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Conference Call: Crisis In Zimbabwe

Speakers: Laurie Garrett, Global Health Fellow, Council on Foreign Relations, and Anthony Holmes, Diplomatic Studies Fellow, Council on Foreign Relations
Presider: Paul B. Stares, Conflict Prevention Fellow, Council on Foreign Relations
December 12, 2008
Council on Foreign Relations

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PAUL STARES:  This is Paul Stares.  I'm a senior fellow at the Council on Foreign Relations and director of its Center for Preventive Action.

Welcome, everybody.  We appreciate you joining us here for this conference call on the unfolding crisis in Zimbabwe.  We're pleased to have two leading experts on the council to discuss this today.

Laurie Garrett, who is a senior fellow for Global Health at the Council on Foreign Relations; as many of you know, she's a Pulitzer Prize-winning author of many books and other prizes, for her work on epidemics and global infectious diseases.

We also have Tony Holmes, J. Anthony Holmes, a long-standing American diplomat with much experience in African embassies and who's been following the situation very closely in Zimbabwe.

I thought it would be useful that we would begin with Laurie Garrett, to give us a quick sort of overview, 5-10 minutes overview, of the situation with the cholera epidemic, in Zimbabwe and the region, and trying to get a sense of its scale and whether this is on the verge of really taking off.  And then we will turn to Tony Holmes to sort of tell us more about the political situation in Zimbabwe and how the crisis is unfolding.

So Laurie, why don't we start with you?  Give us a sense of what we know, about the scale of the epidemic, and how this could potentially unfold.  There's a lot of quite disturbing assessment, coming out of Southern Africa, about the scale of this.

LAURIE GARRETT:  Thank you.

And good morning, everybody.  First of all, I have to say that I'm very biased, on this issue, because I've personally suffered from cholera and survived it, I'm happy to say.

It is not a trivial ailment.  And even when you hear that under ideal circumstances, with sufficient medical care and skilled personnel and antibiotics or even hydration therapy available and so on, the recovery rate is about 99 percent, even so, it is a severely debilitating illness and absolutely amazingly painful and difficult.  And getting through it, getting back into tip-top shape, can take a very long time.

The most crucial element of surviving cholera and getting past it is the availability of clear water, to rehydrate, because the cholera bacteria, Vibrio, cause massive dehydration, through a series of toxins that are released by the micro-organism, into the intestinal tract, and that very specifically attach to receptors, on the very cells that are responsible for maintaining your electrolyte balance and your water balance in the body.

They actually force those cells to expel all the water and potassium and sodium, inside the cells, totally disrupting everything downstream, including the kidneys.  (Audio break) -- a matter of minutes to hours, at best, to rehydrate the individual.

Without rapid rehydration, the mortality rate can be very high.  And I think we need to keep in mind that this is not the first great cholera outbreak on the continent.

Nineteen ninety four was the worst one in recent history.  It followed the mass exodus of refugees from the massacres in Rwanda.  And in that outbreak, we had a very high mortality rate in some cases, in some of the settlements exceeding 35 percent, of those with infection, which is almost unprecedented.  You have to go back to the second or third great pandemics, of the seven known great pandemics in the world, of cholera over history, to see mortality rates that high.

One of the reasons the mortality rates were so high, in 1994, was that the cholera strain that was circulating was highly drug-resistant, so that all the first-line antibiotics failed.  And in fact, it became more drug-resistant, over the course of the humanitarian response, in part because of inappropriate application of antibiotics.  And by the end, the only antibiotics that would work, at all, were very expensive fluoroquinolones.

So I have been trying very hard to get information regarding the nature of the strain that is now circulating in Zimbabwe.  And I have a long train of e-mails back and forth to scientists and to WHO.

Nobody seems to know.  And this outbreak has been going on, as acknowledged by the Zim government, since August but most assuredly been going on since well before that time.  And yet we don't seem to have any published accounts on the specific strain and its profile of drug susceptibility.

The mantra from WHO is that everything in Zimbabwe is about the breakdown of the public health system and that that should be the focus of all attention.  That certainly is true, but it's a little more complicated than that.

Getting health personnel in that end up using the wrong drugs, because of the specificity of the strain, is no help to anybody.  But also the breakdown is more than the breakdown of the health system itself.  It's also that Zimbabwe ran out of fuel for most government services.

Back in September, it was officially announced, the government was no longer getting imported fuel.  And so electrical systems have gone on total triage.  Among the electrical systems that have broken down are those that run the fuel pumps for the water filtration systems.

So it's, this is why we have such a high rate in Budiriro, which is right there in Harare, in the capital city.  Literally the water from the tap is coming out in hideous condition.

