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      Zimbabwe Voters to Elect President While Trained Workers Flee

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      Nurses, doctors and workers of all kinds are seeking to escape the country’s economic turmoil, an issue that has become a central theme in the election scheduled for Wednesday.The hospital where Warren George worked as a nurse in Zimbabwe was so short of basic supplies, like plaster, that he could not make casts to treat people with broken bones. He soon sought to join the exodus of more than 4,000 nurses who have fled the southern African nation in the past two years.But the government has refused to give him and many others the documents they would need to work in, say, Britain or Canada. He says that he now earns only about $500 a month as a traveling nurse and has to pick up extra shifts on his days off to ensure his family has enough to eat.Zimbabweans are scheduled to go to the polls on Wednesday in only the second election since Robert Mugabe, the liberation leader turned strongman president, was ousted in a coup.The vote amounts to a referendum on President Emmerson Mnangagwa, who is seeking a second term after, critics say, failing to steady the economy or stop the flight of workers, including a crippling “brain drain” of educated professionals. The departure of nurses and doctors has increased since the Covid pandemic, contributing to a widespread shortage of health workers on the African continent.Mr. Mnangagwa at an election rally in Harare this month. He is seeking a second term.Tsvangirayi Mukwazhi/Associated PressTriple-digit inflation has become the norm — it spiked to 176 percent in June. The country is $18 billion in debt and cannot get international loans because of political instability. Jobs are sparse, with economists estimating that 90 percent of work is informal. The local currency has become so worthless that the price grocery stores charge for bread has skyrocketed to 12,000 Zimbabwean dollars from 860 in April. Many use the U.S. dollar instead, when they can.“Everyone you meet in the streets, they are desperate to leave the country,” said Dr. Norman Matara, head of the Zimbabwe Association of Doctors for Human Rights, an advocacy organization.“Some of our colleagues have gone outside — you see them doing well in South Africa, in the U.K., in Canada,” he added. “You get the motivation to also leave because, honestly, we are just wasting our time.”This election, like past ones, is taking place in a jittery environment with fears of violence and of vote-rigging in favor of ZANU-PF, the party of Mr. Mnangagwa, which has governed Zimbabwe since independence in 1980.Mr. Mnangagwa came to power through a coup in 2017 that unseated Mr. Mugabe, who became increasingly autocratic during his nearly four decades in power. In the 2018 election, Mr. Mnangagwa eked out a victory, winning 50.8 percent of the vote over his closest rival, Nelson Chamisa, who is now president of the main opposition party, the Citizens Coalition for Change.Makeshift polling stations in Mbare, a township in Harare, on Monday.Siphiwe Sibeko/ReutersThis election is a rematch, and while polls suggest a tight race, many international and domestic observers doubt that the election will be free and fair.“It’s history repeating itself, except that ZANU-PF has perfected the system of rigging,” said Ibbo Mandaza, a political analyst in Harare, Zimbabwe’s capital, who runs an independent social-science think tank.The police have shut down dozens of rallies of the Citizens Coalition for Change and arrested dozens of its supporters. A new law that could result in the death penalty for Zimbabweans deemed to have betrayed the national interest has made many fearful to share their views.Even so, in surveys, Zimbabweans overwhelmingly say that they are dissatisfied with the direction of the country and the economy under Mr. Mnangagwa. If he prevails, political analysts say, there could be a surge in mass migration of Zimbabweans, straining other countries in the region — especially South Africa, where a struggling economy of its own has fueled violence against immigrants. Harare on Saturday. While polls suggest a tight vote, many international and domestic observers doubt that the election will be free and fair.John Wessels/Agence France-Presse — Getty ImagesMany African countries are short on health workers, more than any other region. The continent produces about 150,000 trained medical workers a year, but one in three cannot get jobs because there is not enough money to fund positions, according to James Avoka Asamani, who leads the World Health Organization’s work force team for Africa. The W.H.O. has identified 55 nations with critical shortages of health workers and suggests that foreign countries should not recruit from them. Thirty-seven of those nations are in Africa, including Zimbabwe, added this year, where the government estimates that the country will need at least an additional 69,000 medical workers by 2030.When Angela Khulu, an 84-year-old grandmother, was hit by