WHO: Zimbabwe's cholera epidemic, 98,309 cases, 4,283 deaths

[Sally Furniss]

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 3 731 deaths

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 3 731 deaths

<table class="lan18" align="center" border="0" cellpadding="0" cellspacing="0" width="97%"><tbody><tr><td class="hei22" height="25" valign="bottom"> Number of people affected by cholera reaches 88,000 in Zimbabwe: UN
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GENEVA, March 6 (Xinhua) -- Some 88,000 people have now been affected by cholera in Zimbabwe, the UN World Health Organization (WHO) announced Friday, noting the number of new cases reported weekly is dropping.
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A cholera patient drinks treated water at Budiriro Polyclinic in Harare January 22, 2009.(Xinhua/Reuters Photo)

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At the start of the year, as many as 8,000 new cases were being reported per week at the national level, but over the past few weeks, that number has been slashed by half.
According to a joint update by the WHO and the Zimbabwean government, 395 new cases and 18 deaths were reported Thursday.
Nearly 4,000 people have died from the disease, which is caused by contaminated food or water, the agency said.
But the WHO cautioned the need to remain alert continues since cholera continues to claim lives in the Southern African nation on a daily basis.
It also warned the start of the rainy season could also trigger increased cases of the disease.

 

[Sally Furniss]

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 3 731 deaths

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 3 731 deaths

Harare ? The number of cholera deaths in Zimbabwe has crept past the 4,000 mark and case numbers are receding, but for those on the frontline of the epidemic it is business as usual, and much too soon to talk of victory.

The World Health Organisation (WHO) said on 9 March that 4,011 people had succumbed to the waterborne disease since the outbreak began in August 2008, and the total number of cases recorded had reached 89,018.

Signs that the disease is abating, with cholera infections down by about 50 percent to around 4,000 cases a week, are lost on those fighting the disease.

Stella Moyo, 40, a nurse working for Doctors Without Borders at the Beatrice Road Infectious Diseases Hospital, about 5km southwest of the capital, Harare, told IRIN she was "distraught at the number of cases that we have seen over the past week, at a time that we thought we were winning the war against the cholera outbreak."

One of Africa's most deadly cholera outbreaks in recent history has been fuelled by the collapse of municipal services, including water, sanitation and healthcare.

"We thought we had gone past the peak of the epidemic, and statistics given indicated a downturn, but judging by the number of patients we have been admitting in the last few days, the storm seems far from over," said the nurse, who declined to give her real name.

"There is hardly any clean water throughout the city [Harare] as we speak, and that should explain the renewed spread of cholera."

The establishment of a unity government on 11 February 2009, when Morgan Tsvangirai, leader of the Movement for Democratic Change, was inaugurated as prime minister, has yet to bring any change in the material conditions that contributed to the cholera epidemic.

A check by IRIN of the water availability in many of Harare's high-density suburbs found that the city council had disconnected piped water to homes, schools, recreational and shopping centres, as well as police stations.

Residents were thronging wells, boreholes and the few municipal taps in industrial and residential areas to collect water, but the impatient were drawing water from the Mukuvisi River, known to be contaminated with raw sewage and industrial effluent.

Because of our desperation we are collecting water for washing and cooking from the river. Most of us are boiling the water before we use it, but those that are lucking are putting anti-cholera pills in them

"Because of our desperation we are collecting water for washing and cooking from the river. Most of us are boiling the water before we use it, but those that are lucky are putting anti-cholera pills in them," Bridget Fokoyo, 27, who lives in the high-density suburb of Mbare, in the capital, told IRIN.

Beatrice Road is a referral hospital where 5,360 cholera patients have been treated, of which 268 have died, according to WHO. "Even though the wards designated for such cases are less than half full, it is only a matter of days before all the beds are claimed if the water situation does not improve," Moyo said.

Entire family killed by cholera

"It is not surprising that we have a high number of school children coming for treatment. With no water at home and in the schools, there is a high possibility that the children are picking up the disease at school and passing it on at home, where hygiene is poor."

