Zimbabwe: "Can you rescue us?" (Part 2)

In this photo I am leading a health education session on cholera prevention in a village in eastern Zimbabwe. Cholera was not common in Zimbabwe before 2008 and so most people didn’t know how to prevent or treat the disease. By the start of 2009 an outbreak had killed over 4,000 people and sickened more than 100,000.

Photo: Ingrid Kelters/IRC

Yesterday I wrote about how a decade of economic troubles has eroded Zimbabwe's water and sanitation infrastructure, leaving its people vulnerable to cholera and other water borne illnesses. Today I will describe how my International Rescue Committee (IRC) colleagues and I are working in the remote highlands of eastern Zimbabwe to help restore community water systems and respond to outbreaks of disease.
 
It is very motivating working with people in the affected villages. Whenever I arrive in an area where there has been an outbreak of cholera people always stop the IRC vehicle and ask, “Can you rescue us?” They often ask many questions and have many misconceptions —  for example, some still strongly believe that cholera is airborne since it always seems to affect their areas.

In one village, I met a lady who was giving her children two liters of oral rehydration solution every day whenever there was a cholera outbreak, even though they were not sick. In other communities people have accidently poisoned themselves by swallowing chlorine tablets -- used to treat household drinking water – because they mistook them for pills to prevent cholera.  They often become even sicker than the cholera patients.

A lot of our work is therefore focused on community health education. Sometimes I feel like a teacher: With cholera outbreaks occurring now in a cycle of every three months I meet people who were successfully treated once who have become sick again. They are very eager to learn as much as they can about the disease and how to prevent it.

Recently with two teammates, Edgar Mvududu and Munhamo Pasirayi, I helped train over 200 village health workers to rapidly identify and report cholera cases.  We also carry out cholera awareness campaigns in the villages and at schools with drama, songs and participation from the audience to help prevent more families becoming sick. We spread messages about washing with soap, drinking only safe water and other preventive measures. In all, we have assisted more than 50 villages in five districts.  The communities welcome the IRC with open arms and tell us that they feel that we deliver real results.

Health officials here in Zimbabwe refer to the IRC as their ‘son-in-law’. In the culture of Zimbabwe’s Shona tribe, sons-in-law are always there to assist and support the family.  Over the last two years we have helped families to protect their wells from contamination. We have built latrines and water systems for schools and clinics, and provided cholera treatment kits, disinfectants and cleaning supplies to health workers. We have also constructed incinerators and medical waste pits to help prevent the spread of infections to clinic staff and surrounding communities.

These efforts are making a difference.  The number of people who have died in these recurring cholera outbreaks has decreased tremendously in eastern Zimbabwe. In fact, some districts where we work have recorded no cholera deaths at all this year.  But we still face many challenges, including poor communication links with clinics in remote areas at the start of outbreaks, a shortage of skilled nurses (who are the primary caregivers in the clinics), and ongoing problems with poor sanitation and a lack of clean water in the communities where we work.

Cholera is a killer. We have gone a long way in making sure good hygiene practices that help deter the disease are widely adopted —  and in improving the circumstances in which people live. This is taking a lot of time and effort.  But it is all worth it so that many more lives are saved.