Now, the key thing about, two key things I want to emphasize about cholera, in Zimbabwe, that have not received a lot of attention; the first is the underlying HIV rate in Zimbabwe which, depending on whose database you're looking at, is somewhere between 20 and 25 percent of reproductive-age adults.

When you have an HIV base-rate that high, and individuals are going without their antiretroviral treatments and are malnourished due to starvation, you have a situation in which it's totally predictable that you'll have a far worse mortality rate, when those individuals are exposed to cholera, compared to a healthy individual, like myself when I got cholera.

You'll see that the biggest pockets are in two areas that also have the highest HIV rates that are known, in the country, a pocket that's over on the Mozambique border and then the former -- what used to be called the Township of Budiriro, which was the -- in apartheid days -- they didn't call it apartheid, but it boiled down to the same thing.

In the old Rhodesia, this was where all the blacks were allowed to live.  And it was the slum of Harare, of Salisbury.  And those are the two highest HIV areas.  They're also the two highest cholera areas.  And we may very well see an epidemic that ends up being fueled by the underlying immune deficiency of a huge percentage of the population.

STARES:  Laurie, if I just may interject, what are our best estimates so far of the scale of this, of the cholera outbreak and how many people have been effected and killed?  And you know, is there any sense that this is being contained in any systematic fashion, or are we still in the ascent phase of a classic epidemiological process here?

GARRETT:  Well, first of all, we don't really know the numbers.  We don't even know what the current population of Zimbabwe is.  There's been such a mass exodus of people leaving the country over the last two to three years and going to border nations that whatever denominator numbers you hear, the range of phenomenal.  You can read official U.N. statements coming out, and they range in their estimate of the current population from about 5.8 million all the way up to 12 million, and nobody really knows what the size is of the Zimbabwe population.  That's one big step.

The second is when we say the health system has collapsed, that includes the public health system.  So who's counting?  Who's keeping track of the dead bodies?  Who's keeping track of infections?  Who's been deployed out into the field to make those determination?  The fact is, a lot of the numbers that I'm seeing appear to be based entirely on morgue data.  But in this catastrophe, we know that many people are dying without ever seeing a morgue or a hospital and are being buried in the villages and buried in the outskirts of the cities by family members.

And that goes to another consideration, which is, are we on the ascent?  Is this about to explode in much worse form?

If you follow the traffic of unconfirmed anecdotal reports coming from scientists and physicians who have been on the border areas of Mozambique, Botswana, Zambia and South Africa, the news is very grim.  None of it's confirmed by any officials, but it appears that it definitely has crossed the borders.  You definitely have outbreaks now in the border areas.  And in the poorer countries like Mozambique, where their water systems and filtration may be inadequate, we could very well see this become a regional issue.

And I would remind everybody that we have two other big cholera epidemics unfolding on the same continent.  Right now, in exactly the same area where cholera burst out in 1994, we have an actually what appears to be larger outbreak unfolding in the Democratic Republic of Congo around the whole eastern Congo-Goma area.  It has already spilled over into Uganda, and the strain there appears to be partially drug-resistant.  It's a classic -- what's called classic cholera, but the strain serotype is resistant to the key drug that first gets applied in most cases, popularly known as Bactrim, or trimethoprim sulfate.  We also have an outbreak unfolding of what appears to be a particularly virulent strain in Guinea-Bissau.

So we're looking at a real series of catastrophes that will stress the international donor community, stress the humanitarian response capacity, stress WHO, and spread the troops around very thinly.  And if you add to that a government that clearly is obstreperous at best, has no clear plan for conquering its problem, and a president that has even gone in a press conference and said the problem is over -- whether he was being sarcastic or not -- this is going to tax the capacity of everybody in the region and all of the international responders.

STARES:  And he's not just obstreperous, he's also obstructionist in terms of allowing access to the affected areas.

GARRETT:  Absolutely.

STARES:  Right.

Okay, why don't we move to Tony Holmes.  I think I neglected to say at the outset that Tony is the Cyrus Vance Fellow in Diplomatic Studies at the council, as well as being a long-standing diplomat.

So, Tony, you know, the situation is just unbelievable, with inflation -- I think the latest estimates say 231 million percent inflation.  The situation just seems unsustainable.  And there have been recent reports of cracks appearing in the regime, dissent amongst the security forces, and some still continuing repression.  Are we on the last legs of this regime, or could this go on for a long time?  Could you just give us a sense of your appreciation of the situation?

J. ANTHONY HOLMES:  Well, thank you, Paul.

And thanks to the council.  It's nice to be here.

The Zimbabwe government has been on its last legs for almost a decade, and the capacity of the Zimbabwe population to suffer is incredible.  They are very tolerant people who tend to turn inward and basically revert back to a subsistence/barter economy when stressed.  They've been stressed many times in the past hundred or hundred and twenty-five years, and they're used to doing this.

