Cholera has rampaged through Zimbabwe since August 2008, killing more
than 4,000 people and infecting over 91,000, and although the World
Health Organization (WHO) recently said reports of new cases were
slowing, it warned that the "the risk of the outbreak restarting" was
"real".
Early in March, Simplicius Mushayakarara, 49, returned
to his rural home in Musana, about 85km northeast of the capital,
Harare, after attending a funeral. His stepdaughter died from cholera
but he and his wife were saved by the intervention of their son, who
works in the nearby town of Bindura, in Mashonaland Central Province.
"We
had just returned from the funeral of a relative who died in Harare
when the three of us fell ill, suffering from diarrhoea. We had no
reason to suspect it was cholera because we were not told the cause of
the death of my relative," Mushayakarara told IRIN.
Freely shook hands
"At
the funeral we freely shook hands, as our custom requires, ate food
without properly washing our hands, and some of us even touched the
body of the deceased person as a way of bidding him farewell. To us,
cholera was a disease that only occurred in towns and cities," he said.
Mushayakarara’s
son, Tatenda, arrived at their home by chance, after coming to the
district to pay his respect to the family of a recently deceased
relative, and immediately recognized the symptoms. He was too late to
prevent his sister’s death, but his quick thinking saved his parents.
"Tatenda
gave us a salt and sugar solution and organized transport that ferried
us to Bindura, where we were hospitalised and treated," Mushayakarara
said. "We came back to bury our daughter, and I will always be grateful
to my son because, were it not because of him, we would all have
perished without knowing what disease had hit us."
That week
in Musana, six people from four different families also died, "and that
is when we became aware that cholera was not only confined to urban
areas but could easily spread in villages as well," Mushayakarara said.
Before the outbreak, villagers had only received scant details
of a disease killing people in urban areas and were unaware of the
symptoms of the disease or how it spread.
Sekai Chapwanya, 38,
a community-based HIV/AIDS caregiver in a neighbouring village, has
urged health officials to ramp up cholera education campaigns. "The
majority of the people living in rural communities lack knowledge on
how best to prevent cholera," she told IRIN.
"Health officials
seem to have been concentrating on urban areas, maybe because that is
where most of the deaths have occurred. The cholera outbreak might have
started in cities but it has found its way here as well."
Since
cholera gained a foothold in rural areas Chapwanya has concentrated on
teaching communities about preventing and curing the disease, with some
tacit support from NGOs but none from government.
"I do my visits only when I am not tending my own crops, a situation that makes the anti-cholera fight difficult," she said.
The
incidence of cholera in Musana is relatively low compared to other
parts of the province, as Chapwanya recently discovered when she
embarked on a 50km journey on foot to bury a friend who had died from
the disease.
Depend on water from rivers
The
spread of cholera was worsened by the rainy season she said, and rural
communities depended on water from the rivers for drinking and cooking.
"Villagers also wash in the same rivers, and sometimes relieve
themselves in places close to water sources used by the people. There
are hardly any boreholes, as those that were sunk long back have broken
down and no-one is coming to repair them," Chapwanya said.
Rural
clinics hardly functioned, so the sick had to travel long distances for
medical care. "That means a lot of deaths are occurring at home and on
the way to the hospitals," Chapwanya said.
Innocent
Makwiramiti, a Harare-based economist, told IRIN that rural populations
were vulnerable to disease outbreaks because of poverty and lack of
access to resources.
"Rural areas have not been spared by the
economic meltdown, and that makes them particularly susceptible,
because health centres are not functioning, roads are in a poor state
and people in those areas suffer low literacy rates," he said.
Tsitsi
Singizi, the UN Children’s Fund (UNICEF) Zimbabwe spokesperson, told
IRIN the organization had embarked on cholera education in the rural
areas.
"We are also providing non-food items to promote
standard hygiene in cholera-affected areas, and these include the soaps
and buckets used in chlorination, while at the same time providing oral
and intravenous rehydration," she said.
"As UNICEF, we are
involved in response management and prevention in rural areas, in the
wake of the cholera outbreak. We have been drilling boreholes in rural
communities nationwide to ensure safe water for consumption, and we
started this programme well before the cholera outbreak."
IRIN
Post published in: Analysis