Zimbabwe is a tough country. Even so, life goes on. But sometimes it’s not so easy to keep a positive outlook.

The first time I was really confronted by loss in my humanitarian career was March 1994 in Mostar, Bosnia Herzegovina. There was a small public garden in a sheltered part of the city that had been transformed into a make-shift graveyard – dozens of markers all bearing the date of birth – graves of people in their twenties and thirties – and the date of death, some time in the previous three or four months. The sense of loss was profound. So many young people in such a short period of time.

In the three or four months since I arrived in Zimbabwe, MSF and its team of workers has endured a considerable loss. Just after I arrived, a lab scientist in one of the projects died. Then, a counsellor succumbed to a brief illness and died. Then one of our cleaners died. She had lost her sister only a month before and so had taken in her eight-month old nephew, who was otherwise an orphan. Now their seventy year-old mother is the only care giver for the child, having lost two daughters in two months. One of our drivers lost his brother. Another colleague lost a six month old child. Yet another colleague; his wife and best friend were killed in the same road accident.  I can count three direct employees and at least seven close relatives in the past three months, out of a staff of some three hundred.

The HIV prevalence in Zimbabwe has gone down in recent years. Some people say the reduction is a testament to improving prevention measures. I’m not so sure – the number of funerals that people in our small MSF staff team have attended in the past three months suggests otherwise. Untreated – AIDS kills. Perhaps that accounts for the reduction in HIV prevalence. And it’s not just AIDS that is the killer – this isn’t a good place to have an accident or get sick. At least half of these deaths were in public hospitals. Healthcare is uncertain in any circumstance, but very much more so here. Back home I would have expected a better outcome in the majority of these cases.

Humanitarian assistance is not an easy job. Don’t think that seeing the world and meeting people as an aid worker is like a pleasant walk in the park. Bosnia was a real shooting war, too close to home, and not fought according to any rules or laws or norms of society. But even though brutal and unregulated and horrific, it wasn’t as lethal or destructive as HIV has been in Zimbabwe. It’s not just the countless direct victims of AIDS, it’s the knock-on effect.  Health workers are dying. The combined effect of the HIV pandemic and the economic crisis means that health workers earn more in neighbouring countries, so as the hospitals become ever more packed with patients, they are depleted of trained staff. Death is ubiquitous. Funerals – a weekly occurrence. MSF treats tens of thousands of HIV patients in Zimbabwe with anti-retroviral therapy – more than 42,000 at the last count – but it’s a drop in the ocean with more than 1,200,000 people in the country living with HIV, the majority receiving no treatment at all.

I ask people how they cope. They say, “Life goes on.”

As I said, Zimbabwe is a tough country.