SW Radio Africa (London)
Tichaona Sibanda
4 December 2008
The regime of Robert Mugabe has belatedly declared a national emergency, over the cholera epidemic that is now threatening to engulf the whole country.
Health Minister David Parirenyatwa made the declaration Wednesday after meeting government and international aid officials in Harare. He appealed for money to pay doctors and nurses and for drugs, food and equipment for the country's hospitals.
As recently as last week Parirenyatwa and his deputy minister, Edwin Muguti, had said there was no need to view the situation as an emergency, arguing they had the materials and the manpower to bring it under control.
The World Health Organization (WHO) on Thursday issued a stark warning that the destroyed health care system will struggle to halt the epidemic that has so far officially killed 565 people, although independent observers say it runs into the thousands.
WHO's global cholera coordinator, Claire-Lise Chaignat, confirmed that the situation in Zimbabwe was extremely serious. Officially 12,546 people have been infected with cholera since August. But again independent analysts say the numbers could be in their hundreds of thousands.
'We are in front of a disaster. We won't be able to stop the outbreak just like that, it is escalating. With such a deterioration in the health care system, difficult communication, shortages of food and staff, it will be a huge challenge to avert further deaths and cases,' Chaignat said.
MDC MP for Kambuzuma, Willas Madzimure who recently accompanied deputy party leader Thokozani Khupe on a countrywide fact finding mission described the situation as 'shocking beyond belief.'
'I saw Khupe shed tears when she came face to face with cholera victims, most of whom told her they have been failed by the government. Government should have declared it a disaster because that's what it is naturally--- a national disaster,' Madzimure said.
The cholera outbreak comes as the country has been crippled by a complete economic meltdown and a political stalemate. A Public health expert, Oliver Mudyarabikwa, explained that by declaring an emergency, the government has openly accepted it's failure and has agreed there is a problem that is beyond it's capability to resolve.
'Put simply, this is a way of agreeing to mobilise technical, financial and administrative resources necessary to solve the problem. In the case of cholera, the government has agreed and officially announced that contrary to the propaganda of the politicians there is an outbreak of immense proportion and the government is unable to resolve it without the assistance of institutions outside the public sector,' Mudyarabikwa said.
What this means he said is that all government activities, not just the health ministry, would be directed at solving the cholera outbreak. This would include the Ministry of Water Resources and Local Government, through to councils, transport for ferrying bowsers and construction for setting up temporary treatment centers.
'Since this is now an emergency, hotels, food outlets and markets have to have anti-cholera arrangements in place as a must. The international and donor fraternity would be approached to provide technical and financial resources to contain the disease,' Mudyarabikwa added.
The health expert said there were implications for declaring an emergence for the iron fisted regime. To accurately attack the problem there should be goodwill on the part of the government.
'They should openly, objectively and without malice, accept blame, failure and dereliction of duty to protect the health of its citizens. This allows getting to the root causes of the outbreak - which is the breakdown of personal hygiene facilities - water reticulation systems, sewerage management at home and public places, such as markets, bus stops, shopping centers. These are cholera breeding places that non-government players want identified so that they can match where best they can help, depending on their specialties,' he said.
However Mudyarabikwa said declaring this an emergency was actually a non-event. The situation prevailing now in the country amounted to a national disaster, which is one step further than an emergency. He said had the government declared it a disaster, it would have meant them allowing the intervention of anybody willing to help, no matter where from - regional and overseas governments directly, or friends and even foes. There would have been unrestricted entry, if it were declared a disaster.
'Coming back to the declaration of an emergency, there is virtually nothing more the invited NGO's and international organisations are expected to do that they have not been doing all along. Probably the only addition is that some are now going to come out of their shells and openly do health programmes without fear of the heavy handedness of officialdom exercised by the government against the NGO community,' he said.
Organizations like WHO, UNICEF, USAID, DFID, Save the Children, Doctors without Borders and hundreds of other organizations, have all been working on water and sanitation programmes in deprived areas, under very difficult and risky conditions.
After the March elections, the government banned almost all NGO's allowing only scaled down their operations. An analyst told us that behind their locked doors, government appreciates the situation is a national disaster, but are fearful to open the borders lest the skeletons in their cupboards are seen by other countries.
'To the general public, declaring an emergency is a deliberate understatement of the gravity of the situation. And this is not new to the government because for months they have been denying that the health system has broken down and they have been accusing technical staff of sensationalizing the crisis,' the analyst said.
Cholera is an intestinal infection caused by the bacterium Vibrio cholerae. People get it from drinking contaminated water or eating contaminated food. About five per cent of infected people will become severely ill and will develop profuse watery diarrhea, vomiting, and leg cramps. In severely ill people, cholera will cause rapid dehydration and shock. If not treated, a person could die within a few hours.
But the disease is easily treatable. Rehydrating the patient is the most effective way of treating someone with severe cholera. There are at least two ways of doing this, by drinking large quantities of a rehydration solution -- a prepackaged mixture of sugar and salts that can be mixed with clean water or by intravenously replacing lost fluids, in severe cases.
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