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This article participates on the following special index pages:
Health Crisis - Focus on Cholera and Anthrax - Index of articles
Cholera
in a time of health system collapse: Violations of health rights
and the cholera outbreak
Zimbabwe
Association of Doctors for Human Rights (ZADHR)
February 26, 2009
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Executive
Summary
Although Zimbabwe has
experienced cholera outbreaks since 1992, the outbreak which began
in August 2008 is the worst ever in this country and is set to become
the worst outbreak on the African continent. Violations of the rights
to safe and potable water, adequate sanitation and a collapsed health
system were the cause of the outbreak. The course of the outbreak
has been difficult to predict and to control.
To date, the Government
of Zimbabwe has fallen far short of its responsibility to ensure
the availability of appropriate health services. Despite the epidemic
continuing for more than six months, sanitation remains poor and
lack of access to safe drinking water persists against the backdrop
of a collapsed health system with degraded infrastructure and very
few health workers.
Health is a fundamental
human right indispensable for the exercise of other human rights.
Despite this, the right to health is becoming an increasingly remote
privilege, out of the reach of most Zimbabweans. Health in Zimbabwe
is presently largely unavailable, unacceptable, inaccessible and
of poor quality.
This report concludes
that Zimbabwe will require long term commitment of the humanitarian
and donor agencies working in the country with large scale, multi-faceted
assistance to address the situation. The Government of Zimbabwe
must also take responsibility for the restoration of the basic social
services that fulfil basic human rights.
ZADHR makes the following
recommendations:
On the
public health system
An emergency health response
plan to restore function to the public health system must be produced
and implemented. This plan should begin by focusing on making primary
and secondary care services (clinics and district hospitals) affordable
and accessible to all. The Government must also ensure that health
workers concerns are addressed to ensure that conditions in which
these workers return to work and their skills can be retained are
put in place (including adequate remuneration and safe working conditions).
On access
to safe water
If the outbreak is to
be brought under control, and ultimately to an end, there is an
urgent need to restore safe potable water to communities. Where
infrastructure for piping water exists this needs to be rehabilitated.
On adequate
sanitation
Ensuring that communities
make use of sanitary facilities for defaecation is vital. Everyone
should have access to a toilet connected to a septic tank or working
public sewer system or a ventilated improved pit latrine.
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