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HEALTH-ZIMBABWE: Activists Say Cholera Due to Failed Leadership

Ephraim Nsingo

HARARE, Oct 16 2008 (IPS) - "In my nine years as a nurse, I have never been so devastated. You know how discouraging it is to see people dying before your eyes. And you know very well there is nothing you can do to help them."

Open sewer in a Harare township: poor water and sanitation infrastructure poses a serious health risk to residents. Credit:  IRIN

Open sewer in a Harare township: poor water and sanitation infrastructure poses a serious health risk to residents. Credit: IRIN

These were the words of Caroline Chabuda*, a nurse at Seke North Clinic in Chitungwiza, a satellite town about 30 km south of Harare. The clinic was recently set aside to attend only to cholera cases following a local outbreak of the disease a few months ago. But because of a shortage of key medication, many patients admitted at the clinic have died.

Figures released by the Ministry of Health indicate that 16 people died of cholera countrywide in September. Chitungwiza residents, medical experts and human rights activists believe the figure is much higher than that. They also accuse the Ministry of Health and the Zimbabwe National Water Authority (ZINWA) of ignoring the plight of residents.

"The government and ZINWA are responsible for all this," said Tapiwa Muronzi of St Mary's suburb in Chitungwiza, whose younger brother Carlos died of cholera three weeks ago. Muronzi believes the government has done too little, too late.

"They are only acting now when people are already dying," said a sobbing Muronzi. "We all know that cholera, although it is a very dangerous disease, can be prevented. The authorities neglected us when we needed them most. Why wait until there are buried corpses? These people (government) do not care about our plight. We have been without water for four months now, but ZINWA continue to charge us exorbitant rates."

Muronzi's mother, Ambuya Clara Muronzi, 58, had no kind words for staff at the clinic. "He could have survived, if they had given him care. They neglected him but now they are demanding lots of money for doing nothing," she said.

But Chabuda believes there is nothing they could have done to avert the situation.

"We have a great challenge of a shortage of experienced staff, people who really know how to handle such cases. Cholera is not like any other disease," said Chabuda.

"Cholera is a very sensitive and contagious disease. It needs to be handled by highly-qualified medical personnel. Most of the nurses we have at the clinic are still young and inexperienced. The youngsters are so ignorant. We cannot risk patients' lives by letting them attend to (cholera victims)." said Chabuda.

While Chabuda was talking to this reporter, patients, mostly children, could be seen writhing in agony on the floors. The few nurses who were present appeared to be struggling to attend to them. Among other things, the nurses gave them dehydration salts and aqua tablets, for use in drinking water.

"We do not have some key medicines, this is what we can do under the circumstances," said another nurse, who identified herself only as Caroline.

Cholera linked to wider problems

With Chitungwiza hosting this year's national commemorations of the Stand Up and Speak Out Against Poverty Campaign, the wider failures that have led to the outbreak will be brought to the fore.

The Combined Harare Residents Association (CHRA), which also covers Chitungwiza, says some areas of the city have been without a reliable water supply for years.

In a statement, CHRA said: "The water and sewer management problems have seen some residential areas going for years, months and weeks without water and unattended sewer bursts respectively. The shortage of water dictates that residents fetch water from unprotected sources thus diseases like cholera breed easily. CHRA has so far received countless cases of cholera and diarrhea."

The organisation says the authorities should "stop burying their heads in the sand and attend to the governance stalemate as a matter of urgency".

Human rights activists have lambasted the government for neglecting residents, which they said is "criminal".

"The government should treat the health sector like they are doing agriculture," said Itai Rusike, the director of the Community Working Group on Health (CWGH) – a Harare based non-governmental organization that pressures government on health issues. The government has for the past two years been providing agricultural inputs free of charge under the farm mechanisation programme.

He added that the government's official figures for cholera deaths were "very under-represented".

Acknowledging that ZINWA has not maintained regular supplies of potable water to Chitungwiza, spokesperson Tsungirirai Shoriwa, said the company was not responsible for the outbreak of cholera in Chitungwiza, saying the state-owned utility was doing the best it can despite a shortage of necessary materials.

"We do not give people untreated water, it would be a crime for us to do so. If we do not have the chemicals to treat water, we do not supply the water. ZINWA has never advised people to boil wate,r because according to us it is clean," said Shoriwa.

He insisted ZINWA was not supplying dirty water that had contributed to the outbreak of cholera.

"It would be unfair for people to blame ZINWA for the people who are dying of cholera in Chitungwiza. As far as we are concerned, our water is clean. You should be aware there are many factors that have contributed to the spread of cholera such as the eating dirty food."

ZINWA took over water management in the urban centres from most local authorities last year. This resulted in a chorus of complaints from human rights activists and some politicians, who believe the government-run company does not have the capacity to manage urban water.

The Zimbabwe Lawyers for Human Rights (ZLHR) and the Zimbabwe Doctors for Human Rights have described the cholera outbreak as an indication of "an unacceptable failure of leadership".

"These wanton deaths (from cholera) are intolerable and shameful, and the state's failure is merely a replication of other high level failures, where the citizenry has now been disenfranchised of almost all their basic human rights. If more than a dozen people have died from cholera in just less than a month, we can only imagine how many more are currently affected by, or at risk of contracting, this avoidable disease," ZLHR said.

Thousands of residents, and many others from surrounding areas will converge on the town for the Stand Up and Take Action Against Poverty on Oct. 18. Issues of sanitation and water supply in Chitungwiza and other urban areas are set to take centre stage.

*Not her real name

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