Relatives and friends, many holding containers of the salt-and-sugar solution recommended for the rehydration treatment of cholera victims, brought those suspected of having the disease on wheelbarrows, or in the back seats of private vehicles.

Many patients arrived and first went to be tested for HIV/AIDS and then to the cholera desk a few metres away. "I requested staff at the testing centre to give my sister priority and place us at the front of the queue because I also suspect that she has cholera," Givemore Kabhachi, 48, from Mbare, told IRIN.

"It looks like she has the HIV, but then she started having diarrhoea that I have been told could be due to cholera. I am not leaving anything to chance," he said.

Kabhachi has every reason to be cautious: cholera recently killed a whole family in one of Mbare's neighbourhoods. "First to die was my neighbour's son. Before he could be buried, the father, mother and remaining child were rushed here [Beatrice Hospital] but, unfortunately, they were too late," he said. "They are all still in the mortuary because there is no money to bury them, and the house has since been locked up."

Justice Chasi, an advocacy officer for the Combined Harare Residents Association (CHRA), told IRIN that investigations by the organization showed cholera was spreading to areas that had previously escaped the disease and cited Glen View as an example, which recorded 87 cases last week.

"Our survey indicates that there is some sort of an upsurge in the number of cholera cases reported in the city, and that increase coincides with the critical shortage of safe water in suburbs, a situation which has left residents relying on sources such as rivers, wells and boreholes that have been proved to be unfit for human consumption."

We have also received reports of dead bodies that have been found in water sources and we are still investigating this

Chasi said the water shortages were caused by a lack of water-purifying chemicals, a breakdown in pumping infrastructure and "administrative hiccups" after the transfer of responsibilities from the Zimbabwe National Water Authority (ZINWA), the water parastatal, to Harare municipality.

"We have also received reports of dead bodies that have been found in water sources and we are still investigating this," Chasi said.

At another referral centre in Harare's working-class suburb of Budiriro, a nurse who also declined to be named said his application for leave had been turned down by his superiors because of the "overwhelming number" of cholera cases.

According to recent report commissioned by the WHO, all water sources in Budiriro, including borehole water, were found to be contaminated and unsuitable for human consumption.

"Since October last year, I, like my other colleagues at this clinic, have not been able to take time out to rest. I was due to go on leave in the second week of March but have been told that I could not do so, since the outbreak that had shown signs of decreasing is now spreading again," the nurse said.

Some medical staff were transferred to satellite clinics, like the one in the neighbouring suburb of Glen View, where patients were given initial attention before being referred to the Budiriro clinic or Beatrice Road for hospitalization, he said.

"We are recording at least five deaths a day, and even though the figures are not as high as what we experienced when the epidemic broke out last year [2008], it is a cause for concern. I wonder why municipal authorities are cutting water supplies now, when we are still struggling with cholera," he said.

The nurse said unhygienic practices were still prevalent in Budiriro, which has recorded 8,458 cases and 200 deaths.

The Harare City Council has not clamped down on vendors selling food in the open. "These vendors are not helping our case because they are selling fish, meat and fruits in open places," the nurse said. "They are creating breeding grounds for cholera."

http://allafrica.com/stories/200903091445.html

 

[Sally Furniss]

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 4,000 deaths

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 4,000 deaths

Zimbabwe Public Funeral Gatherings Present Cholera Risk - Doctor <table style="direction: ltr;" border="0" width="100%"> <tbody><tr> <td valign="top"> By Marvellous Mhlanga-Nyahuye
Washington
09 March 2009
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</td> </tr> </tbody></table> Interview With Dr Douglas Gwatidzo - Download (MP3)
Interview With Dr Douglas Gwatidzo - Listen (MP3)