I actually lived in Zimbabwe in the first half of the 1990s, during what was then a -- the largest-known sub-regional drought in southern African history and a real crisis in Zimbabwe not dissimilar to the humanitarian and food-shortage crisis that exists today.  And the people -- I mean, they would eat leaves, they would eat grass, they would squeeze whatever they could out of what little they have in order to survive.  And it was amazing how far they were able to squeeze and, you know, how ultimately they did survive.

But let me take a couple steps back.  There are a couple or three crises in Zimbabwe.  Laurie has really gone into detail on the immediate crisis from the cholera epidemic, but that is overlain on a broader humanitarian crisis that's been going on for a number of years.  According to the World Food Programme and the U.N. system, there are about five-and-a-half million Zimbabweans who are dependent on donated food -- emergency food relief -- and there's not enough food to go around.  They've issued calls; they've been issuing calls for the past several years.  But what this is is a reflection of the devastation to the agricultural sector, and this is very much an agriculturally based economy and one that is tremendously wealthy and quite a proficient exporter of food when it's operating well, but has slowly ground to a halt during the course of this decade in the wake of the seizure of the white-owned farms and the just deterioration, the crumbling, of the larger economic infrastructure.

So there's a real weakness -- physical weakness on the -- you know, in the Zimbabwean population that affects their immune systems, and means that they're much more susceptible to the cholera epidemic.  And then, more broadly, you've got this political and economic systemic crises that, you know, underlie all of the problems that have been accelerating since 1998 or 1999 and for which the -- you know, to which the international community is reacting, but for which there are no good solutions.

I mean, the unfortunate reality is that there is no consensus in the international community for action.  You have lots of calls from extremely high-level officials in the West -- Condoleezza Rice, George W. Bush, the British prime minister, the European Union -- and increasingly from a selected few African leaders:  Raila Odinga, the prime minister of Kenya, Desmond Tutu in South Africa, Ian Khama, the president of Botswana.  But this does not constitute an international consensus.  It still basically is the West against Africa, as seen from the Zimbabwean, and even much of the rest of Africa's, perspective.

And until the Africans themselves decide that they must take action, I don't think that there's any immediate prospect for the situation to be resolved.  Just in the past two or three days, the African Union and the Southern African Development Community have said that they're -- they don't believe that any sort of active intervention or military solution is called for.  And they reiterated their support of continuing to pursue negotiations to implement the September 15th agreement in which Morgan Tsvangirai and the MDC would share power with Mugabe and the ZANU PF government.  Of course, Mugabe's participation and position in those negotiations makes a mockery out of the agreements, and out of South Africa's mediation over the course of the past, actually, seven or eight years.

But that's where we are.  I mean, the political reality in the international community is that whatever outside solution that might be imposed must be led by Africans.  There's just too much historical baggage with racial and colonial overtones for the West to take the lead.  It has to be Africans.

I thought I'd take a look at -- just for a moment at South Africa's role.  Everybody's aware it -- I mean, and many people have expressed disappointment at Thabo -- former South African president Thabo Mbeki's mediation efforts.  Most people see him as having protected Zimbabwe and protected Robert Mugabe, and actually having facilitated a deterioration of the situation to the point we're at today.

But in September, Mbeki got overthrown -- got, you know, legally, constitutionally dumped, and replaced as president by Kgalema Motlanthe, who's viewed as an interim president until Jacob Zuma, who defeated Mbeki for the presidency of the African National Congress a year ago, can be elected in his own right in elections that are expected at the end of March or early April next year.  During the past year, with this shift in power in South Africa, there has been a very marked shift in attention from international events, which was what Mbeki really enjoyed and where he liked to focus, to domestic South African political and economic issues.

There have been a whole raft of problems that have sprung up in South Africa during the past year, and just by background and interest, Motlanthe and Zuma and the new leaders of the ANC are much more domestically focused.  And they seem only too happy to leave Mbeki in charge of the mediation of the Zimbabwe conflict, which, frankly, doesn't augur very well for any sort of either expeditious solution or heightened South African engagement, to try to take bold initiatives and put real pressure on the Zimbabwe government and Robert Mugabe.

So where does that leave us?  Basically, you know, we've got a choice.  And probably the way I see things shaping up is that there is going to be a much stronger inclination on the part of the international community to move aggressively to deal with the cholera epidemic and perhaps, more broadly, the food emergency in Zimbabwe.  This permits Western governments and the U.N. system to meet the political demands coming out of their constituencies for action, to do something now to -- you know, to prevent the loss of life, to deal with the humanitarian crisis.

