19 December 2012

Zimbabwe: Typhoid Outbreaks Again!

Seven hundred cases of typhoid were recorded in the capital last week, while five deaths have been documented since the beginning of last month as typhoid; dysentery and diarrhoea continue to wreak havoc in Harare.

The capital has become a soft target for water-borne diseases because of erratic water supplies, poor hygienic practices and inadequate sanitation. Water shortages have made it difficult for residents to maintain hygienic conditions in their homes and communities, with many of them digging shallow and unprotected wells in their backyards.

Since October 2010 when the typhoid epidemic hit the capital city, government has been unable to provide lasting solutions to the crisis. With the rainy season nearing its peak period, the epidemic could claim more lives.

In fact, health experts say the prevalence of diarrhoeal diseases during the rainy season might lead to the outbreak of other diseases such as cholera. But despite the warnings, it has been business as usual at Town House, the city's administrative nerve centre.

The situation in some of the high density suburbs in Harare resembles a ticking time bomb, as there is no sufficient clean water for drinking and other household chores, contributing to the increasing number of water-related illnesses.

Dzivarasekwa has once again emerged as the epicentre of the typhoid outbreak.

Analysts said the epidemic will continue to cause havoc throughout the country as long as government and local authorities are not working together to find a lasting solution.

Typhoid is referred to as a primitive disease because of its association with poor hygienic practices including the consumption of water laced with human waste. And yet city fathers are struggling to keep it in check.

As a result, Zimbabwe has been breaking world records for all the wrong reasons. For instance, the 2008 cholera outbreak was rated as the worst in Africa in the past 15 years by the World Health Organisation.

Typhoid cases have been reported in different parts of the country since last year, with the worst affected areas being the densely populated suburbs.

Cases of typhoid have also been reported in Bindura, Mashonaland Central and Norton and Zvimba in Mashonaland West, including Chitungwiza and Kadoma.

The Harare Residents Trust (HRT) said there was no urgency on the part of the city fathers to deal with the endemic in the areas of public health and water supplies, which remain largely neglected.

"Firstly, the responsible authority -- the City of Harare -- has not placed public health and water delivery at the top of their development projects lists. They have, instead, prioritised increasing salaries and allowances for employees, who are themselves under-performing in most cases," said HRT co-ordinator, Precious Shumba.

"Secondly, government has not invested in the rehabilitation of water sewerage reticulation infrastructure for the last decade, meaning the underground water distribution pipes and sewerage pipes have aged to the extent that they are leaking and breaking down more frequently than they can ever be adequately repaired," Shumba added.

"The HRT has continued to monitor reactions or responses of the City Health Department, the Harare Water Department and the Environment Management Co-mmittee, from the local authority's viewpoint, and also from Central Government side -- the Ministry of Local Government, Rural and Urban Development and the Mini-stry of Water Resources Develop-ment and Management. We are shocked and disappointed at these structures' lack of urgency in handling this matter, they continue to deal with it like any other issue, yet human lives have been endangered," noted Shumba.

Concerns about water-borne diseases remain prominent, particularly in Harare where typhoid has been concentrated as the city fails to meet water requirements.

According to the City of Harare, the capital needs at least 1 400 megalitres of potable water per day in summer, 200 megalitres more than the requirement in winter but can only provide 620 megalitres a day, less than half the daily requirement.

For years, Harare has been raising the red flag on the poor state of water supply and sanitation. The city loses 29 percent of its water due to burst pipes, and little has been done to fix the water reticulation system.

Community Working Group on Health, executive director, Itai Rusike, said Zimbabwe has not yet met the Abuja commitment on 15 percent government budget to health although progress has been made towards it.

Rusike however, said the forces that perennially produce typhoid outbreaks in Harare are beyond the City of Harare, which he said should work with other sectors under the leadership of the Ministry of Health and Child Welfare to address the social determinants leading to people dying of primitive infectious diseases like typhoid and cholera.

"This implies increasing budget commitments and domestic funding for health. Given the challenges the economy is facing, the resources from donors have to be properly managed so that Harare residents have access to safe water and sanitation," Rusike said.

"Government should sustain the inter-sectoral co-ordination on water and sanitation without politicising it and explore how to involve public private partnerships for financing the operation, maintenance and infrastructure investments while protecting access for poor communities.

"Ring fence funds collected for water by local authorities and use this for improving water supplies including investments in infrastructure," he added.

Civil society groups have also demanded that government immediately set up a commission of enquiry to investigate the outbreaks and recommend solutions to end the problem.

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