Displaced families escaping fighting between soldiers and rebels face new threat of disease.
IRIN – A year ago Zimbabwe was immersed in one of the continent’s worst ever cholera outbreaks, and more of the same was expected in 2010, but the waterborne disease has so far kept a low profile.
The cholera epidemic that began in August 2008 and lasted for a year before it was officially declared at an end in July 2009 caused the deaths of more than 4,000 people and infected nearly 100,000 others.
The 2008-09 outbreak was attributed to dilapidated and broken sanitation and water infrastructure, much of which is still in the same state, raising the fear that the 2009-10 rainy season would bring a resurgence in cases.
Cholera, a waterborne bacterial disease, infects the gastrointestinal system, causing vomiting and diarrhoea that can lead to acute dehydration; left untreated, the disease can kill within 24 hours.
Photo: Médecins Sans Frontières (MSF)
|Cholera is making a comeback|
(IRIN) – Five people have died from cholera at two different locations in Zimbabwe, and 30 other people are undergoing treatment for the waterborne disease, raising the spectre of another epidemic.
The permanent secretary for health, Gerald Gwinji, told the state-run newspaper, The Herald, on 20 October that three people had died from cholera in Mashonaland West Province, in the northeast of the country, while two other deaths were recorded in Midlands Province, in central Zimbabwe.
Gwinji attributed the deaths in Gokwe North, Midlands, to “religious objectors who for a long time have been reluctant to seek medical attention. We are still trying to come up with ways of addressing this special group.”
A cholera outbreak that began in August 2008 and lasted for a year before it was officially declared at an end in July 2009 caused the deaths of more than 4,000 people and infected nearly 100,000 others.
The cause of this epidemic was dilapidated and broken sanitation and water infrastructure, much of which is still in the same state as a year ago, so the coming rainy season is likely to facilitate the spread of the disease.
“We have received confirmation of the cholera cases from the government and this poses a new challenge, in the sense that there is need to educate and sensitise some communities which are resisting prevention and medication for cholera,” said Tsitsi Singizi, a spokesperson for the UN Children’s Fund (UNICEF).
“Our education teams are already out in full force, and we hope that this time the effect of cholera will not be as it was last time,” she commented.
Samuel Sipepa Nkomo, the minister for water resources development and management, told IRIN that repairing the water and sanitation infrastructure in the capital, Harare, was the main priority, as this had been the epicentre of the previous cholera outbreak.
|The cholera causing germ, Vibrio cholerae|
At least 100 people have died of cholera in parts of eastern Democratic Republic of Congo (DRC) since January, say medical sources.
South Kivu Province is the worst affected, with at least 75 people dead and 6,392 infected, said Eugene Kabambi, who is in charge of communications at the UN World Health Organization (WHO) in DRC.
The South Kivu governor, Louis Leonce Muderwa, said the 10 worst-affected health zones in the province included Fizi in the region of Baraka, Nundu, Uvira, Kadutu, Ibanda, Bunyakiri, Katana, Minova, Nyantende and Kabare zones. Two deaths have been reported in Kadutu and one each in Ibanda and Katana.
Muderwa declared a cholera epidemic there on 14 September.
In neighbouring North Kivu Province, 48 deaths had been recorded and 4,609 people infected by 13 September, according to a WHO report.
Five health zones have recorded cases, including the main town of Goma, Karisimbi, Masisi, Mutwanga and Rutshuru areas. Other eastern regions have also recorded cases, with Katanga listing 199 new cases and two deaths.
The North Kivu provincial medical inspector, Dominique Bahago, blamed the cholera outbreaks on poor hygiene. “The majority of the population’s supply of cooking and drinking water is from Lake Kivu where all kinds of waste is dumped; cholera is endemic in that zone,” said Bahago.
Cramped living conditions in displaced persons camps, as well as the inconsistent use of latrines, had exacerbated contamination, he said.
An estimated two million people are displaced in eastern DRC, some of them repeatedly since the start of conflict there in 1996.
The International Committee of the Red Cross (ICRC) and partners are helping to distribute water to affected locations in North Kivu, chlorinating water, disinfecting premises and conducting hygiene awareness, among other activities, according to a 25 September press release. The cholera treatment centre in Virunga was also reopened on 14 September to deal with the outbreak.
“As the rainy season [arrives] in this cholera endemic zone, it is very important to take measures that will allow for the spread of this epidemic to be contained,” said Catherine Savoy, ICRC health coordinator.
More than 10,000 cases have been recorded in the Kivus since the beginning of the year, according to Kabambi of WHO.
Photo: WHO/Paul Garwood
|Checking on cholera|
(IRIN) – Zimbabweans have been given the good news and bad news about their water supplies. First, the government declared the end of the devastating cholera outbreak; then, residents in the capital, Harare, were told to expect widespread cut-offs of water supplies over unpaid bills.
When the last case of the waterborne disease in the Harare township of Budiriro was recorded on 3 July 2009, the cholera epidemic that began in August 2008 had claimed the lives of more than 4,200 people out of about 100,000 known cases.
Health and child welfare minister Henry Madzorera told local media: “The nation experienced the worst cholera outbreak between August 2008 and June 2009, but the epidemic has been successfully contained and has ended.”
Zimbabwe’s dilapidated water reticulation system and decaying sanitation system were widely blamed for Africa’s worst outbreak in 15 years. The collapse of infrastructure mirrored the country’s rapid economic descent, when routine maintenance of the water and sanitation networks was neglected and the scarcity of foreign currency meant water treatment chemicals could not be imported.
The Zimbabwe National Water Authority (ZINWA) was unable to provide clean water – or any water at all – so residents took to digging shallow wells, which were contaminated by the raw sewerage spilling into the city’s streets. The responsibility for water provision has now reverted to local municipalities.
Analysts link the fading away of cholera to the onset of the dry season, which reduces favourable conditions for the waterborne disease to spread, and to widespread education programmes.
“All districts, provinces and cities will conduct post-mortems of the epidemic in their areas, evaluating their responsive strategies, and plan forward for future outbreaks, which have a strong likelihood of recurring in view of continued sewerage and water problems,” Madzorera said.
Raw sewage still spills onto the streets of some suburbs, providing a dank reminder of the danger that cholera could return with the coming rainy season, but work on restoring the city’s water and sanitation systems has begun.
No free water
Harare’s municipality this week placed a slew of adverts in the local media, warning residents that the water supply would be disconnected if they did not settle US$23 million in outstanding accounts, and has since made good on their threats.
“Harare Water would like to inform its valued customers that with effect from Monday, 27 July 2009, there will be a massive disconnection of water in the low-, high-density, commercial and industrial areas to all those consumers with outstanding water bills,” the adverts said.
The mayor, Muchadeyi Masunda, dismissed complaints by residents and insisted that all monies owed be paid. “I have not received water at my house for more than four years but I still pay my bills. No one is going to be relieved of their obligation to pay their dues to council,” he told IRIN. “What we may consider is to reduce the amounts, but not total waiver.”
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