100,000 cases The spectre of cholera remains in Zimbabwe - Advocacy report

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100,000 cases The spectre of cholera remains in Zimbabwe - Advocacy report
IFRC communications department /
                                                                     100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

                           Communications department / May 2009 //

                           100,000 cases
                           The spectre of cholera
                           remains in Zimbabwe
                           Advocacy report
international federation

                                                                                                                                         1
100,000 cases The spectre of cholera remains in Zimbabwe - Advocacy report
IFRC communications department /
 100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

                                                                                          response. Despite this warning, the operation’s

                    Top line summary
                                       Current trends suggest that Zimbabwe               original budget of 10.17 million Swiss francs
                                       will, in the coming week or two, record            has only been 45 per cent covered.
                                       its 100,000th case of cholera.
                                       Almost 4,300 people have died of this ill-         The IFRC operation – estimated at one stage
                                       ness since the outbreak began in mid               to have constituted 60 per cent of the country’s
                                       2008.                                              entire cholera caseload – has since been down-
                                                                                          graded prematurely. The seven Emergency Re-
                                       The threat of cholera remains very real
                                       for Zimbabwe. The outbreak was born                sponse Units deployed across the country have
                                       largely as a result of the country’s almost        been demobilized, with responsibilities as-
                                       entirely collapsed water, sanitation and           sumed by the Zimbabwe Red Cross.
                                       health systems. These issues have not
                                       been addressed.                                    The focus now is on medium to long-term re-
                                                                                          covery and rehabilitation activities –measures
                                       Reluctant support from donors has un-
                                       dermined the Red Cross Red Crescent                to alleviate the impact of severely degraded
                                       cholera operation – forcing a premature            civil society infrastructure, such as providing
                                       down-scaling of emergency operations.              communities with semi-permanent access to
                                       The Red Cross Red Crescent is now call-            clean water and basic sanitation.
                                       ing for support for mid to long-term re-
                                       covery and rehabilitation efforts.                 The threat of cholera remains very real.

                                       Introduction                                       Retreated,
                                                                                          not defeated
                                       In the coming days Zimbabwe will record its
                                       100,000th cholera case. The epidemic has en-       In December 2008, the World Health Organi-
                                       trenched itself as Africa’s worst outbreak in      zation (WHO) released a worst case scenario
                                       more than 15 years. Almost 4,300 people have       for Zimbabwe’s cholera outbreak of 60,000
                                       now died, and the case fatality rate stands at     cases. This figure was quickly passed in Febru-
                                       4.4 per cent – unacceptably high given that a      ary 2009, and the organization soon released
                                       controlled cholera outbreak is defined by a rate   new analysis with an upper estimate of above
                                       of one per cent or less.                           100,0001.

                                       Rates of infection and death have declined         In February of this year, the meteoric rates of
                                       markedly over the past one or two months.          infection of December 2008/January 2009
                                       The reasons for this are varied: the impact of     had already begun to slow. Red Cross Red
                                       the humanitarian response; the establishment       Crescent field assessments from this time high-
                                       in some areas of interim social services, and;     lighted a ruralisation of the outbreak. Where
                                       the natural life of any public health crisis.      once the crisis had been focused in urban areas
                                                                                          – particularly the high density suburbs around
                                       However, the eradication of cholera in Zimba-      the capital Harare – the illness had now taken
                                       bwe or the complete conclusion to this current     a foothold in villages and communities across
                                       epidemic is unlikely unless the underlying         the countryside.
                                       causes of the health crises are addressed. Cen-
                                       tral to this outbreak remains the almost com-      To an extent, this shift explained the slowing
                                       plete collapse of Zimbabwe’s basic water, sani-    rate of infection: fewer people lived in these
                                       tation and health infrastructure. Communities      communities than in the semi-formal settle-
                                       across the country are still without access to     ments surrounding the large cities, for exam-
                                       potable water and basic sanitation, and health     ple. But this new trend also brought with it
                                       facilities continue to be understaffed and un-     new challenges.
        1. IRIN, “In brief:
   Zimbabwe’s cholera                  der resourced.
         cases expected                                                                   During the urbanized phase of the outbreak,
      to reach 115,000”,
          www.irinnews.
                                       In January 2009, the International Federation      treatment and prevention efforts could be cen-
        org, http://www.               of Red Cross and Red Crescent Societies            tralized. Cleaned and chlorinated water could
   irinnews.org/report.                (IFRC) warned that its cholera operation was       be provided to large numbers of people, large
aspx?ReportID=82797,
                26/02/09               at risk as a result of a surprisingly slow donor   treatment centres could service high density

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100,000 cases The spectre of cholera remains in Zimbabwe - Advocacy report
IFRC communications department /
                                                                     100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