Public health experts say that authorities and Zimbabweans themselves must take care not to spread cholera when thousands gather for a memorial service on Tuesday honoring Susan Tsvangirai, the late wife of Prime Minister Morgan Tsvangirai, killed in a highway crash.
Many thousands are expected to converge on Glamis Arena, an outdoor venue in the Harare Showgrounds, and on Wednesday in Buhera, Manicaland province home town of both Morgan and Susan Tsvangirai, to bid farewell to the woman now called "the mother of the nation."
Susan Tsvangirayi was killed on Friday in a highway collision between the Toyota Land Cruiser in which she and her husband were traveling, and a truck which veered into their lane.
She is to be buried at her rural home in Buhera on Wednesday.
Dr. Douglas Gwatidzo, chairman of the Zimbabwe Association of Doctors for Human Rights and one of the doctors who treated Mr. Tsvangirai after the crash, said large gatherings like those planned for tomorrow and Wednesday present cholera infection risks.
He told reporter Marvellous Mhlanga-Nyahuye of VOA's Studio 7 for Zimbabwe that those attending memorial services should abstain from shaking hands as is traditional on such occasions, and that organizers should carefully oversee food preparation.
In a cholera update through Sunday, the epidemic has claimed 4,011 lives since last August from more 89,000 cases, the World Health Organization said.


http://www.voanews.com/english/Africa/Zimbabwe/2009-03-09-voa45.cfm

 

[Sally Furniss]

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 4,000 deaths

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 4,000 deaths

In Mudzi, shortages of fuel and medicine compound challenges of tackling cholera epidemic


<!--docTitle--><!--Attention ligne utilis?e pour l'impression--> Source: Oxfam
Date: 12 Mar 2009