And I suspect that they're going to have to make some compromises.  They're going to have to hold their nose and make some compromises that are going to permit the -- Mugabe and his people to have far greater control over the distribution of those relief supplies:  medicine, food, whatever.

And there will be a much greater likelihood that -- of significant diversions to Mugabe's supporters, including the army, which, as you mentioned a few moments ago, Paul, was rioting in the streets last week because it itself wasn't being paid.  Its families of soldiers were being subjected to the same humanitarian stresses that the rest of the Zimbabwe population is being subjected to.

In the longer term, to deal with the political and economic situations -- I mean, the donors have been holding back.  There has not been money flowing.  And the reason is because the donor countries -- both bilaterally, in terms of countries and to the World Bank and the multilateral institutions -- have very explicitly been waiting for the implementation of that September 15th agreement, and to have tangible evidence that Morgan Tsvangirai will play a meaningful role and be able to initiate a process of reform -- particularly, in the short term, economic reform, but in the medium to longer term, political reform -- that would convince them the country's now on a more positive track and that they can go ahead and begin disbursing significant amounts of aid that'll make a difference.

I don't see any solution, not in the foreseeable future.  I think we suffer a little bit from the political hiatus in Washington, where we've got a lame-duck Bush administration that's -- and a -- Obama administration, I think, that's likely to be much more forcefully engaged in the Zimbabwe issue, but isn't going to come into power for another six weeks.

So in the meantime we will continue to jawbone.  I mean -- and there will be a lot of public pronouncements of outrage.  But in terms of practical -- practicalities, the best we can hope for is a combination of the negotiations led by the South Africans, and internal Zimbabwean political pressure that would somehow peel away the members of the so-called National Security Council, the service chiefs and intelligence chiefs, eight or 10 people who are really calling the shots and, frankly, wouldn't let Mugabe compromise if he were so inclined, because they've accumulated so much over such a long period of time that they fear his departure will lead them to be brought for crimes against humanity to the International Criminal Court.  So it's not quite a stalemate, but there's no reason for any optimism.

STARES:  All right.  Well, thank you, Tony, and thank you, Laurie.  We have a good chunk of time left for Q and A, and so why don't we just open it up?

OPERATOR:  Okay.  If you would like to ask a question, please press the star key followed by the 1 key on your touchtone phone now.  Questions will be taken in the order in which they are received.  And if at any time you'd like to remove yourself from the questioning queue, press star-2.  Again, that's star-1 to ask a question.

And our first question comes from Jim Dingman with INN World Report.

QUESTIONER:  Yeah, hi.  I'd like to get your assessment as to what you think the internal stability of the security forces will be, since as you said -- just to finish your comment -- we all know that they basically said to Mugabe, you know, "You can't leave, because if you leave, we're going to go down the tubes."  And so what is the likelihood of the security forces essentially from the bottom up overthrowing the government in this situation?  Because it seems as you described and as we all know the situation internally has been intolerable for quite a long time.

And secondly, what do you think -- you say the Obama administration may change its policy or be more forceful, but yet Obama himself comes from a political machine in Chicago, particularly the Mayor Washington and the new Mayor Daley machine, that during its reign actually had a foreign policy towards southern Africa that was very much engaged in the whole anti-apartheid movement, which lingers in the minds of some in the administration coming from that milieu of Chicago?  And I just wonder how you think that's going to play out?

STARES:  Tony, do you want to --

HOLMES:  Yeah, sure.  I'm happy to.

First, the Zimbabwean security forces -- I mean, as became apparent -- I mean, it has been apparent for quite some time, but has manifested itself publicly last week -- the security forces in Zimbabwe are not monolithic.

What you've got is a very small circle of people around Mugabe who are -- who benefited immensely from corruption domestically in Zimbabwe -- well, in -- I mean, the entire independent reign since 1980, but particularly the past decade -- and whose wealth was augmented by five years' exploiting diamonds and other resources in the Congo, from 1998 to 2003.  So these guys have an awful lot to lose.  They've been involved in pretty blatant human rights abuses, and they see themselves as vulnerable.

Underneath them, however, are the rank and file of the Zimbabwe security forces.  And, you know, in addition to, you know, a fairly sizeable army and a smaller air force and -- there are couple of -- at least a couple of intelligence services and the police, and all of these forces have not been treated equally.  It was shocking to many people to see the police end the riots by the disaffected soldiers and to arrest a lot of them and to beat up a lot more and to, you know, end this demonstration -- this -- these riots.

And the government very quickly printed a lot of money and began paying, you know, back wages and giving financial supplements to the disaffected soldiers.  But, you know, with a 231 million percent rate of inflation, the $500 million note that went into circulation in Zimbabwe yesterday, which was worth 10 U.S. dollars is going to be worth -- is 10 U.S. cents this morning and, you know, virtually nothing tomorrow.  So that's not going to put out the fires for very long.