a car recently and stumbled into a hospital in Bulawayo, in Zimbabwe’s south, most of the administrative nurses and hospital clerks were already ending their day shifts. She waited in a long line while the few medical workers on duty bounced between patients.Praying for a peaceful election during a church service in Harare on Sunday.John Wessels/Agence France-Presse — Getty ImagesAfter two hours, with pain radiating down her left side, she was seen by a doctor, who recommended checking for internal bleeding. But the hospital, Mpilo Central, did not have enough radiographers — or X-ray films — so, despite her serious symptoms, she was sent home and told to come back the following day.Dr. Tawanda Mapfumo, who works at Mpilo Central, says he has become accustomed to the chaos at the hospital, where about three dozen patients cram onto wooden benches in the corridors and waiting rooms. He says he cannot shake the guilt of seeing patients die because there are no resources to treat them.Those trying conditions have created an opening for Britain, in particular, to lure away Zimbabwean health workers. Nearly 22,000 Zimbabweans have received health care work visas from Britain over the past three years (though not everyone who receives one actually moves).Britain’s recruitment has drawn the ire of Zimbabwe’s government. In April, the vice president, Constantino Chiwenga, who is also the health minister, suggested introducing a law to criminalize the recruitment of Zimbabwean health workers by foreign countries. No law has been formally introduced yet.But within the past two years, health workers in Zimbabwe said, the Health Ministry has made it more difficult for them to get the letters of good standing they need to be hired abroad.A 31-year-old doctor, who requested anonymity to avoid trouble with the Zimbabwean government, said that in 2020, when he applied for his letter to move to Namibia to practice, he paid $40 and received the letter the same day.But when he sought another letter from the Zimbabwean authorities in early 2021 to move from Namibia to South Africa for more training, he was confronted with a fee of $150 and a five-page form with questions he considered intrusive. He filled out the form and paid but has still not received his letter.A hospital in Harare last year. The W.H.O. has identified 55 nations with critical shortages of health workers. Thirty-seven of those countries are in Africa, including Zimbabwe.Jekesai Njikizana/Agence France-Presse — Getty ImagesNonetheless, he said he was fortunate because he still works in Namibia, where his $3,000 monthly salary is roughly 10 times what he made in Zimbabwe.“It’s not worth your time or dignity,” he said, referring to the poor pay in Zimbabwe.The Zimbabwean Health Ministry did not respond to requests for comment. Christopher Mutsvangwa, spokesman for ZANU-PF, said that the government was not opposed to citizens going abroad for jobs but that it needed to control the flow to ensure that some skilled workers remained.Despite the government’s barriers, Zimbabweans are still finding ways to flee.Wynter Banda swapped her life as a hairdresser in Harare to become a nursing home aide in Britain. She and her husband, Godwill, a teacher, sold their car and borrowed from friends to come up with the $5,000 she needed for the visa fee and other moving expenses.Her husband eventually joined her and works as a science teacher. Things are tight, she said, because of debt and high rent. Still, she said they had made the right decision.“Even though it’s not easy and the working hours are very long and stressful, I can’t imagine going back to Zimbabwe,” she said. “We suffered there.”Studying during a power cut in Harare last year. Critics say that Mr. Mnangagwa’s government has failed to steady the economy or stop the flight of workers.Associated PressJeffrey Moyo More

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      Biden Should Take Voters’ Concerns About Age Seriously

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      Only 47 percent of Democrats want to see Joe Biden on the ballot in 2024, according to the latest Associated Press poll. That’s not because they think he’s done a bad job in office. Democrats tend to like President Biden and continue to give him good marks on handling the economy and foreign policy.But many Democrats, particularly younger ones, are worried that he will simply be too old to be effective in a second term, which would end when he is 86. “My problem with him running in 2024 is that he’s just so old,” one Democrat told pollsters.That may be deeply unfair — people age at different rates — and in Mr. Biden’s case, it’s impossible to deny that politics and conspiracy theories, rather than facts, fuel at least some of the concern. But candidates shouldn’t pretend, as Mr. Biden often does, that advanced age isn’t an issue. Mr. Biden is 80 now, the oldest American to serve as president, and even supporters, including the political strategist David Axelrod, have expressed deep worries that his age will be both a political liability in 2024 and a