Home | Help | Search | Login | Register

mulonga.net forum  |  IT Centers  |  Binga.Online  |  Topic: Zimbabwe: ICRC extends support to rural areas as cholera persists « previous next »
Pages: [1] Print
Author Topic: Zimbabwe: ICRC extends support to rural areas as cholera persists  (Read 4179 times)
Peter Kuthan / AZFA
Global Moderator
Hero Member
Posts: 819

« on: February 10 2009 »

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.

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 the 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 by 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 reach 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 dehydration 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, 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.

source: ICRC N.S. BRIEFING NOTE: Ref.: NS09/033

Peter Kuthan / AZFA
Global Moderator
Hero Member
Posts: 819

« Reply #1 on: February 17 2009 »

Cholera has 'burnt its way through' Zimbabwe villages

by Pia Engebrigtsen, a Norwegian nurse, who worked for two months in Zimbabwe's Masvingo province during the country's massive and unprecedented cholera outbreak where, so far, MSF has treated more than 45,000 people. This was Pia's fourth mission with MSF.

MSF, February 17, 2009

Life or death for a mother and her six children

"I was awakened in the night by a phone call from a nurse on night duty who had been told that four children were seen along the road, too sick to continue their walk to the nearest CTC.

"It is absolutely pitch dark here at night. We did not know where the children were and we have night curfew, so we had to wait until sunrise to go looking for them. The hours passed slowly while I pictured the children lying sick, frightened and helpless all alone in the dark.

"I prepared myself for the worst and together with a national colleague I set off at dawn with first aid equipment and body bags.

"We found them in a village after searching for two hours - six children and a mother who were more or less unconscious. Some of the children we were not able to arouse, while the others were awake but too weak to speak or move. The children were lying in the arms of the mother. Inside the house we found the father dead. We also found their neighbour unconscious.

"We started intravenous fluid treatment and we had to get them all urgently to the clinic. I will assume that they all would have been dead if we had come a few hours later. There was not enough space in the car so we had to put them more or less on top of each other to make room for them all.

"We were about an hour's bumpy drive away from the nearest cholera treatment centre. As we drove the metal floor of the car became burning hot and I tried to gather as many children as possible in my lap while I was also securing airways for them to breathe and making sure that their IV drips were running. Two of the children vomited uncontrollably. I felt so sorry for the family and could not hold the tears back, the reality was too bad.

"The neighbour passed away soon after we got to the hospital, but the mother and the children were cured after several days. The mother said that she had lost her husband the same night that she and her children fell ill.

"Her husband and the neighbour had participated in a funeral for a cholera victim some days earlier. She realized that the disease was deadly and tried to find a way to get to the nearest clinic, which was about 50 km away. But she had no money and her neighbours where not willing to transport her with their donkey carts as they feared contracting the disease.

"She said she quickly became weak and was no longer able to walk the distance by foot. She was left with no other possibility than to wait for death to come and relieve them. We came the next morning and she said she could hardly believe it when she first saw the car and realised we were coming for them."

A quick killer
"Dealing with cholera is different than other emergencies I have worked on. It was the speed of it that made it so different. When you enter an area with many people sick from cholera, or a clinic completely overloaded with cholera patients, you know lives will soon be lost.

"Cholera can kill within hours as a result of dehydration, so you have to make very quick decisions. Tomorrow might be too late. This was a different way of thinking from my previous emergency experience. At the same time, we had to make wise decisions. Cholera was literally all over the country and we needed to be consistent in the support we gave.

"Cholera patients lie completely still on their beds, while the intravenous (IV) drips that rehydrate them are running quickly. You see they are exhausted. You can often tell just by looking at them how dehydrated they are. Their eyes are sunken and the whites of their eyes will still show even though their eyes are closed.

A day in the life "We used different strategies to help as many people as possible in the large, mostly rural province where we worked. I was part of an exploratory team that visited rural areas affected by cholera to decide whether or not MSF needed to intervene. Sometimes we also went to areas where we didn't know if cholera was present, just to see the situation for ourselves. We had to travel long distances and sometimes slept in the villages.

"I really liked going out into the countryside because the people were friendly, but it was never relaxing because we were always expecting to be faced with yet another cholera-affected community. The roads in the countryside were really bad; we sometimes had to struggle, even with a four-wheel drive.

"I would imagine how hard it was for people who only have a donkey cart to transport the sick to a health centre.

"The people in the villages were very calm when we arrived. The children were different, of course. They laughed and pointed, and giggled when they touched us.

If there was no health facility in the area, we would sometimes set up our own cholera treatment centre (CTC), which was often the case in the old farm lands that covered huge areas in the bush. We carried the essential equipment in the car set up supplies such as plastic sheeting, buckets of various sizes, chlorine, cleaning equipment and protective clothing (apron, boots), as well as medical supplies including ringer lactate, oral rehydration salts, IV sets, antibiotics, gloves and first aid kits.

"If there was a health centre, we made improvements so they could properly isolate the cholera patients. We trained staff to identify cholera patients from those with another diarrheal disease and to evaluate who needed urgent attention.