So because of this split between the inner circle, these few leaders, and everybody else, I think there's some reason to expect increasing tension within the services, within the military, that could lead the national security council to decide that it's got to do something.  And from its perspective I think it's going to want to do two things.

First is Mugabe is a very visible symbol that they can sacrifice that will build, to a certain extent -- part of the way, anyway, to satisfy international demands.

The other thing, of course, is they're going to try to negotiate an out for themselves.  I don't know who would have them.  I don't know what guarantees can be elicited.  You know, it's not a simple negotiation to try to, you know, get guarantees of immunity from ICC prosecution.  Who's going to provide that?  There's no person, no nation that can do that.  But that's what they'll be inclined to do.  And I can easily imagine that the situation would reach the point where they're going to -- it's going to be every man for himself, and they're going to try to negotiate what they can.  And ultimately, you know, they could easily try to flee.

STARES:  And the second question, Tony, what can the Obama administration do differently?

HOLMES:  Well, I mean, the Chicago analogy -- I'm not convinced that there's any relevance there at all.  Many U.S. sub-federal jurisdictions -- states and cities -- had their own foreign policies and many took positions on apartheid and the boycott of the 1980s.

But I do think that there will be a new dynamism, a redoubling of interest and commitment and energy from the Obama administration towards solving the half-a-dozen or so major African crises, among which Zimbabwe, you know, is placed.  But they -- the new administration, like the old administration, is going to face that reality of African ambivalence, at best, but the decided reticence to intervene more than rhetorically and more than just in supporting negotiations.

So I think a very aggressive U.S. diplomacy is called for as well as some sub rosa efforts to try to accentuate those divisions within Zimbabwe.

STARES:  Okay, next question.

OPERATOR:  Okay, the next question comes from Liz Harper with "The NewsHour with Jim Lehrer."

QUESTIONER:  Hi.  Thanks so much for doing this today.

First question.  There was a report in the Zimbabwe Mail about a new operation called "lets finish them up" has been launched recently, and -- rounding up human rights workers, enlarge a previous campaign.  But this report says that there are Rwandans involved who are actually wanted for the 1994 genocide, and they are now working for Mugabe.  Have you seen any evidence of that?

HOLMES:  I have not.  I mean, this is news to me.  I hadn't heard of either the organization or seen any reference to Rwandans at all.  I mean, there's no question that MDC people continue to be abducted, a couple of well-known people in the last 10 days or so.  And since September 15th, the ZANU-PF sort of cadres have reduced their abuses on the MDC, but nonetheless there's been an ongoing campaign to intimidate, and people have been abducted, and some, you know, apparently murdered because they've just disappeared for good.

QUESTIONER:  And my second question is, what do you think about some sort of targeted sanctions on the mining sector?  Apparently Mugabe's hard-liners get so much money through the mining sector and other things.

HOLMES:  Well, I mean, sanctions are a very ineffective tool unless they're quite tight multilaterally.  I mean, further sanctions by the U.S. and the U.K. and the European Union aren't going to have a tremendous impact.  I mean, you're correct in that business continues to be done in Zimbabwe despite how far things are fallen.  Money continues to be made, and the reserve bank and the leadership continue to exploit the global economy and to export what they can to survive, as well as to continue to enrich themselves personally through diversions into their offshore accounts.

But with minerals, I mean, it's a landlocked country, and to export anything they have to have the cooperation of their immediate neighbors -- basically South Africa, to a lesser extent Mozambique.  And you know, if those countries -- I mean, they haven't shown any interest in sanctions as well as, you know, not being interested in direct action.  It's certainly -- I mean, a lot of squeezing can be done.  And South Africa, if it closed the border, if it stopped exporting electricity to Zimbabwe, could put a lot more pressure on the government, there's no question about that.  But you know, I mean, what -- how -- what will be the price in lives and humanitarian terms if Zimbabwe is squeezed so hard that the place really does implode, there is anarchy, and you know, everybody's scrambling to survive or to kill or to do the best they can?  I mean, that's a pretty dire situation.

Have we reached the point where that's called for?  I'm not really sure.  And it's awfully difficult to assess what would occur in such a situation and what the unintended consequences would be.

STARES:  Okay.  Thank you, Tony.

OPERATOR:  Okay, and our next question comes from Lawrence Freeman with Executive Intelligence Report.

QUESTIONER:  Hello, this is Mr. Freeman.