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by Coco McCabe
The letters on the printed warning were small, but the string of exclamation points that followed shouted with alarm: "Cholera outbreak!!!!!!!!!!"
Tacked to the outside wall of a government office building in Zimbabwe, the warning served notice to all who could read English that Mudzi district is in the throes of a major public health crisis. Like wildfire, hot spots of cholera?a waterborne diarrheal disease that can kill quickly if not treated properly?continued to erupt in late January in this rural northeast region on the border with Mozambique. I heard about the spikes?and the challenge of stopping their spread?at the morning meetings at Kotwa hospital, where aid groups and government health officials gather to coordinate each day's attack on the disease. Oxfam and its local partner, Single Parents Widow(er)s Support Network, or SPWSnet, are among those responding to the crisis.
Fanning out from the hospital grounds, a small team of nurses, water engineers, and public health promoters hit the road each day, traveling up to two hours to reach the more remote areas where people need everything from clean water to basic information about cholera prevention. And they return each night?sometimes long after dark?to prepare their reports for the next morning.
The news they deliver, along with their statistics, is often unsettling: Reports of people drinking from a stream in which others are washing dirty clothes and dishes; shortages of oral rehydration salts and disinfectant; an ox cart toting a patient who died before reaching a clinic. All of it paints a picture of a country crippled by hyperinflation and failing water and sanitation systems. In Mudzi, less than a third of the households have access to proper latrines, according to one estimate.
Already cholera has sickened close to 85,000 people across Zimbabwe, killing more than 3,900 of them as of Feb. 6. The World Health Organization has called it one of the largest outbreaks ever recorded. And Mudzi, poor and far from central areas of commerce and government activity, has been one of the hardest-hit districts.
Fist bumps replace hand shakes
Here, in Mudzi, fear of the disease is palpable. Fist bumps have replaced handshakes as people worry that palm-to-palm contact could transmit cholera. Some people are even afraid to eat, though of course they must, one man tells me.
"We are not settled," says the man, Wonderful Nyatsuto, as he helps a SPWSnet engineer repair a deep well, known as a bore hole, about a mile and a half from his home. About 15 people in his village have contracted the disease, he says, and a third of those have died. Cases of cholera started to erupt when people began fetching their water from a nearby river after the bore hole stopped functioning. Across Mudzi, many of the region's 600-plus boreholes no longer work and communities are too poor to repair them. But without a supply of clean water, residents face a growing danger from the disease.
"We are trying to maintain the rules they tell us," Nyatsuto adds. "Boil water. Clean hands before you eat. Clean the toilet."
Still, in a region where many locals supplement their meager incomes by panning for gold in a network of streams and drink the contaminated water as they labor, people are continuing to get sick.
But getting to a clinic is no easy matter. Functioning ones are few and far between. Some have no medicines. Others have no medical equipment. And so sick people trudge great distances to get the care they need. Roads are rough, sometimes barely more than tracks through the bush, cars are scarce, and fuel is both dear and hard to find?even for aid workers who have access to outside resources to buy what they need. Sometimes, aid groups have to send vehicles all the way back to Harare, the capital, a two-and-a-half hour drive from the Kotwa hospital, to scrounge for a small supply of fuel that they can port back to keep their trucks in Mudzi running.
A clinic in Makaha
One day in late January, 49 patients packed a clinic in Makaha, a ward in Mudzi where cases of cholera were suddenly spiking. A series of tents and one dimly lit concrete room served as wards for people stretched out, limp and mostly silent, on cholera cots?beds with large holes cut in the middle beneath which buckets are placed.
Snaking between the tents and the out buildings was a narrow path of mud bricks powdered, here and there, with flecks of white?the remnants of the dried lime-chloride used to disinfect contaminated surfaces. Mixed with water, a jug of it sat at the exit of the clinic, a reminder to all visitors to give their hands a thorough dousing.
As she finished hosing down an empty cot with the chloride solution, a nurse, her face flat with exhaustion, described some of the misery she had witnessed in the last few days. A mother, six months pregnant and very sick with cholera had managed to get herself to the clinic only to lose her baby. The next day, her husband arrived with their five-year-old son whom he had carried more than 16 kilometers from their home in search of help. Weak with cholera, the boy had died en route. And now the husband was gravely ill, too. The nurse was uncertain whether he would survive.
Behind her, on a shelf, stood a plastic barrel?a mini storage tank for the mixture of oral rehydration salts that were helping to keep the clinic's patients alive. But the barrel had barely two inches of liquid left in it?nowhere near enough to sustain all those who desperately needed the sugar-and-salt mixture. And there was no more solution anywhere else in the clinic. Fortunately, we had a small supply of rehydration packets in our Oxfam truck and immediately gave them to the nurse. But that's not all she needed. The clinic had just two doses left of ciprofloxacin, an antibiotic used to treat a variety of bacterial infections including severe cases of diarrhea.
Beyond the tents, was the observation area?a patch of dirt in the shade of a large tree. Here, patients waiting to be admitted slumped on the ground and those who had improved continued to rest before making the journey home. Outside the gate to the clinic, family members huddled around small cooking fires, the smoke curling around them. They were preparing food for the patients inside?a kindness that was also a cause of concern to nurses who feared cholera could soon sweep through the family support network.
Haunted by hunger
Compounding the challenge of treating cholera is the widespread hunger many people in Zimbabwe are now confronting in the months leading up to the next harvest. Hunger has left people weak and more vulnerable to the disease.
The World Food Program plans to feed more than five million people in February, the greatest number in a single month since 2002. But because more people need food, the program is reducing ration size so that it can stretch its stocks far enough to accommodate everyone.
For some families, even coming up with the basics to fight cholera?such as sugar for a rehydration solution?can be daunting. Dutchman Matika tells of having to borrow sugar from a neighbor to make his wife the solution when she came down with cholera. As he speaks, two of his young sons listen intently, their hair tinged with orange?a sign of malnutrition. With 11 children and three wives in his household, Matika says mealie meal?a local staple?is in short supply.
"When you walk around, you see it," says an aid worker about the malnutrition that has followed on the heels of several poor harvests and that's affecting people most acutely in the interior of the country. "Poppy tummies. That's one of the very clear indications. It's mainly in kids. And you get wasting away in adults."
But this year, in Mudzi, there are signs the next harvest may be better. While there is never enough fertilizer to guarantee robust crops, the rains during the current wet season have been unusually plentiful. Where corn and sorghum, millet and ground nuts have been planted, green shoots abound?slivers of hope for the future.



http://www.reliefweb.int/rw/rwb.nsf/db900SID/CJAL-7Q3PXC?OpenDocument

 

[Treyfish]

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 4,000 deaths

Re: WHO: Zimbabwe's cholera epidemic, 83 000 suspected cases, 4,000 deaths

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Evicting refugees spreads epidemic

NOSIMILO NDLOVU | JOHANNESBURG, SOUTH AFRICA -

Mar 13 2009 06:00
Humanitarian organisations assisting Zimbabwean refugees in Musina have warned that the closure of the showground -- a large open field near the border where 3 000 to 4 000 Zimbabweans queue to apply for asylum and seek refuge at night -- could worsen the spread of cholera and other diseases.