                           areas, and community education efforts could        across the country, and millions of litres of
                           reach whole communities relatively rapidly.         clean water being produced. Thousands of
                                                                               community based volunteers have disseminat-
                           With a ruralised crisis, comparatively more         ed potentially life-saving public health mes-
                           resources, that were more flexible, were            sages, arming families and communities with
                           needed. The endemic frustrations of operat-         the information that they needed to reduce
                           ing in Zimbabwe – inadequate transport and          their risk of exposure to cho
                           communications – also played out more
                           acutely. Aid organizations were often only          But again, the fundamental drivers of this pub-
                           made aware of community-level outbreaks             lic health crisis remained largely unchecked.
                           when their treatment centres were inundated         The treatment centres and water purification
                           with cases.                                         units were only ever interim measures. The
                                                                               steady decline in the spread of the illness should
                           In the months since, new cases across the coun-     not be seen as a complete victory. Unless sig-
                           try have declined, though some new flare ups        nificant efforts are made to rehabilitate at least
                           were reported again in and around Harare and        some components of the country’s degraded
                           other cities. The humanitarian response no          water and sanitation infrastructure, communi-
                           doubt contributed to this welcome trend, with       ties remain vulnerable to further and severe
                           cholera treatment centres being established         outbreaks.
international federation

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100,000 cases The spectre of cholera remains in Zimbabwe - Advocacy report
“Zimbabwe is not Ethiopia
  IFRC communications department /
  100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

25 years ago. The dead
are not dropping in the
street (…) but the gnawing
hunger that plagues
people (is) compounded
by collapsing immune
systems. With that comes
disease.”
                        The Guardian UK, 13/02/09

                                                                            international federation

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100,000 cases The spectre of cholera remains in Zimbabwe - Advocacy report
IFRC communications department /
                                                                        100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

                         Beyond cholera:                                          lation. Again, this food crisis has been fed by a
                         A broader base                                           number of factors: hyper-inflation for instance
                                                                                  has disenfranchised many farmers from essen-
                         of suffering                                             tial agricultural inputs such as fertilizers and
                         As the cholera crisis continues quietly, other           seeds.
                         factors such as HIV, food insecurity and natu-
                         ral hazards add to the daily challenges faced by         Zimbabwe’s fields are sown with substandard
                         ordinary Zimbabweans. The ground was laid                seed, scavenged often from graneries or from
                         for this cholera outbreak by years of infrastruc-        the side of the road. It is extraordinarily un-
                         ture degradation, and the unchecked rising of            likely that the 2009 harvest will significantly
                         HIV and hunger, aggravated by recurrent                  surpass 2008 – the worst in the country’s
                         floods, inconsistent rainfall, and in some parts         history.
                         of the country, drought. The situation is ag-
                         gravated by a still deteriorating economic situ-         These factors are obviously interrelated. Each
        2. World Food
          Programme,     ation, high unemployment and chronic issues              feeding into a worsening downward spiral: the
    “Zimbabwe crisis:    surrounding transport and communication.                 food crisis is undermining stunted efforts to
     as of 15 January,
2009”, www.wfp.org,
                                                                                  provide anti-retroviral treatment, and is con-
 http://www.wfp.org/     Per capita, Zimbabwe is now the most food aid            tributing to the high fatality rate of the cholera
countries/zimbabwe,      dependent country in the world. The World                epidemic. The UN believes that 54 per cent of
             26/02/09
                         Food Programme believes that seven million               all children who have died from cholera were
3. WFP, http://www.
  wfp.org/countries/
                         people are in need of food assistance2 – some-           malnourished, with 47 per cent of the coun-
zimbabwe, 26/02/09       where between 65 and 80 per cent of the popu-            try’s population undernourished3.

Cholera rising

100,000

                                    Cases
                                    Deaths
 80,000

 60,000

 40,000

 20,000

         0
             December             January           February                March               April                      May

                                                     Source: http://ochaonline.un.org/CholeraSituation/tabid/5147/language/en-US/Default.aspx

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IFRC communications department /
    100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

                               Almost 4,300 Zimbabweans have now died                                    The seven Emergency Response Units deployed
                               from an illness that is entirely preventable and                          at the onset of the outbreak have been demobi-
                               easily treatable. Although infection rates have                           lized, with operational responsibility handed
                               dropped, the spectre of cholera will not be de-                           over to the Zimbabwe Red Cross Society. An
                               feated until the underlying issues are addressed.                         estimated 3.75 million Swiss francs (USD 3.44
                                                                                                         million/€ 2.47 million) is urgently required to
                               Funding impedes                                                           ensure that sustainable medium to long term
                                                                                                         measures are implemented. The Red Cross Red
                               response                                                                  Crescent aims to rehabilitate 1,150 non-func-
                               In January, 2009, the IFRC warned that chron-                             tional water sources, to drill 263 bore holes and
                               ic underfunding of its Zimbabwe cholera op-                               construct 3,755 latrines. With a well estab-
                               eration would result in activities being scaled-                          lished network of over 1,000 trained volunteers
     4. IFRC, “Zimbabwe:
                               back4.                                                                    and community health workers, this plan of
     As cholera escalates,                                                                               action aims to reach 665,000 households in
             Red Cross Red     The warning was not heeded, and as a result,                              high-risk areas.
           Crescent funding
          falls short”, www.   the operation – estimated at one stage to have
      ifrc.org, http://www.    constituted 60 per cent of cholera related hu-
       ifrc.org/docs/news/
            pr09/0509.asp,
                               manitarian work in the country – was prema-
                   26/02/09    turely downscaled.

