For the past few months a cholera epidemic has swept through Zimbabwe, affecting all provinces except one. Harare and the southern town of Beitbridge are the worst-hit. The ICRC is providing cholera treatment centres in Harare and Chinoyi with drugs and medical supplies, in addition to supervising the treatment of patients elsewhere in the country. It is also working closely with health workers in Harare to treat cholera patients and control the spread of the disease. The health workers are going from door to door, disinfecting the homes of patients or people at risk of contracting the disease by spraying toilets, latrines, blankets and clothing with a chlorine-based disinfectant.
Who is vulnerable to cholera, and how is it spread?
Anyone can be infected with cholera. It is caused by a bacterium that is spread through contaminated water or food. An infected person may carry the cholera bacteria on their hands after using the toilet, and can contaminate food or drinking water. This may then be consumed by another person who will in turn be infected with cholera.
The bodies of dead cholera victims are highly infectious and are often a source of contamination for those who prepare corpses for burial. If cholera treatment centres are not sufficiently protected by isolation measures, they can become a point of contamination for families and health workers.
Avoiding infection
Although cholera is contagious, it can be prevented by washing the hands with soap after using the toilet. Drinking only safe water that has been boiled, chlorinated or filtered, eating only cooked food, peeling fruit and vegetables and washing them in chlorinated water are simple but efficient ways of protecting oneself from cholera. It is also important to avoid shaking hands unnecessarily since this can spread cholera bacteria.
Every suspected case of cholera needs to be referred promptly to a treatment centre. Once a case is confirmed, the patient’s house should be disinfected. Taking antibiotics in order not to catch cholera (“antibiotic prophylaxis”) is not recommended as it gives a false sense of safety; protection lasts only a week. Antibiotics will not stop a cholera outbreak. Hygiene and sanitation measures will.
Public health facilities could also take measures to prevent the spread of the disease. Large-scale, systematic chlorination of drinking water would curb the epidemic, as would proper waste management.
How the ICRC is helping to contain the epidemic and prevent future outbreaks
Activities include spraying the insides of the homes of infected people to prevent the spread of the disease.
Since mid-December, the ICRC has been working closely with health workers from Beatrice Infectious Diseases Hospital and Budiriro Polyclinic, visiting homes in the affected areas of Harare to disinfect them. Affected households are identified at health clinics by investigating the history of cholera patients. Health teams then visit the patients’ homes to spray toilets, latrines, blankets and clothing with a chlorine-based disinfectant. This protects others from the disease.
The ICRC-supported health teams consist of at least five health professionals who, in addition to disinfecting the homes, familiarize family members and other residents in the neighbourhood with the risk of cholera and ways of preventing it. The teams are using this outreach to identify cases of cholera and transport patients to treatment centres.
The teams distribute water purification tablets, buckets, and soap to promote sanitation in cholera-prone communities. The ICRC is providing protective clothing, basic supplies and transportation to the teams.
The ICRC has also donated pumps, water-testing equipment and spare parts to the main water-treatment plant for Harare and its suburbs. This will help the authorities improve access to safe water for city residents, and stem the spread of water-borne diseases such as cholera.