Jacob Matakanye, director for the Musina legal advice office, said "It was easy for us to access the refugees and help them when they were at the showground; it was better because they were organised and could be controlled, unlike now when they are scattered all over and left loose."

Last week the Department of Home Affairs in Musina removed refugees from the showground and ordered all supportive activities to stop. Humanitarian organisations including Medecins Sans Frontiers (MSF), United Nations High Commissioner for Refugees (UNHCR), Save the Children, Musina legal advice office and various local churches had been providing food, clean drinking water, access to healthcare and legal advice to Zimbabwean nationals.

As the health system in Zimbabwe continues to deteriorate, more Zimbabweans are coming to South Africa to seek medical care. Upon arrival in South Africa they go to the Refugee Reception Office at the showground to apply for asylum. However, due to long queues, they often wait for weeks, and even months, to get their asylum papers. With no papers and nowhere to go they stay at the open field at the showground.

MSF field coordinator Sara Hjalmarsson said they have been seeing at least 2 000 Zimbabwean refugees a month at their mobile clinics at the showground, including a lot of women who have been raped while crossing the border. They are also treating a high number of cases of sexually transmitted diseases, HIV, tuberculosis, diarrhoea and pregnant women.

Nyaradzo Maphumo (23) came to the showground in January when she was nine months pregnant. "Most clinics are not working in Zimbabwe. Those that are have no equipment; you have to have at least R5 000 and bring your own equipment, such as towels, bandages, gloves and staff for stitching, then they can provide you service to give birth," explains Maphumo.

With only R150 in her pocket, Maphumo decided to come to South Africa and seek asylum, hoping she could receive her documents in time to get healthcare for herself and her unborn child. "I stayed at the showground while I was waiting for the papers because I had nowhere else to go and only had R50 left after using R100 for transport fare. I went to the MSF mobile clinic where they helped get my papers and provided me with healthcare until it was time to give birth and they transferred me to Musina hospital."

Maphumo breathed a sigh of relief when she gave birth to a healthy baby girl, Diana, a week ago.

In the pouring rain men and women sit around small fires outside the showground, using small piles of luggage as seating or cushioning for their backs. Little kids, barely dressed despite the cold weather, walk about, playing with used condoms they find on the ground. Police patrol the area, questioning and demanding the refugees to move their possessions -- which have spilled two centimetres onto the road -- off the road and show some identification.
"snip":tiphat:http://www.mg.co.za/article/2009-03-13-evicting-refugees-spreads-epidemic

 

[Shiloh]

Re: WHO: Zimbabwe's cholera epidemic, 98,309 cases, 4,283 deaths

Source: http://www.pretorianews.co.za/index.php?fArticleId=5000347

Cholera strikes 100 000
In Zimbabwe's infection rate the worst in Africa in 15 years

May 27, 2009 Edition 1

The cholera infection rate in Zimbabwe is nearing the 100 000 mark in Africa's worst outbreak in 15 years, aid agencies say. The death rate is slowing down but the threat of cholera remains "very real", says a report released by the Zimbabwe Red Cross Society and the International Federation of Red Cross and Red Crescent Societies.

"It is likely that at some point in the coming week, the 100 000th case of cholera will be officially reported in Zimbabwe. So far, 98 309 cases have been reported, with some 4 283 deaths," says the report, released today.

The causes of the outbreak still needed to be addressed, the aid agencies warned.

"The outbreak was born largely as a result of the country's almost entirely collapsed water, sanitation and health systems. These issues have not been addressed," the report states. "Although infection rates have dropped, the spectre of cholera will not be defeated until the underlying issues are addressed."

It said the "reluctant support" from donors had undermined the Red Cross Red Crescent cholera operation, "forcing a premature down-scaling of emergency operations".