The Red Cross Red Crescent
Operation – an overview

 In December 2008, the IFRC deployed seven
 Emergency Response Units (ERUs) to Zimbabwe.
 An ERU is a specialized team that is trained and
 equipped for emergency humanitarian scenarios.
 The Zimbabwe deployment is the largest of its kind
 in Africa, and comparable to the deployments
 undertaken in the wake of the 2005 Pakistan earth-
 quake.

Operational highlights

 The Red Cross Red Crescent has:
 > Supported 75 hospitals, clinics and cholera
   treatment centres (CTCs).
 > Provided 450,000 people with access to clean
   water
 > Distributed 700,000 water purification sachets
   to more than 175,000 people
 > Reached over 250,000 people with direct hy-
   giene promotion activities
 > Constructed 58 latrines, eight waste disposal
   pits and four incinerators at CTCs
 > Reached over 700,000 people with potentially
   life-saving public health information through in-
   formation, education and communication (IEC)
   materials
                                                                              international federation

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IFRC communications department /
                                                                     100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

                           The politics of                                     Calling governments to account and cam-
                           emergency aid                                       paigning for change is the hallmark of a civil
                                                                               society. Yet this should not be confused with
                           The deteriorating humanitarian situation in         the mandate of organizations like the IFRC,
                           Zimbabwe coincides with ongoing political,          which is to impartially provide aid on the basis
                           social and economic tensions and develop-           of need, and need alone, without recourse to
                           ments. Following the signing of the Global Po-      ideology, politics or difference.
                           litical Agreement, the transitional government
                           has redirected its efforts in economic recovery     It is vital that a neutral, independent and im-
                           strategies resulting in the development of the      partial humanitarian space be fostered and
                           STERP (short-term emergency recovery pro-           protected.
                           gramme), which aims to inject and stabilize
                           growth.

                           At the epicentre of the economic crisis, have           “Today, our appeal
                           been unprecedented levels of hyper-inflation,
                           sustained period of negative Gross Domestic             is less than half
                           Product (GDP) rates, massive devaluation of
                           the currency, low productive capacity, loss of          funded. We will
                           jobs, food shortages, poverty, massive de-in-
                           dustrialization and general despondency. Gov-           begin revising our
                           ernments around the world are monitoring
                           these situations, and global media continues to         operation, scaling
                           provide analysis.
                                                                                   back just at the time
                           But while the international community con-
                           tinues to wrestle with the politics of Zimba-           when humanitarian
                           bwe, Zimbabweans are still being infected by
                           cholera.                                                assistance needs
                                                                                   to be dramatically
                                                                                   scaled-up. This is
                                                                                   simply untenable.”
                                                                                               Ms Emma Kundishora,
                                                                                        Zimbabwe Red Cross Society
                                                                                     secretary general, February 2009
international federation

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IFRC communications department /
100,000 cases: the spectre of cholera remains in Zimbabwe / May 2009 //

100,000 cases: the spectre
of cholera remains in Zimbabwe
For more information, to set up interviews or to obtain footage or photos, please contact:

Press contacts
Matthew Cochrane
communications manager (Johannesburg)
Tel: + 27 83 395 52 66
Stambuli Kim
communications officer (Zimbabwe Red Cross)
Tel: + 263 11 517 264
Paul Conneally
Media and external communications manager (Geneva)
Tel: +41 79 308 98 09
Media service duty phone (Geneva)
Tel: + 41 79 416 38 81

    The International Federation of
    Red Cross and Red Crescent
    Societies promotes the
    humanitarian activities of National
    Societies among vulnerable
    people.

    By coordinating international
    disaster relief and encouraging
    development support it seeks
    to prevent and alleviate human
    suffering.

    The International Federation,
    the National Societies and the
    International Committee of
                                                                                                                 159500 05/2009 E

    the Red Cross together constitute
                                                                                  Our world is in a mess.
    the International Red Cross and                                               It’s time to make your move.
    Red Crescent Movement.                                                        ourworld-yourmove.org

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