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Cholera Risk Persists in Zimbabwe

From August 2008 through June 2009, Africa's worst cholera outbreak in 15 years killed more than 4,000 people and infected almost 100,000 in Zimbabwe, according to the United Nations. By early July, few new cases or deaths were being reported, but fears of another epidemic when the rainy season comes in late October or early November have agencies deeply concerned.

Agnes Mwenyali

Agnes Mwenyali, a 13-year-old orphan cared for by her older brother, smiles when showing off her safe, clean latrine. Photo by Debbie DeVoe/CRS

Tarwireyi Chivese, a water and sanitation project advisor for Catholic Relief Services in Zimbabwe, recently shared an overview of the cholera situation in the country with Debbie DeVoe, Catholic Relief Services' regional information officer for eastern and southern Africa.

Debbie DeVoe:
Are cholera epidemics common in Zimbabwe or was last year's outbreak a rare occurrence?
Tarwireyi Chivese:

Incidences of cholera occur every two to five years in Zimbabwe. Last year, a serious epidemic emerged due to the breakdown of water and sewage systems from age and disrepair. Cholera first broke out in the capital of Harare and then spread to rural areas. With little sanitation coverage, the disease continued to spread rapidly as rural rivers and streams became contaminated by people using the bush instead of proper toilets. Chronic power cuts exacerbated the problem, as power is necessary to treat and pump water, leaving people struggling to maintain good hygiene in the face of water shortages.

Happy With Hippo Rollers in Hopley

Hippo Roller

The design of the Hippo Roller lets 77-year-old Rebecca Mugone easily push the large container of water back to her homestead in Hopley settlement. Photo by Debbie DeVoe/CRS

Agnes Mwenyali is 13 years old. Rebecca Mugone is 77. They may be far apart in age, but they have many things in common.

Both love their new Hippo Rollers. These bright blue barrels hold around 20 gallons of water—an enormous amount that couldn't possibly be carried on one's head or by hand. Because the water containers are round, Agnes or Rebecca can give her Hippo Roller a shove to tip it on its side, attach a metal bar, and push the barrel along with ease.

"It's not heavy. I don't know about others, but for me it's OK," the elderly but sprightly Rebecca says (and I agree after pushing a full barrel myself). "I now have my water here in just a few minutes."

Agnes and Rebecca also greatly appreciate their new ecological sanitation toilets, which consist of two pits side by side. The first pit is covered with a toilet slab and enclosed in a simple privacy structure. After each use, family members add a bit of ash to the pit to reduce odor and speed decomposition. Once the pit is full—after about a year for a family of five—the toilet slab is transferred to the other pit. The family then uses the decomposed waste of the first pit as rich manure for their farms or gardens.

"I was using the bush," Agnes admits. Her mother died a few years ago, and her father disappeared soon after, likely suffering from mental illness. Agnes now lives with her 20-year-old brother, but because he works long hours, she spends a lot of time alone. While she often stays with neighbors, she is very happy to have a safe, clean toilet to use, particularly at night.

The wooden structures built around the toilets are often better constructed than many of the houses in Hopley settlement, where Agnes and Rebecca live. Hopley used to be a fallow field. Then squatters moved onto it in 2005 after being forced from other lands, which they were living on illegally. Now a legal settlement, Hopley is extremely underdeveloped. Small shacks that seem barely able to withstand the wind dot the field, with no stores, schools or churches in sight.

While life in Hopley is difficult—particularly during these cold months that leave hands and faces frigid—Agnes and Rebecca are happy that CRS' assistance is helping them prevent cholera infection and improve their health.

Debbie DeVoe is CRS' regional information officer for eastern and southern Africa.

DeVoe:
What actions did Catholic Relief Services take to help contain the epidemic?
Chivese:

Since last December, CRS has worked with local partners on a number of cholera projects to help prevent disease spread and contain the epidemic. These projects target the most vulnerable community members, particularly the elderly, children and people who have HIV.

For example, one project funded by the United Nations focused on the three highly affected areas of Harare, Chinhoyi and Chitungwiza. First, CRS and our local partners trained 180 community volunteers in cholera prevention. These volunteers went door to door teaching residents to identify cholera symptoms, understand what steps to take for immediate treatment if infection was suspected, and know what actions to take to prevent infection. Residents learned to regularly wash their hands and only use water from a clean source. If a clean source was not available, they were taught to treat the water with purification tablets or boil the water for five minutes.

Through the project, CRS also helped some families build household toilets, renovated public toilets near 10 marketplaces, and distributed hygiene kits to improve community health and sanitation.

Another project funded by the United Nations is allowing CRS and the national Catholic Development Commission to set up water purification systems in eight rural communities. These small systems provide safe water for two villages, a school and a clinic. Other cholera projects are assisting additional communities.

DeVoe:
What is the current status of the cholera epidemic in Zimbabwe?
Chivese:

Now the cholera epidemic is contained. Cases are close to zero, and treatment centers are being closed down.

DeVoe:
Is there risk of another outbreak?
Chivese:

If infrastructure problems are not attended to, then we are most likely to have a similar outbreak when rains start in October or November. Some things are being done here and there, but the pace is slow. What needs to be done is to rehabilitate wastewater treatment plants so wastewater is treated properly and is free of contamination before being discharged into the environment.

DeVoe:
Do you think our work in the last year will help in the event of another epidemic?
Chivese:

People now know to drink safe water and immediately seek care if they exhibit symptoms of cholera infection. Our hope is this will help reduce infections and deaths.

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