barrier to a successful second term. If Mr. Biden runs again, as he recently said he intends to, questions will persist about his age until he does more to assure voters that he is up to the job.Mr. Biden’s age makes him an outlier even in an era when the nation’s political leadership is getting older. The current Senate, where the average age is 63.9 years, is the second oldest since 1789. The House, where the average age is 57.5 years, is the third oldest. By comparison, the average age in the United States is 38.8 years.Concerns about age — both in terms of fitness for office and being out of touch with the moment — are legitimate, as Mr. Biden acknowledged in an interview in February with ABC News. His standard line, repeated in that interview, is: “The only thing I can say is, ‘Watch me.’”But Mr. Biden has given voters very few chances to do just that — to watch him — and his refusal to engage with the public regularly raises questions about his age and health.The usual White House method of demonstrating a president’s mastery is to take tough questions in front of cameras, but Mr. Biden has not taken advantage of that opportunity, as The Times reported on Friday. He has held fewer news conferences and media interviews than most of his modern predecessors. Since 1923, only Richard Nixon and Ronald Reagan took fewer questions per month from reporters, and neither represents a model of presidential openness that Mr. Biden should want to emulate. His reticence has created an opening for critics and skeptics.The president also needs to talk about his health openly and without embarrassment, and to end the pretense that it doesn’t matter. Those who are watching him with an open mind have seen a strong performance this year. His State of the Union address on Feb. 7 shattered the Republican attempts to portray him as doddering. With a passion rarely seen at one of these speeches — let alone in his political history — Mr. Biden presented a remarkably effective defense of his presidency and gave a preview of what is likely to be an imminent re-election campaign.The Times reported last summer that Mr. Biden’s overall energy level has declined, and he continues to stumble over words in his public appearances. But those flaws alone don’t signal a politician who is too old to run again. His first term, in fact, is already full of accomplishment: The economy has added 12.6 million jobs since he took office, inflation is cooling, and he has signed significant legislation to fight climate change, improve access to health care, and make investments in manufacturing and infrastructure. He has stood up to Russia’s destructive campaign in Ukraine, and rallied the West to Ukraine’s side.Nonetheless, as Mr. Biden nears his actuarial life expectancy, concerns about his ability to handle the demands of campaigning and a potential second term are unlikely to disappear. Only a combination of performance and complete candor will change the minds of skeptical voters. Old age remains a sensitive topic, and many people, particularly men, are reluctant to discuss personal infirmities for fear of demonstrating weakness or being pushed aside by impatient younger generations. There is good reason for the federal government’s prohibition of age discrimination in employment — a protection that begins at age 40. Ageism is real.That law, however, doesn’t apply to people who are running for office. Voters have every right to ask questions about the medical condition of a candidate who wants their support. In 2016 both Donald Trump and Hillary Clinton gave the public very few details about their health. (Mr. Trump released a particularly preposterous doctor’s letter claiming he would be “the healthiest individual ever elected to the presidency.”)Mr. Biden acknowledged during the lead-up to the 2020 campaign that he was “chronologically” old but said it was up to voters to decide whether that was important. In that election, against an opponent who was only four years younger, the answer was clearly no. In November 2021, he released a medical report that said he was a “healthy, vigorous 78-year-old” and noted nothing more serious than a stiffened gait due to spinal changes and some acid reflux that caused him to cough.His most recent health summary, released on Feb. 16, said much the same thing, describing him as a “healthy, vigorous 80-year-old male who is fit to successfully execute the duties of the presidency.” But his cognitive abilities went unmentioned. That’s something he should discuss publicly and also demonstrate to the voters, who expect the president to reflect the nation’s strength.If he runs again, Mr. Biden will need to provide explicit reassurance to voters; many of them have seen family members decline rapidly in their 80s. Americans are watching what Mr. Biden says and does, just as he has asked them to do.Source photograph by Azure-Dragon, via Getty Images.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. More

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      in Elections

      Should Candidates Be Transparent About Their Health?