"We found many patients in a very severe state; many were unconscious without palpable pulses. Then, after a few hours with intravenous fluid therapy, they were able to sit up and talk. You really feel how you save lives, and there are so many patients like this you get to meet. Most patients stay in the centre for two to three days, then go home completely cured.

"Even so, it was very sad to be there. There were many people we were not able to save as cholera was all over the provinces; many little villages were affected. Sometimes we came too late - the cholera had already 'burnt its way through' the village by the time we got there. This was the biggest problem - the distances are huge and we were not able to reach everyone in time.

"The days were long; we normally worked every day until after midnight. Every day was unpredictable so you had to get as much work out of the way as possible each day. We tended to stay up late each night to finish the days' work.

Welcomed by the community
"We felt very much welcomed in the communities. The people have been suffering for a long time without receiving much help from the international community, so I think any type of support would have been welcomed. They were very open and realized the need for help to fight the disease. We drove to isolated villages where we were always met by very hospitable villagers who willingly shared information and their concerns.

"The nurses who worked in the local health centres were usually very grateful for our support. Most of them lacked equipment and had not been supplied with essential drugs for a long time, so our trainings and donations made a big difference in their daily work.

Teaching people about cholera
"The importance of educating people about how to prevent cholera became increasingly clear to me when I realized that people were dying just because they lacked basic information. They did not know how cholera was transmitted so they could not take preventative measures.

"I used every opportunity to talk to community leaders about cholera and make them understand how they could help stop the spread of the disease in their own villages. If we had time, we would also ask the leader to gather the whole community so we could explain what cholera was, how to prevent it and what to do when a person became ill. We also asked them to agree on who would provide an 'ambulance donkey cart' for the village, since most people did not have any means of transportation.

"It felt very good to teach people about how to take precautions against cholera. In the beginning, many people would die in the community without having gone to the health centre; many others would arrive at the centre in a very severe state. After health education, patients would come much earlier. People rarely died in the community. The funerals of people who died from cholera were monitored by health staff to help ensure that cholera was not spread there cholera funerals are a main source of infection in the countryside as people touch the body and then eat together.

How working with cholera changed me
"The experience has definitely changed me. Before I came to Zimbabwe, I had not imagined how cruel cholera was, for me it was just an infectious diarrheal disease. Now I know what damage it brings with it. All the suffering made a strong impression on me. So many more lives would have been spared if more international aid had been present.

"I think what made the strongest impression on me was meeting parents who had lost their whole families. They could be completely silent, but their eyes spoke of their pain and their hopelessness. I think many of them felt guilty for not having brought their sick family members earlier to the health facilities. But the barriers are so many; lack of money, lack of transportation means, lack of knowledge, huge distances. It is so easy to be the judge afterwards.

I will remember all the people, they were so friendly and good humoured and wise. I cannot imagine how it is possible to keep your spirit up under such hopeless conditions, but somehow they managed. They were strong minded and were not willing to give up.

Peter Kuthan / AZFA
Global Moderator
Hero Member
Posts: 819

« Reply #2 on: February 22 2009 »

Zimbabwe: Cholera Crisis Worsens As Number of Dead, Infected Steadily Climbs - UN

20 February 2009

The mounting death toll from Zimbabwe's devastating cholera epidemic has reached almost 3,800, with more than 80,000 people infected, the United Nations World Health Organization (WHO) reported today.

Some 3,759 people have now died from cholera since the outbreak first hit the besieged southern African country in August last year, with all 10 of Zimbabwe's provinces having been affected by the water-borne disease, which has spilled over to neighbouring countries.

WHO noted that South Africa, which has a relatively strong health care system, has been able to limit the number of fatalities to below one per cent of people infected by the deadly disease, compared to four per cent in Zimbabwe last December and between one and two per cent in recent weeks.

A high number of cholera cases have also been reported in Malawi, Mozambique and Zambia, all countries where the disease is endemic.

There are 365 cholera treatment centres operating in Zimbabwe and WHO has set up a Cholera Command and Control Centre in the capital, Harare, with its partner agencies to provide technical support in the areas of epidemiological and laboratory surveillance, case management, social mobilization, logistics, and infection control and water sanitation in treatment centres.

WHO warned that containing the rate of infection remains a significant challenge given the country's dilapidated water and sanitation infrastructure and a weak health system.

Its priorities now include decentralizing the emergency response, particularly to areas with no active non-governmental organizations (NGOs), and strengthening social mobilization within communities to improve access to health services and earlier treatment. The agency will also focus on resource mobilization and greater involvement of partners in the field.

Copyright 2009 UN News Service. All rights reserved. Distributed by AllAfrica Global Media (allAfrica.com).
Pages: [1] Print 
mulonga.net forum  |  IT Centers  |  Binga.Online  |  Topic: Zimbabwe: ICRC extends support to rural areas as cholera persists « previous next »
Jump to:  

Powered by SMF 1.1.8 | SMF © 2006-2008, Simple Machines LLC