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Zimbabwe: ICRC extends support to rural areas as cholera persists

10-02-2009 Feature

The ICRC is supporting the health authorities' efforts to cope with the cholera epidemic. Since last December it has extended its assistance to rural areas.

  See also: Photo collection  
  © ICRC/R. Waudo    
  Nyamupamire village, north-western Zimbabwe. A temporary cholera treatment unit.    
  © ICRC/R. Waudo   
  Nyamupamire village, north-western Zimbabwe. A nurse adminstering oral rehydration salts to a young cholera patient.    
  ©ICRC/R. Waudo   
  Nyamupamire village, north-western Zimbabwe. Health staff informing rural people about ways of preventing cholera.    

The disease has claimed more than 3,200 lives and over 63,000 cases have been recorded. This is the worst epidemic in 14 years and no part of the country has been spared. Although the situation is now improving in the capital, Harare, the epidemic is still spreading in remote rural areas.

The epidemic's spread is due mainly to a lack of awareness among the rural population of how to stave off the disease, and to insufficient water and sanitation infrastructure. These problems are compounded by poor nutrition brought on by the economic crisis.

Chinhoyi is a small town 115 kilometres from the capital in the north-western part of the country. It is situated in one of the areas worst affected by cholera, with almost 4,000 recorded cases and more than 140 deaths.

When the health authorities set up a temporary cholera treatment centre in Chinhoyi's community hall, it was the only point of treatment in the district. Infection rates and deaths related to cholera continued to increase significantly in remote areas of the district, mainly because the residents of impoverished rural communities could not afford to travel to Chinhoyi for treatment. The health authorities therefore set up nine satellite treatment units in rural areas.

 The bumpy road to cholera treatment  

The cholera treatment unit in the village of Nyamupamire is 65 kilometres from Chinhoyi, but it takes ICRC staff an hour and a half to make the bumpy journey by car. The treatment unit consists of 11 tents, eight of which were donated by the ICRC. The head nurse, Edington Murwira, explains t he current situation: " Only four patients are here today since the peak last week. Luckily we were able to discharge all the others. " Nomsa, one of the in-patients, is resting in bed. " When I was brought in I was very sick. I cannot even remember how I got here, but today I am finally going home, " she says.

A group of five people are walking towards the entrance. One of them is pushing a wheelbarrow which another is tugging with a rope attached to the front. On this improvised mode of transportation lies a person under an old blanket. Two health workers go to help. They show the group to the tented " consultation room. "

The head nurse removes the blanket to find an elderly woman who is very thin and in pain. He quickly examines her and gives instructions to the nurses. The old woman is taken to the tented " female ward, " where cholera treatment begins immediately with an intravenous infusion. Re-hydration will help restore the patient's bodily fluids and save her life. Many people infected with cholera cannot reach medical facilities, or they arrive too late and die from the disease.

After the patient is admitted, the clothing and hands of the relatives who brought her are sprayed with a chlorine water-based solution, which destroys cholera-causing bacteria.

 "We did not know what to do"  

Those who brought the patient are her close family. " She was not eating anything, and she was vomiting all the water we gave her to drink. We did not know what to do, so we brought her here, " explains her sister Elisabeth in a trembling voice. " We pray that she will be healed. "

The Nyamupamire cholera treatment unit and the eight other satellite units are an essential part of the strategy to bring medical services within re ach of affected rural communities. These health facilities have treated more than 3,800 cholera patients. In support of the health authorities, the ICRC has supplied 3,250 litres of intravenous fluid packs, 1,500 packs of oral rehydration salts, 10,000 antibiotics tablets, other medical items, and protective garments for health workers.

The ICRC is also providing much-needed food for patients and medical staff. Besides managing cholera cases, the ICRC is promoting prevention through community awareness and health education, supervising burials, and disinfecting patients'homes by spraying. In addition, the ICRC is working in the towns of Kadoma and Chegutu to improve water and sanitation, and to promote cholera-prevention efforts.

The ICRC is coordinating its activities with the Zimbabwe Red Cross Society, the International Federation of Red Cross and Red Crescent Societies, and emergency response units of the National Red Cross Societies of Austria, Britain, Finland, France, Germany, Japan, Norway and Spain to support the health authorities in their efforts to help people who have contracted cholera in different parts of the country. Although it is difficult to predict how the epidemic will evolve, the number of cholera patients in Zimbabwe is still on the increase today.