The question I have is in terms of the Western response to this cholera outbreak.  Even though as the speaker mentioned it's a debilitating disease, it is one that we do know how to deal with in terms of fresh water, clean water and sanitation.  So it would seem to me that if we wanted to deal with the crisis, it would be a huge mobilization from the West, from the donor countries, and supporting the SADC countries who are supporting this effort for clean water with chemicals for the cleaning.  But instead, on Monday/Tuesday you saw these calls coming out, fuel blockade I think by Cameron, other people calling for tightening the screws.  One report said that the real disease is Mugabe, not cholera.  And this is all British press and some of the other press.

So the question is, is there another agenda?  Is there an agenda to allow this humanitarian crisis to continue because the agenda is really regime change for Mugabe?  I mean if the West is really serious and moral, wouldn't we be doing everything possible to assist?

GARRETT:  Well, I -- I don't -- I haven't seen those British press accounts you're referring to, but I find --

QUESTIONER:  Wall Street Journal, Financial Times, Tony (sic/David) Cameron, Miliband, they're all out on Monday and Tuesday.

GARRETT:  The point -- if I may, I am well aware of many health care workers, volunteers, that are stuck at borders and can't get visas to to into Zimbabwe.  The Zimbabwe government has made certain specific agreements with a cholera response team and has been very picky about who gets in to help them and who doesn't.

I find it hard to believe that there's any conspiracy in Geneva at WHO to sit back and let everybody die, and I would take great offense at any such claim.

HOLMES:  Lawrence, I would just add that the fact that the Zimbabwe government has refused to allow into the country, by denying visas to so many health workers -- and I'm not talking about just the political people, the Jimmy Carters and Kofi Annans and Garasham Michels (ph), but I'm talking about the French teams of cholera experts who are waiting, you know, poised to go into Zimbabwe, but can't get in because the government won't allow them basically refutes that line of argument.

QUESTIONER:  Well, except the fact that the Zimbabweans are very defensive, maybe, and paranoid, as was the case with Bashir when there was an open policy for regime change, that these countries would be coming in and carrying out operations against the sovereignty of the country, which I think is a fair attitude to have.  But I mean, it seems to me the donor countries in the West said, okay, we're having trouble with Mugabe, we'll work through South Africa, especially Mozambique -- I mean, there could be a huge humanitarian effort.  And I think that as you look at all the comments that were made by leaders, especially coming out of the Brits, they're saying squeeze, squeeze, squeeze -- more blockades, more sanctions -- which is exactly the opposite if you're concerned about the human life and humanitarian disaster.

STARES:  Okay.  All right.  Well, let's move along.

Laurie, I just had a quick question.  You know, there was suggestion in some of your remarks that the cholera outbreak in Zimbabwe may be a similar sort of drug-resistant strain to what we've seen elsewhere in the continent at the moment.  How long typically does it take for WHO and others to develop a response to that?  Is this something that takes weeks, months, days?  You know, how -- I'm completely ignorant on this, so I'm just curious:  How long can we really expect before we can respond to this effectively?

GARRETT:  Well, in terms of knowing what the strain is and its drug susceptibility, that should be a matter of two or three days.

STARES:  Really?  Okay.

GARRETT:  So it's shocking that, if that is known, it's not been made public.

STARES:  I see.

GARRETT:  It may have something to do with the very difficult stature -- and this kind of goes to your prior questioner's remarks -- the difficult stature of WHO.  It's always a problem, which is that by charter it answers to the ministries of health of countries.  And by charter, based on its 1949 charter, it has to request permission from ministries of health for release of documentation and information.

So this slows everything down tremendously if you have a ministry that is run by a government that's seeking to cover things up or distort information, or in fact it's just simply so beleaguered that it's incapable of functioning in a responsible manner.  And I mean, that goes to what I was saying before about we have no reliable numbers, we have no reliable estimates of what's going on.

And you know, one of the issues that I wonder about, in light of Tony's comments about the need for an African response -- which I agree with completely -- is the neighboring states and the spillover of cholera.  As it worsens, will you see those states demanding some kind of at least regional response?

I have been in -- in Zimbabwe many times over the years, going back to the days when it was absolutely a glorious, beautiful place in the early 1980s and one of the most desirable addresses to live in on the entire African continent, and I loved it.  And watching it deteriorate, visit after visit, over the years has been utterly heartbreaking.  And it's not coincidental that the highest HIV rates, and now the highest reported cholera rates, are in areas that have been the most repressed.

The Mozambican border area and the town of Mussina -- I think, unless you've been there, it would be very hard to imagine this place.  But I mean, I've had my life threatened in Mussina.  I have experienced what -- what the ZANU terror campaign is like.  They have tried to keep the masses from fleeing into Mozambique by creating a border situation that is utterly beyond-belief terrifying, with thugs beating the hell out of people and raping the women.

