Author: clarency

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Harare Now an Ancient City…As Harare Tops In Typhoid Cases – Health Times

THE city of Harare now resembles an ancient town as it lacks the characteristics and requisites of a modern day city due to poor planning and recurrent diarrheal diseases like Typhoid and Cholera which were most prominent during ancient times.
Typhoid was first discovered in 1880 in New York City but is also believed to have existed around 430 BC in Greece where it almost wiped out a whole army.
Briefing a Community Working Group on Health (CWGH) Public Dialogue meeting on Recurrent Outbreak of Typhoid and Diarrheal Diseases, Director for Epidemiology and Disease Control in the Ministry of Health, Dr Portia Manangazira said Harare is now a serious health hazard due to increased activities which are fertile breeding ground for ancient diseases like Typhoid and Cholera.
“What is an urban area, it is defined, but when you go to Hopley Farm and Hatcliff you wonder whether its urban or rural. This is where we get it wrong, we want to be urban but we are not that urban. Urban areas come with its stipulations and unfortunately we are failing to them in Zimbabwe. We have to start by regulated urbanisation first, and we are already talking 30, 50 years ago just making a proper urban setting and then the state that now lead you to a healthy city.
“If you go to a city in Europe today, you would think you are in a forest, they are well wooded with trees and open spaces, but what are we doing with our cities here, we put houses and then the houses are not serviced there is no sewage, there is no waste management systems, so we have gone back to the Victorian type of a city and yet we still want to be associated with modern times,” said Dr Manangazira.
She added that Zimbabwean cities are demoting health rather than promoting and called on local authorities to fix the mess and restore the City to its former Sunshine City status. She also said water in the city should only from tapes and not boreholes and wells.

A borehole with an installed Chlorinator
A borehole with an installed Chlorinator

Harare has seen an uncontrollable sprouting of overpopulated illegal residential areas like Hopely, Calledonia (though it was recently regularised) Epworth and others. The areas lack in basic health, water and sanitation facilities as most residents uses bushes as toilets and get water from unprotected holes and boreholes.
According to city health experts, most boreholes in Harare in particular Hatcliff are contaminated and residents should use best water treatment methods like chlorinating or boiling water before use. Hatcliff recently had more than 13 inl-ine boreholes Chlorinators installed in a bid to reduce the spread of Typhoid through drinking water.
A borehole with an installed Chlorinator
Meanwhile, Dr Issac Phiri also from the department of Epidemiology in the ministry of health said Harare has recoded highest Typhoid cases since it was first reported in 2009.
“From January, we had an increase in cases of Typhoid in Harare, specifically in Mbare where over 1 405 as we speak and 78 of them were laboratory confirmed. Unfortunately, three deaths were recorded and this could be an underestimation.
“By district, Harare, has contributed a majority, over 80 percent of the cases were reported in Harare. Over 1 2018 have been reported in Harare. Mashonalnd Central, 200 cases, Mash West, 30 cases and these have been conformed to be Typhoid. All deaths were recorded in Harare.”

September 29, 2017 NewsRoom By Michael Gwarisa
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Nurses’ shortage hits Binga . . . unqualified village health workers man clinic

Unqualified village health workers in Binga are reportedly manning a clinic located about 180 kilometres from Binga District Hospital.
Chunga Clinic, which is the furthest public health centre from Binga Centre, is difficult to access due to a poor road network and also has poor telephone network.
Binga North Member of Parliament Mr Prince Madubeko Sibanda said the district, which is a high risk area for malaria, was failing to access healthcare due to a shortage of nurses.
He said village health workers were forced to take on the job of trained nurses when most of them were only qualified in basic first aid.
“Some of our clinics are still manned by village health workers with no certified nurses and that’s a challenge,” said Mr Sibanda. “We also have a serious shortage of ambulances, for example from the district hospital to the furthest clinic in the constituency it’s a distance of about 180km.
“Firstly, it is difficult to communicate. The bad road network makes it difficult for patients to travel to the district hospital, hence many resort to traditional healers.”
Mr Sibanda said the district urgently needed ambulances to ease the burden.
“About 10 years ago we were promised that Siabuwa Clinic would be upgraded to a hospital to improve the situation. It is very difficult to retain doctors in rural areas. As we speak we have only three junior doctors for the whole district,” Mr Sibanda said.
He said most villagers in the area were poverty stricken and could not afford the user fees charged at health centres.
Speaking during the just ended 24th Community Working Group on Health annual meeting, Mr John Ngirazi, the chairperson of the organisation, appealed to Government to increase public funding in the health sector.
“It is worrying to note that in the past few months, the country has experienced outbreaks of medieval diseases such as typhoid, cholera, dysentery and scurvy diseases that were completely eliminated in some parts of the world and Zimbabwe at one time,” he said.
“Zimbabwe’s health challenges are also compounded by health systems’ constraints such as a critical shortage of personnel, ageing equipment and infrastructure, limited funding and lack of enabling health policies.”
The country’s health institutions need about 8 000 nurses to operate smoothly amid revelations that there are about 4 200 qualified unemployed nurses.
Health and Child Care Minster Dr David Parirenyatwa recently told Senators that he was working tirelessly to ensure that there is an update of the establishment which was last revised in 1983.