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      More from our inbox:Revised Drone RulesLiving in Political FearPreparing for Future PandemicsHow Fossil Fuel Donations Sway Climate PoliticsLt. Gov. John Fetterman of Pennsylvania greets supporters following a Senate campaign rally.Kriston Jae Bethel/Agence France-Presse — Getty ImagesTo the Editor:Re “Candidates Must Disclose Medical Issues,” by Lawrence K. Altman (Opinion guest essay, Sept. 30):Dr. Altman correctly calls for the full disclosure of medical issues by major candidates, especially presidential. He has championed this cause for years, but his voice has gone unheeded.The most famous candidate health cover-up was J.F.K.’s adrenal insufficiency, Addison’s disease. But John McCain’s recurrent melanoma, Bill Bradley’s atrial fibrillation, Joe Biden’s cerebral aneurysm in his 1988 campaign and Bernie Sanders’s significant coronary disease requiring a stent were all either downplayed or denied.The most egregious example of health misrepresentation was in 1992, when Paul Tsongas and his physicians declared he was cured of his non-Hodgkin’s lymphoma when he was not. If he had been elected president rather than Bill Clinton, he would have required ongoing cancer treatments while in office, which would have compromised his ability to fulfill his duties. He died on Jan. 18, 1997.With the likelihood of one or more candidates over 75 running for president in 2024, the case for full medical disclosure is more compelling than ever. The country would be well served to remember the advice given by William Safire in 1987, when he wrote, “The president’s body is not wholly his own; that is why we go to such lengths to protect it.”Kevin R. LoughlinBostonThe writer is a retired urologic surgeon and a professor emeritus at Harvard Medical School.To the Editor:I would like to respectfully disagree that candidates owe their voters full medical transparency. Confidentiality of medical records exists for good reason, and to throw it away — citing confusion over John Fetterman’s health in the Pennsylvania Senate campaign — is the wrong approach.For example: Does a female candidate owe it to voters to reveal whether she has ever had an abortion? Some would argue yes, she should. I would argue that it’s none of the voters’ business.What else should a candidate reveal? Therapist’s notes? Past substance use?A real-life example is Thomas Eagleton, who was tapped to be George McGovern’s running mate in 1972 until it was revealed that he had undergone electroshock therapy for depression 12 years earlier. Because of this, he was dropped from the ticket.In the U.S., we are extremely fortunate to have the rights we have, including a right to privacy. We should not be looking for ways to chip away at these rights.Gregory FedynyshynMalden, Mass.Revised Drone RulesAn Air Force Predator drone, right, returning from a mission in the Persian Gulf region in 2016. The new policy suggests that the United States intends to launch fewer drone strikes away from recognized war zones.John Moore/Getty ImagesTo the Editor:Re “Rules on Counterterrorism Drone Strikes, Eased by Trump, Are Tightened by Biden” (news article, Oct. 8):Are we supposed to be assured that the United States is now acting ethically, legally and judiciously with President Biden’s revised drone assassination policy?Our clandestine killing of terrorist leaders outside conventional war zones only provokes greater risk for American citizens and soul-searching trauma for drone operators thousands of miles way. It deeply stains our own sense of national righteousness.This is not a policy that needs to be reformed. It’s a policy that should be abandoned for ethical, tactical and practical reasons.Dave PasinskiFayetteville, N.Y.Living in Political FearHouse and Senate leaders have their own security details, including plainclothes officers and armored vehicles, but it can be more difficult for others to obtain such protection.Andrew Harnik/Associated PressTo the Editor:Re “Lawmakers Fearing the Worst as Intimidation Tactics Grow” (front page, Oct. 2):The appalling acrimony and threats directed against duly elected representatives