I went there in one case to document the relationship between the rape campaigns and the spread of HIV, and it was in that situation that the thugs threatened my life and ran me down, and I managed to escape.

And it is not a surprise that these are the areas where you see the greatest deterioration of the public service/public goods infrastructure and, in its place, thugs who take a toll off of every truck trying to cross the border, like mobsters, and run brothels to service the truck drivers, where the women are all likely to be HIV-positive that are servicing the truck drivers.

This is the kind of "state," quote-unquote, that we're talking about, and it can't mount, as a previous caller asked, a massive humanitarian response if the humanitarian workers, A, can't get in because they're not allowed in with visas, and then once in have to work side by side with the very thugs that the people on the ground recognize.  They know who that guys is:  He's the one that killed their daughter; he's the one that beat the crap out of their son; he's the one that burnt down their store.  And now here comes the international health worker, side by side with these thugs, and it's the only way they can operate.  They don't have any choice.

STARES:  Okay.

Next caller.

OPERATOR:  Okay, next question comes from James Kirchick with the New Republic.

QUESTIONER:  Hi.  Can you hear me?

GARRETT:  Mm-hmm.

STARES:  Yes, sir.

QUESTIONER:  Two things.  One is just a request, in regards to the last caller.  I don't know why CFR allows people from Lyndon LaRouche's newspaper on this press conference call.  It's really a waste a time for everyone, and that a better job should be done in screening the press calls so that only legitimate publications are allowed.

That said, in terms of a military intervention, we have two African governments now in support of that.  What is -- is there any ability for that to happen?  And if it were to take place with, you know, Botswana and Kenya, what would happen to the Zimbabwean military?  Is it strong enough to respond to that?  Would it dissolve?  Would soldiers mutiny?  It seems that they're not being paid and that there are fissures within the military establishment.

HOLMES:  Well, that's quite a hypothetical, given the African Union and the SADC disavowals of any inclination whatsoever in the military or other heavy-handed direction.  But theoretically, I am not certain, but based on all of the sort of circumstantial evidence that I've been able to absorb, that the military would be very weak and would have a difficult time in resisting any credible military intervention.

But it would take so long to put together the political consensus and then on the grounds the practical intervention force that, you know, I would lay long odds that you would be able to, once the Zimbabweans themselves realized that, you know, this was not a mirage and was going to happen, that there would be a negotiation -- you know, a new negotiated solution.  But yeah, I mean, you don't have soldiers rioting in the streets because their families don't have enough food and they can't get more a couple of dollars' worth of Zim dollars out of their bank accounts and that would be a credible force.  It's just absurd.

I mean, the infrastructure -- both the physical infrastructure and the institutional infrastructure of the country has fallen apart.  You know, the reason for the cholera epidemic is because the water system has broken down.  The financial system has frozen up because of the incredible level of inflation.  The agricultural sector -- you know, the only real production that's occurring is subsistence production.  So, I mean, there's no defense capability there.

GARRETT:  Actually, I would -- I would go a step further and say I think from what I've observed over the years with the way -- what I would call "adaptive behavior" by the populace, meaning -- day in and day out, people make calculus decisions about these terrorizing thugs that are the ZANU gangsters, which is not the same as the ZANU -- as the national army.  And I would say that the moment they thought that it was safe to do so, that there was real security arriving, whether it came from an outside army or from the U.N. or whoever it came from, you would see these people rise up and take revenge against those that have terrorized them for so long.

And then the problem would be the possibility of some pretty rampant violence, especially down at the village level where specific thugs have sort of operated like warlords, extracting wealth from the impoverished population and demanding sexual favors from the women in ways that are just absolutely hideous.

HOLMES:  Well, those are the some of the unintended consequences I alluded to a few minutes ago.

STARES:  Okay.  Why don't we move on?

OPERATOR:  Okay.  Our next question is a follow-up from Jim Dingman with INN World Report.

QUESTIONER:  Yes.  Laurie, I'd like you to go further into the issue of cholera in Guinea Bissau.  What do we know about what's going on there?  You mentioned in your comments that it was a particularly virulent strain.  And I just wanted to get a better sense of what is known about it, because the other two situations obviously are interrelated to wider social, political, military crises -- the Congo and Zimbabwe.

And another question to Tony.  Tony --

STARES:  Jim, can we just make sure that there are no others waiting.

QUESTIONER:  Fine.  No problem.

STARES:  Because that's a tangential question.  But if there are no other people waiting to ask on Zimbabwe, we can come back to your question.  But if there are others waiting to ask questions on Zimbabwe, could we move ahead?

QUESTIONER:  Well, I did want to also throw Zimbabwe into the mix, because obviously --

STARES:  Yeah, I know, Jim.  There may be -- you've already had one question or two, and so I just want to make sure --

Q    Okay, sure.  No problem.

