighted the high prevalence of HIV and AIDS in Zimbabwe is of great concern. Recently with increase prevalence of HIV and AIDS, the health delivery system in Zimbabwe has been failing to cope with the number of patients. And as such households, communities, NGOs, business, GoZ, and national institutions have been advocating to HBC. Home based care providers were located in respective wards where they reside and offer help to the infected and affected using social networks. This system has been existence in the last decade and resources that have been channelled to this programme have been substantial to ensure success. HBC is organised as an initiative by the community a response by volunteers to the HIV/AIDS pandemic. It was therefore critical that this survey capture this information. Unfortunately, when the survey was conducted, this aspect was not captured, therefore no data is available for Harare. The national average from the households sampled was 14% of the respondents claiming that they had lost HBC. When this data was further disaggregated to capture households hosting chronically ill, it resulted in a subsequent increase to 40%. This could a result from HBC providers and recipients being dislocated by the operation. 3.3.13 Loss of Comprehensive treatment - Anti-retroviral treatment (ARVs) Consistency in the administration of anti retroviral drugs is an important measure for effective results. Clinic, hospitals and health facilities strategically located in wards and specific sites were dedicated to the provision of anti retroviral drugs. Logically, HIV positive individuals were registered in their respective residential areas. However due to the disruptive nature of the Operation and secondary information from partners, there was great speculation on the actual figures that had been affected by the Operation in Zimbabwe Operation Murambatsvina/Restore Order National Survey Report 25