The agencies said an estimated 3.75 million Swiss francs (R28.8m was "urgently required" to rehabilitate 1 150 non-functional water sources, drill 263 bore holes and construct 3 755 latrines. "Rates of infection and death have declined markedly over the past one or two months.

"The reasons for this are varied: the impact of the humanitarian response; the establishment in some areas of interim social services; and the natural life of any public health crisis.

"However, the eradication of cholera in Zimbabwe or the complete conclusion to this current epidemic is unlikely unless the underlying causes of the health crises are addressed," the report says, adding that the situation is exacerbated by the southern African country's socio-economic instability.

The cholera epidemic started in August last year and spread to surrounding areas in Botswana, Mozambique, South Africa and Zambia.

Meanwhile, aid agencies also said yesterday that Zimbabwe was the most food aid-dependent country in the world.

Also, nearly 55 percent of children who died of cholera in the southern African country were malnourished. "Per capita, Zimbabwe is now the most food aid- dependent country in the world. The World Food Programme believes that seven million people are in need of food assistance - somewhere between 65 and 80 percent of the population," the report states.

The food crisis was caused by several factors including hyperinflation which disenfranchised many agriculture farmers, the report states.

"Zimbabwe's fields are sown with substandard seed, scavenged often from granaries or from the side of the road. It is extraordinarily unlikely that the 2009 harvest will significantly surpass 2008 - the worst in the country's history," says the report.

 

[Shiloh]

Re: WHO: Zimbabwe's cholera epidemic, 98,309 cases, 4,283 deaths

Source: http://www.google.com/hostednews/afp/article/ALeqM5gBFe6MjuxYG89JSjY94jNTf_vVVA

Zimbabwe says cholera epidemic 'has ended'

By by Fanuel Jongwe (AFP) ? 1 hour ago

HARARE ? Zimbabwe's health minister said Thursday a cholera epidemic had ended, after at more than 4,200 deaths and 100,000 cases since last August, but warned new outbreaks remain a threat.

"The nation experienced the worst cholera outbreak between August and June 2009, but the epidemic has successfully been contained and has ended," Health Minister Henry Madzorera said in the official Herald newspaper.

"As the pandemic comes to an end, all districts, provinces and cities will... plan forward for future outbreaks, which have a strong likelihood of recurring in view of continued sewerage and water problems," he added.

The outbreak erupted in August as post-election violence was sweeping the country, while public services including hospitals and clinics shut down.

The diarrhoeal disease thrives in places without proper sanitary facilities. Cholera is deadly but easily preventable with clean water and proper sanitation.

The outbreak began in Chitungwiza, a dormitory town outside the Zimbabwean capital whose sewer system has been overburdened by a booming population and experiences perennial water shortages.

Cholera then spread to 55 of the country's 62 provinces.

Since Zimbabwe's unity government formed in February, hospitals have re-opened as doctors and nurses resumed work, though conditions remain grim with little access to medicine and supplies.

The International Federation of Red Cross and Red Crescent Societies said the cholera epidemic was the worst to hit Africa in 15 years and warned the disease had now entrenched itself as an endemic illness in Zimbabwe.

"Our concern is that the fundamental issues -- access to sanitation and access to clean water -- haven't been meaningfully addressed," said IFRC spokesman Matthew Cochrane.

"Cholera is now endemic in Zimbabwe, like it is in most countries in this region."

"Effort has to now be made that communities have access to basic amenities like clean water and sanitation."

Zimbabwe is trying to raise more than eight billion dollars over three years to revive public services, including repairs to sewage lines that leak through populous neighbourhoods.

Fears for a new outbreak will heighten around the rainy season, which runs from November through February, when poor drainage last year left filthy pools of water in the streets.

Zimbabwe had suffered cholera cases before, but usually in rural areas. Now the disease appears more urban, with densely populated neighbourhoods most at risk.

The country's health system was once the envy of Africa, but Zimbabwe depended almost entirely on international assistance to contain the cholera outbreak.

Cochrane said that more work still needed to be done to dig new water wells and ensure sanitation, even as the government works to rebuild sewage and water lines across the country -- a process that could take years.