A Death in Zimbabwe

The death of one child from possible medical malpractice at a private hospital in Harare, the capital of Zimbabwe, might not seem a case of a human rights abuse on a continent where literally millions of people are dying from starvation and AIDS, and continue to suffer from such preventable diseases as cholera, dysentery, polio, and tetanus. But the difficulties encountered in Harare by Charles and Mary Khaminwa as they tried to make the medical profession accountable for the death of their daughter Lavender in August 1990 raise fundamental questions not only about the relation between professional responsibility and a respect for human rights, but also about the increasingly repressive policies of the Mugabe government. What are the consequences when medicine—or for that matter, law, journalism, the academy, or the clergy—fails to uphold basic ethical standards against the self-interest of its members? And if the profession places no restraints on their greed and health care is left unregulated in a free-market economy, who will protect citizens from the arbitrary use of authority, whether in hospitals or in prisons, by doctors or by guards?

On February 12, 1991, Charles and Mary Khaminwa wrote to the Washington office of Africa Watch requesting help that would “enable us to continue our legal struggle to bring to book those responsible for the death of our child, the late Miss Lavender Muhonja Precious Khaminwa.” As their letter explained, the Khaminwas were a Kenyan couple who had moved to Harare in 1984 so that Charles, a lawyer with several years’ training in the US, could direct a community development project. Ten-year-old Lavender, their eldest child, had been attending a private boarding school on the outskirts of Harare. During the first week of August 1990, she came home complaining of stomach pains; when the Khaminwas took her to the family pediatrician, he recommended that she see a surgeon. “On 9 August 1990,” the Khaminwas recounted, “Lavender was admitted to a local private hospital, the Avenues Clinic in Harare…. On 10th August 1990, she was subjected to an appendectomy and died suddenly a few hours later.”

On the basis of autopsy reports, statements made by the physicians and nurses, and reports of other cases in Harare of death or disability from anesthesia, the Khaminwas were convinced that “Lavender was the victim of wrong, unorthodox, hazardous and seemingly experimental treatment, and of poor or non-existent post-operative and post-anesthetic surveillance and care.” For six months they had tried to persuade the Zimbabwean medical societies and public officials to investigate the circumstances of her death, but had been so far unsuccessful. “We have been shocked to discover the extent to which medicine…seems to be operating in an ethical vacuum. A deficit of control exists in the monitoring apparatus.” The politicians “leave their medical communities to more or less administer themselves”; physicians inevitably cover up for each other, and average patients, whose “fear of authority, any kind of authority, had become so ingrained,” cannot even imagine mounting a protest. The Khaminwas’…

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