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Mitigating cholera in Zimbabwe through community water, sanitation, and hygiene (WASH) activities
USAID / OFDA
September 17, 2009

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From August 2008 to July 2009, Africa's largest cholera outbreak in 15 years struck Zimbabwe, resulting in nearly 4,300 deaths and nearly 98,600 cases nationwide. Poorly maintained water and sanitation infrastructure contributed to the scope of the outbreak, and Zimbabwe's fragile health system was unable to treat patients adequately. In response, USAID/OFDA committed more than $7.3 million in emergency assistance to support the provision of emergency relief supplies, WASH and health interventions, hygiene promotion and social mobilization activities, and humanitarian coordination and information management to improve epidemiological reporting and analysis.

USAID/OFDA has supported WASH activities throughout Zimbabwe since Fiscal Year (FY) 2007, as the increasingly irregular provision of water and sanitation services heightened the potential for the spread of waterborne diseases such as cholera. The case of Bulawayo, Zimbabwe's second-largest city, demonstrates the merits of community-based WASH interventions. For the past several years, Bulawayo has suffered inconsistent water supply and has a sewage system that functions poorly, like most Zimbabwean cities. In 2007, the city suffered a diarrheal disease outbreak as a result of a severe water shortage that prompted relief agencies, including USAID/OFDA, to increase WASH intervention activities.

Since 2007, USAID/OFDA-supported programs in Bulawayo have included hygiene promotion activities to raise awareness; social mobilization to increase community reporting of cholera cases and sewage system breaks; distribution of soap and other hygiene supplies; provision of water storage tanks and water containers to schools and houses; and provision of water purification materials for community and household use. During the cholera outbreak, the metropolitan Bulawayo area recorded 445 cases and only 18 deaths, rates significantly lower than other urban centers. By comparison, Harare, the capital, and Harare's highdensity suburbs and dormitory towns recorded nearly 19,600 cases and more than 650 deaths. Several factors played a part in keeping Bulawayo's rates comparatively low; among them were ongoing USAID/OFDA support for WASH activities in Bulawayo.

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