Thursday, January 8, 2009

A National Blitz to Control Cholera in Zimbabwe

A song composed and performed by some of Zimbabwe's best known musicians talking about how to prevent the spread of cholera is set to become the country's unofficial anthem -- at least if the government has its way.

The song,"Cholera -- Chenjerawo", which translates as "Cholera -- Beware" , will be played on radio stations across the country every thirty minutes. Performed by a group of musicians calling themselves Artistes for Health, it's the brainchild of some of Zimbabwe's top performers including Tanga Wekwa Sando and Oliver and Sam Mtukudzi who wanted to do something to help stop the rapid spread of the epidemic -- the country's largest ever recorded outbreak. Cholera has now affected every province in Zimbabwe. More than 33,000 suspected cases have been reported and the disease has claimed over 1,600 deaths.

The first cholera case was reported in August in a suburb of Harare. This week, at a meeting attended by government ministers, provincial governors, traditional chiefs, health experts, the commander of the Zimbabwe's defence forces, diplomats and the media, the government announced what it called a nationwide blitz to control, cure and eliminate the disease.

"Information is the greatest tool in fighting this epidemic", declared Dr Edward Mabhiza, permanent secretary at the Ministry of Health and Child Welfare.
The plan is to recruit as many as 20,000 volunteers to help spread messages about good hygiene. Radio jingles, messages in the papers and on television will be used in the campaign. Pamphlets and posters carrying information on how to prevent cholera are to be distributed everywhere, from beer halls to church entrances, and everyone, from provincial chiefs to soldiers, is being urged to play a part in the national effort.

Theatre groups will be also enlisted. Oxfam, which last month announced a £4 million aid appeal for Zimbabwe, is already using drama groups to promote key health messages as it distributes hygiene kits to vulnerable communities across the country.

Team Arts Works, a drama group working with Oxfam

Using music, theatre, dance and humour, the groups entertain the crowds. But its entertainment with a message, as the shows also highlight the need for careful hand washing and food hygiene.

Yet even the government, which acknowledges there is still some way to go before it can declare the epidemic under control, concedes that it needs more than educational messages to fight the cholera epidemic.

The country's sewage systems have broken down; rubbish is no longer collected and piles up rotting on streets. Hyperinflation has caused many health workers to stay away from work, unable to live on their salaries which are paid in rapidly devaluing Zimbabwean dollars. More boreholes need to be drilled, to provide clean water sources for communities. And many Zimbabweans are struggling to feed themselves.

There are worries that the epidemic could spike with the approach of the peak season of heavy rains, which could spread contamination to shallow wells; flooding; and the movement of infected people within Zimbabwe and to other neighbouring countries.

Education, though, can go a long way. And the call for action to mobilize the nation is an important step forward.

Saturday, January 3, 2009

new year in Zimbabwe: hopes for a better 2009

As the midnight countdown ended, cheers rang out and the crowd hugged and kissed friends and strangers in the small jazz club bar in downtown Harare.

2008 was an especially grim year in Zimbabwe – and prospects for the coming year seem little better. The fact that Zimbabweans were celebrating the new year at all might seem surprising. But many people, or at least those with some money living in the cities, were in the mood to party, if only for a night and to forget their worries.

Zimbabwe is gripped by economic collapse. Hyperinflation, the worst in the world, has seen prices skyrocketing, making it hard for many to access food and fuel. Last month, the country’s central bank introduced a 10 billion Zimbabwean dollar banknote, but its actual worth, about $10 US dollars on the black market, is rapidly decreasing day by day. Most shops now only accept foreign currency not Zimbabwean notes.

On top of the economic meltdown – which has seen doctors, teachers, and most government staff staying away from work because their pay in local Zimbabwean dollars won’t even cover their crippling transport costs – is a serious and worsening humanitarian crisis.

A cholera outbreak in August has now affected more than 30,000 people, and claimed the lives of more than 1,600 people, with cases now being reported across every province in the country.

Cholera is an easily preventable and treatable water-borne disease. But its spread in Zimbabwe is being fuelled by the collapse of health, sanitation and water services. There are limited medical supplies and many don’t have access to clean drinking water or proper sanitation. The onset of heavy rains this month is worsening an already alarming situation.

A second humanitarian crisis, still under-reported, is worsening malnutrition and food shortages. There have been several years of failed harvests; a serious shortage of seeds and fertilisers; and driving hunger is forcing many to eat seeds instead of planting them for next year’s crops.

The UN has warned that around five million people, more than half of the population, will soon rely on food aid.

The country is also facing political deadlock. Efforts to form a power-sharing government between the ZANU-PF party of President Robert Mugabe, who has been in power since 1980, and the opposition Movement for Democratic Change, has stalled.

I got a sombre insight into many of the problems the country was facing as I visited Kadoma city in central Zimbabwe, about 180 kilometres west of the capital, Harare.

Oxfam has been working in the area, drilling boreholes so that communities can access safe drinking water; distributing hygiene kits and undertaking health promotion work.

The health authorities have reported nearly a thousand cholera cases since mid November, with 29 deaths. Unofficial statistics put the figure even higher.

The Cholera Treatment centre in Kadoma City

The cholera treatment centre – mainly consisting of makeshift canvas tents – was packed with 120 patients. And staff were working flat-out.

Two people had died that day; and I was shown a tent containing the wrapped corpses of seven bodies, several of which had lain there for several days and were swelling. Fuel shortages and rocketing prices meant that there were no vehicles available to take the bodies to the local cemetery.

“Things aren’t stabilising,” said one nurse, “they’re getting worse. We’re seeing more patients every day.”

With early access to treatment - intravenous fluids and oral rehydration – patients can recover quickly and be discharged within days.

But a visit to a nearby housing estate – described as a cholera ‘timebomb’ by a senior health official - made clear why the epidemic is sweeping across the country.

The sewage system had broken down; and residents were disposing human and other waste in the narrow lanes around their homes.

Open sewers in Kadoma City

Children played alongside open sewers. There was no running water and the community of around 1200 depended on water from a borehole Oxfam had provided.

Those images haunted me as I sat in the jazz bar that night. Zimbabweans might have little to celebrate, other than surviving another difficult year; but they are still pinning their hopes that the coming year might bring some change for the better.