Zimbabwe’s ongoing political strife has led to the virtual collapse of its health services. A chronic lack of health workers, clinics, essential drugs and clean water and sanitation, led to a cholera outbreak in late 2008. Claiming more than 4,000 lives and affecting 98,000 people, this is the largest cholera outbreak in Africa for 15 years.
HOW MERLIN IS HELPING
Merlin entered Zimbabwe in 2008 in response to the cholera outbreak. We now have a team of 46 staff members (four international and 42 local).
Tackling cholera
We have reached up to 500,000 people
During our partnership with the NGO German Agro Action (GAA), we set up 63 Oral Rehydration Points (ORPs) in the capital Harare and the Midlands province. ORPs are critical in stopping the development of severe dehydration, which is the primary cause of all cholera deaths. Staff at the ORPs diagnosed cases of cholera, effectively treating mild cases, and referred severely affected patients to dedicated treatment centres.
Now that the peak of the 2008 cholera outbreak is over, the majority of the ORPs have been decommissioned leaving nine sentinel ORPs which are being used as part of the ongoing surveillance for new cholera cases.
Mirroring the decrease in the severity of the 2008 outbreak, our work has changed from emergency response to preparedness and prepositioning. This involves training health workers and supplying clinics with medical equipment and other materials.
Clean water and sanitation
Lack of clean water and sanitation is a key cause of cholera. We are encouraging community members to drink clean water, wash their hands after going to the toilet and store their water correctly. And we are providing the equipment for them to be able to do this, such as water storage tanks, purification tablets, soap and hand washing facilities.
Training health workers
Merlin is training health volunteers, rural clinic staff and village health workers on cholera treatment and prevention, ensuring they are able to react to future outbreaks in a timely and effective manner.
Future plans
We have established a good working relationship with the Ministry of Health and Child Welfare and are developing joint programmes to revitalise the collapsed health system through primary health care and HIV/AIDS programmes in selected districts.
Key achievements
• We are training 1250 village health workers in the southern city of Chiredzi in basic medical skills, malaria prevention and diagnosis and referral practices
• We have assessed 61 clinics for their preparedness to respond to future cholera outbreaks, and will be assessing a further 20 clinics in the coming weeks
• We are currently supplying the assessed clinics with the equipment required for an immediate response to future outbreaks
• We provided cleaning materials and protective clothing to community volunteers who took part in a clean-up campaign in Harare
• We are training more than 2,000 health workers in cholera treatment and prevention
Donors supporting Merlin’s work
ECHO, the Man Group, CERF
Read more about Zimbabwe
Zimbabwe: Impressions of Merlin’s cholera response
16 Jul 09: Hugo Slim is a leading scholar in humanitarian studies and a Merlin patron. He recently visited Zimbabwe and gave the following impressions of our response to the cholera epidemic.
Zimbabwe: "My name is Stanley, I'm 39 years old and I almost died."
7 Jul 09: Stanley was in a coma when he was brought to Gladys, a volunteer Community Health Worker. Carried on the shoulders of six friends, he'd been sick for days from severe diarrhoea and vomiting. With cholera running rampant throughout Zimbabwe, it was obvious to Gladys that Stanley needed urgent medical treatment.
Field diary: Treating cholera in rural Zimbabwe
15 May 09: Steve Hide is Operations Coordinator for Merlin and German NGO Welthungerhilfe (GAA) in Zimbabwe. He has been working in Zimbabwe since 2005 on various humanitarian medical projects. This is his first diary entry.
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