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Rumbidzayi Zinyuke-Senior Health Reporter

THE Government has put in place measures that seek to strengthen systems as part of its effort to address the current cholera outbreak in the short and long term.

These include putting water, hygiene and sanitation (WASH) infrastructure to ensure that communities have access to safe drinking water and basic sanitation.

Zimbabwe has been experiencing a cholera outbreak since February last year recording 18 332 suspected cholera cases and 329 suspected deaths. About 2 145 cases and 71 deaths have been confirmed as cholera.

Health and Child Care Permanent Secretary Dr Aspect Maunganidze said the Government was seized with addressing the determinants and drivers of cholera including perennial water shortages, breakdown of sanitation infrastructure, improving rural water and sanitation coverages, and enforcement of city by-laws.

“Government is working to ensure that we address all the drivers of cholera. The surge of cases, increase in deaths, the countrywide spread of the outbreak, and the continued persistent existence of underlying drivers of transmission needs a whole of Government, whole of society response so that we stop the further spread of cholera in Zimbabwe,” he said.

He emphasised the need for increased supply of potable piped water without interruptions at household level.

“Where there is no council water, alternative sources should be availed for the affected communities through water trucking. In this regard, the private sector should be engaged to assist,” he said.

In October, the Ministry of Health drilled eight boreholes at clinics in cholera hotspots in Buhera and since then, more have been drilled across the country in direct response to the cholera outbreak. This has complemented the already existing boreholes which were sunk under the Presidential Borehole Scheme which had a target of drilling 35 000 boreholes in all 10 provinces.

Dr Maunganidze said there were plans to drill more boreholes in the hotspots.

To date, 60 out of the 63 districts in the country have reported cholera cases with other districts such as Chiredzi, Buhera, Mazowe, and other districts within Harare province being more affected.

While the drilling of boreholes and provision of sanitation services will help in the long term, the Government also has short-term initiatives in place to combat the current crisis. 

“We have ensured the provision of commodities to strengthen point-of-use water treatment such as JIK, aquatabs and waterquard while encouraging that communities boil drinking water where possible for use at the household level as a culture and regular practice,” added Dr Maunganidze.

Environmental Health Technicians across the country have also been collecting samples of water and testing for quality while also disinfecting contaminated wells and homes to minimise spread of cholera. Contact tracing has also been conducted where cholera cases have been detected.

Government also recently launched the Chenesa campaign which is being rolled out in partnership with the Environmental Management Agency (EMA) with the Civil Protection Unit (CPU) coordinating the deployment of trucks, refuse compactors and other heavy machinery.

The operation has seen dozens of dumpsites being cleared in Harare as these have been identified as a major driver of the cholera outbreak.

The permanent secretary said the routine solid waste collection by all municipalities and clearance of all identified dumping sites was a key response that needed to continue into the future.

“Taking into consideration that schools are now open, there is an urgent need to put in place a conducive safe health environment for school pupils. As a precaution, measures are being conducted in all schools including the training of the school health coordinators on cholera prevention and control, adherence to prescribed minimum hygiene conditions in all schools as well as adequate water supply in schools, adequate and functional sanitation facilities on site, provision of hand washing facilities with soap, food hygiene improvements where meals are prepared on-site,” he said.

Zimbabwe is also set to start deploying the Oral Cholera Vaccine (OCV) to the hot spots districts although this will be a temporary measure.  

The country has been awarded 2,2 million doses from the World Health Organisation. The first batch of vaccines is expected in the country next week.

The cholera vaccine is effective at preventing cholera and provides about 85 percent protection for the first six months after vaccination. When enough of the population is immunised, it may protect those who have not been immunised  

The WHO recommends the use of the oral cholera vaccines in combination with other measures among those at high risk, which is what the Government has been doing.

“We appreciate the support we have received in the fight against this epidemic and we look forward to strengthening collaboration with the development partners like the WHO, UNICEF, MSF, Red Cross Society to mention a few, who have been instrumental in ensuring that we have the lifesaving supplies for prevention and treatment of cholera,” The permanent secretary added.

While previous cholera outbreaks in the country have mainly affected urban areas, the current outbreak has seen an increase in rural areas recording a high number of cases as was the case with Buhera, Mazowe and Chiredzi which recorded a surge in cases this week.

DR Maunganidze said the ministry had a risk communication strategy in place which sought to educate communities on the disease while raising awareness on ways to prevent it.

“Government continues to engage community, religious, and influential leaders to take a leading role in the control of cholera through managing gatherings, encouragement of hygiene practices and uptake of other health measures as a matter of urgency and avoid further spread. We have also called for the intensification of the monitoring of all burials and other gatherings to curb the further spread,” he said.

He said his ministry had also increased the human resources for health to respond to the outbreak.

Zimbabwe’s outbreak is not isolated as 12 other African countries have since been affected in one of the worst cholera outbreaks to hit the region in years.

As of January 15, more than 200 000 cases, including over 3 000 deaths, have been reported in the East and Southern African region.

UNICEF regional director for Eastern and Southern Africa Ms Etleva Kadilli yesterday said investment in strengthening of systems was key in addressing the current crisis.

“In the face of escalating challenges posed by cholera and other disease outbreaks, we thank Governments for their major efforts in managing health crises, and all partners for their support to address the situation. Investments in strengthening systems to address the root causes of cholera and other public health emergencies, particularly on enhancing access to clean water, improved sanitation and hygiene, social behaviour change and quality of case management are imperative,” she said.