have a chilling trickle-down effect to citizens as well. I recently received what I considered a banal lawn sign from the League of Women Voters. One side states, “Vote — Our Democracy Depends on It,” and the other, “Vote 411 — Election Information You Need.”In other election years, I would have placed it on my lawn without thinking twice. But after the Jan. 6 insurrection, I’m hesitant. Even though I live in a mostly progressive, blue-voting Westchester community, I know that many of my neighbors hold other political beliefs. There are a surprising number of “Blue Lives Matter” banners and “1776” flags in my neighborhood, which make me wonder how many of these neighbors doubt the legitimacy of the 2020 election.I worry that displaying a message that our democracy depends on voting would be more of a red flag than a civic reminder.And I am ashamed that in our current fractious, and dangerously degraded, political climate, my fear will keep me from exercising my political beliefs.Merri RosenbergArdsley, N.Y.Preparing for Future Pandemics Brynn Anderson/Associated PressTo the Editor:Re “Unprepared for Covid and Monkeypox. And the Next Outbreak, Too” (news analysis, Oct. 1):Apoorva Mandavilli highlights an important issue when she writes that the United States “remains wholly unprepared to combat new pathogens.”Governments do need to be ready for future pandemics when they hit, but their priority must be preventing them in the first place. We know that most infectious diseases can be traced to pathogen transmission between wildlife and people, particularly in our increasingly degraded and exploited natural world.Governments across the globe must prioritize efforts to reduce the risks of future pathogen spillovers, including via trade and at wildlife markets.A critical first step is recognizing the intrinsic links between the health of humans, animals and the ecosystem, and acknowledging the foundational importance of an intact and functioning environment to our well-being.A new international treaty or agreement can help bring governments together to catalyze needed change. With several hundred thousand yet undiscovered viruses in wildlife that can potentially infect humans, this is not the time to ignore the science and avoid action.The adage that “an ounce of prevention is worth a pound of cure” is now truer than ever.Susan LiebermanChris WalzerDr. Lieberman is the vice president for international policy at the Wildlife Conservation Society. Dr. Walzer is its executive director for health.How Fossil Fuel Donations Sway Climate PoliticsFrom left, Florida’s governor, Ron DeSantis, and two senators, Rick Scott and Marco Rubio, in 2019.Kevin Lamarque/ReutersTo the Editor:Re “Republicans Talk About Rebuilding, but Not the Cause of Climate Change” (news article, Oct. 5):Large political contributions from fossil fuel interests are blocking federal action against climate change even in Florida, one of the areas most vulnerable to hurricanes. Its vulnerability is fueled by warmer oceans along with storm surges worsened by rising seas and downpours increased by a warmer atmosphere that holds more moisture.The United States could become the world leader in battling climate change, inspiring and helping other countries to do more while creating millions of jobs. Incredibly, Florida’s Republican governor and two senators have voted against action to mitigate climate change.Why? “If you’re from Florida, you should be leading on climate and environmental policy, and Republicans are still reticent to do that because they’re worried about primary politics,” Carlos Curbelo, a former Republican congressman from South Florida, is quoted as saying.That is, Republicans who stray from the fossil fuel line will face a primary opponent well funded by fossil fuel interests.Public funding of election campaigns must replace big contributions if we want our democracy to stop being distorted. Indeed, if we want to safeguard our planet.Richard BarsantiWestern Springs, Ill. More

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      Biden Shows Off a New Accessory: A Walking Boot

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