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100,000 cases: The spectre of cholera remains in Zimbabwe
International Federation of Red Cross and Red Crescent Societies
May 30, 2009

http://www.ifrc.org/Docs/News/pr09/2709.asp

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Summary

Current trends suggest that Zimbabwe will, in the coming week or two, record its 100,000th case of cholera.

Almost 4,300 people have died of this illness since the outbreak began in mid 2008.

The threat of cholera remains very real for Zimbabwe. The outbreak was born largely as a result of the country's almost entirely collapsed water, sanitation and health systems. These issues have not been addressed.

Reluctant support from donors has undermined the Red Cross Red Crescent cholera operation - forcing a premature down-scaling of emergency operations. The Red Cross Red Crescent is now calling for support for mid to long-term recovery and rehabilitation efforts.

Introduction

In the coming days Zimbabwe will record its 100,000th cholera case. The epidemic has entrenched itself as Africa's worst outbreak in more than 15 years. Almost 4,300 people have now died, and the case fatality rate stands at 4.4 per cent - unacceptably high given that a controlled cholera outbreak is defined by a rate of one per cent or less.

Rates of infection and death have declined markedly over the past one or two months. The reasons for this are varied: the impact of the humanitarian response; the establishment in some areas of interim social services, and; the natural life of any public health crisis. However, the eradication of cholera in Zimbabwe or the complete conclusion to this current epidemic is unlikely unless the underlying causes of the health crises are addressed. Central to this outbreak remains the almost complete collapse of Zimbabwe's basic water, sanitation and health infrastructure. Communities across the country are still without access to potable water and basic sanitation, and health facilities continue to be understaffed and under resourced.

In January 2009, the International Federation of Red Cross and Red Crescent Societies (IFRC) warned that its cholera operation was at risk as a result of a surprisingly slow donor response. Despite this warning, the operation's original budget of 10.17 million Swiss francs has only been 45 per cent covered.

The IFRC operation - estimated at one stage to have constituted 60 per cent of the country's entire cholera caseload - has since been downgraded prematurely. The seven Emergency Response Units deployed across the country have been demobilized, with responsibilities assumed by the Zimbabwe Red Cross.

The focus now is on medium to long-term recovery and rehabilitation activities -measures to alleviate the impact of severely degraded civil society infrastructure, such as providing communities with semi-permanent access to clean water and basic sanitation.

The threat of cholera remains very real.

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