STARES:  We only have five, 10 minutes left.

Q    No problem.

HOLMES:  How many people are in the question queue?

OPERATOR:  The only others are follow-ups.  So it would be a second question from anyone else.

STARES:  Please proceed.

OPERATOR:  Sure.

QUESTIONER:  The other question is to Tony in terms of the -- we know that the veterans movement in particular was used to mobilize support for Mugabe.  And I gather from what Laurie's talking about, what she experienced on the ground is in part the manifestations of that political nexus that Mugabe was able to mobilize for his support.  Where are they at?  Where are we at with -- what do we know about that particular groupment in terms of how he's using it in the present situation?

HOLMES:  Well, the veterans movement was always a canard.  I mean, basically these were ZANU PF thugs.  The youth brigade.  They became active in the early '90s when I was there, and it was amazing how few of them were old enough to have participated in the liberation war, which ended in 1979.  You know, it's been 15 years -- pushing 15 years since I left Zimbabwe, and anybody who's around now is almost certainly not going to have been a liberation war veteran.

This is just the mechanism off of control that ZANU PF has developed to terrorize, to intimidate the population, to minimize opposition political activity and to, you know -- their participation in democratic processes, like elections, and to maximize control.  And to cede it to them at the local level, which is what Laurie was referring to, is basically total police authority, and they are interchangeable with the police.  The police stand by while they do their, you know, dirty work, while they commit their crimes.  And then, you know, they move on to the next one.

They were very active during the seizure of the white farms to soften up the farmers to get them prepared to go very quickly, you know, once the boom was lowered legally.  I mean, I don't think that they are any sort of credible independent force.  It's just a manifest of the regime.

STARES:  Okay.  Next follow-up.

OPERATOR:  Okay.  We have a follow-up from Lawrence Freeman with Executive Intelligence Report.

QUESTIONER:  I just wanted to say -- respond to the comments from this fellow from the New Republic that I don't think the CFR should practice what you accuse other people of doing and use groupthink or political correctness to keep out other points of view.  I mean, I think there's's a legitimate issue about the response to a serious nightmare and crisis.  And numerous (people in the ?) public press have raised questions --

HOLMES (?):  Well, and we've answered your questions.

QUESTIONER:  Okay.  It's a legitimate question that should --

STARE:  All right.  Thanks very much.

HOLMES (?):  Thanks a lot.

STARES:  Is there another -- another question, please?

OPERATOR:  Again, if you would like to follow up, press star-one to ask a question.  (Pause.)

MR. STARE:  Okay.

HOLMES:  Maybe while we're -- you know, in the last couple minutes, I would say something about this new theme in international discourse when it comes to Zimbabwe and a few other countries around the world, mainly in Africa.  And that's the responsibility to protect.  In 2005, the United Nations passed a resolution that permits the international community to, in cases of genocide and crimes against humanity, intervene.  And there's really a very legitimate question, I think, as to whether the situation in Zimbabwe recently hasn't crossed the line to the point where that would be permitted under international law.

And not to -- there's a basis for a lot of the calls by Desmond Tutu and other African leaders, as well as British, American and other European ones as to, you know, whether we shouldn't be considering this.

And I would only say, besides that being, you know, a very legitimate question, is that it's very clear that even though it was passed by the United Nations, many African nations individually and the collective regional and subregional organizations are very ambivalent about the right of -- the international right of the responsibility to protect.  There's just not a consensus, I think, in any situation short of genocide, to invoke that on the part of the African governments.

I think that if this was 1994 in Rwanda, it would probably be possible, after great effort, to get African consensus to invoke the right to protect.  But I'm not aware of any other situations, including Darfur from 2003 to 2005, that would -- in which the African community would agree to move.

STARES:  There are reports, Tony, that Kofi Annan is sort of waiting in the wings.  I don't know whether it's as his sort of role as one of the elders, so-called elders.  And so the question is whether, in the absence of a sort of official response, whether you could see pressure being brought, by these private organizations, for action.  And that might actually provide the tipping point for African action.

HOLMES:  Well, I think, it's great, I mean, for non-governmental organizations, human rights groups.  I mean, it's a legitimate issue, for them to raise, as it is for governments of course.  But you know, to invoke that through the U.N. Security Council would entail a level of consensus that clearly doesn't exist today in the case of Zimbabwe.  And you know, I mean, this is just my speculation.  But I think that anything much short of the '94 Rwanda genocide would encounter similar difficulties.

STARES:  Okay.  Unless there are any other questions, I think, we can conclude this media conference call.

Again I want to thank the speakers today, Laurie Garrett and Tony Holmes, as well as the rest of you, for joining us.  Thank you so much.

.STX

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