In the wide, arid plains of Matabeleland North, a 15-year-old girl walks several kilometres each week to attend secondary school.
She does not live at home. Instead, she stays at an unregulated “bush boarding” facility near her school because her parents, both struggling with mental health conditions, are unable to care for her or afford transport.
Her situation, described by local poet and advocate Obert Dube, highlights what community leaders say is a deepening but largely hidden crisis in Zimbabwe’s poorest province: the intersection of untreated mental illness and extreme poverty.
According to the 2024 Zimbabwe Livelihoods Assessment Committee (ZimLAC) report, Matabeleland North now has the lowest average household income in the country, at US$66 per month. While 10.5% of households report having a member with a confirmed mental illness, local leaders say the social and economic impact stretches far beyond those figures.
“Many people in the rural areas suffer from mental health challenges with no psychiatric support,” said Councillor Given Moyo of Kachechete in Hwange district. “We see families collapsing because the breadwinner is no longer stable, and the burden falls on children who should be in a classroom, not acting as primary caregivers. Without specialised clinics, these families are left to rot in poverty.”
In the same district, Mr Dube said he encountered a nine-year-old girl who dropped out of school because her mother, who is mentally unwell, could not raise the US$20 in school fees.
Across the province, similar stories emerge.
In Kamativi, in Binga district, 70-year-old Lenziwe Mwembe is raising two grandchildren and caring for her adult son, who has chronic mental health problems. Matabeleland North has the highest proportion of elderly-headed households in Zimbabwe, at 30.1%.
“I am old and tired,” she said. “The children have no shoes, and with maize meal prices in some areas reaching US$1 per kilogramme, I must choose between a bag of mealie-meal and their school books.”
In Tsholotsho, Maria Sibanda looks after her sister, who is mentally ill. She says the demands of caregiving make it difficult to earn a living through casual labour.
“When the mind is sick, the stomach follows,” she said. “If I stay home to stop my sister from wandering into the bush, we earn nothing.”
The ZimLAC report shows that 13.1% of children in the province are out of school due to financial barriers.
Village health workers, who provide frontline support in rural areas, say they are ill-equipped to deal with psychiatric cases. Although 83% of the province has access to such workers, they are primarily trained in basic health care.
“We can offer general advice, but we are not trained for psychiatric crises,” said Hlanganani Village Health Worker Bongani Ndebele in Hwange. “We see children failing to grow properly because their grandparents cannot manage the Pfumvudza or Intwasa plots that should be feeding them.”
Community leaders argue that while government assistance programmes exist, they often fail to reach households headed by children or elderly caregivers, particularly where mental illness is a factor.
They are calling for district-level psychiatric services, school fee waivers for affected children and targeted social protection measures.
“Without a dedicated effort to provide psychiatric care and educational support, we fear a generation of children in Matabeleland North will be lost to the shadows of their parents’ illness,” Mr Ndebele said. “We would be grateful to have psychiatric hospitals in our districts so that parents can receive proper treatment and their children can also receive counselling.”