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Village health workers earn $14

June 24, 2017 in News

Village health workers across the country’s provinces earn a paltry $14 each month, given to them on a quarterly basis by the United Nations Development Programme (UNDP) and other development partners, it has been revealed.
By Vanessa Gonye
The workers move around communities educating people on preventing and treating common ailments related to HIV, typhoid and tuberculosis among others.
Speaking at the Community Working Group on Health annual national meeting in Harare on Thursday, Binga North Member of Parliament, Prince Sibanda, who is also a member of the Parliamentary Portfolio Committee on Health, expressed concern at the meagre earnings being given to over 2 000 village health workers (VHWs) across the country.
“The burden they are carrying is too much compared to the remuneration they are getting,” he said.
Sibanda bemoaned the fact that the VHWs were doing more than what was initially set for them whereby each person would work in a single village, but now each of them was obliged to work in around five villages in near-round-clock routine.
He urged government to prioritise health services and cut on unnecessary expenditures.
“We made a recommendation that at least they should be given $200 per month, in addition to what our development partners are bringing in so that we encourage them to continue doing their work,” Sibanda said.
A VHW from Goromonzi acknowledged that they were indeed earning $14 per month for the services they were offering in their villages.
“We get $14 per month which comes on a quarterly basis from UNDP though it is not guaranteed as it may never be availed, some haven’t received anything from 2004,” Isabel Mombe from Chikwaka said.
“We really don’t know who is responsible for paying us though we hear it’s UNDP, it is not really clear and we don’t know who to ask when we do not receive our money.”
According to ZimStat, in 2014 the total consumption poverty datum line for one person was $102, which places village health workers way beneath that margin.

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Improving emergency care vital

Improving emergency care vital

I. Rusike, E. Sharara, C. Chimhete and T. Munouya
In front of us in one of our rural districts is a road accident with injured passengers including children.They are distressed – the local public hospital has no ambulance and they are trying to find enough money to assure the private ambulance service that they will be able to pay the fee before they will send the ambulance.
The fee is more than they can afford, but if they don’t find someone to pay and get people to care quickly the injured people could have complications or suffer avoidable deaths.
This is not the only problem people who have emergencies face. Ambulances can take long to respond. Many ambulances do not have basic equipment or adequately trained staff to take care of patients during transit, also complicating their recovery or risking fatalities in transit.
Emergency departments are under resourced, without adequate equipment and staff to cope with the critically ill patients coming to them, including patients who have delayed seeking care until they have an acute emergency.
In some countries in our region, a critical shortage of doctors and other skilled health workers has affected the quality of the response to emergencies. Yet in others, like South Africa and Uganda, ambulances are better equipped and staffed, and people arriving at emergency facilities find doctors and nurses on stand-by and ready to receive patients and give them prompt care.
This situation is compounded by conditions that increase the risk of traumatic injury. For example, the state of our roads in Zimbabwe raises concern, especially when they are further damaged by heavy rains and other climate disasters.
Poor roads not only raise the risk of accidents, but also mean that ambulances cannot easily access patients in need. During the rainy season, rural roads become impassable, making access for emergency services even more difficult.
While communities assist with emergencies where they can, local transport operators sometimes take advantage of poor conditions to overcharge desperate patients in need of acute care, including pregnant women, carers of sick children and elderly people.
In the absence of adequate investment in roads and services, poor people pay the price. Allocating funds to improve road systems will prevent accidents and also make it easier for ambulances to reach emergencies.
Yet in 2017, of the $15 million that the Harare City Council said it needed to improve the road network, it received only US$1,2 million from the Zimbabwe National Road Administration (Zinara).
The situation may be worse when air rescue emergency services are needed, as a key component of an effective emergency care system. Air rescue emergency services are more scarce healthcare resource, and as in Zimbabwe, the only public service for this may be the Air Force.
There are private services for those who can afford the costs of private insurance or providers, but these are unaffordable for the majority, and thus only used by a minority of people.
In the common discussions on universal health coverage and emergency responses, it is important that we at minimum ensure availability, accessibility and affordability of effective and good quality emergency medical services for everyone in the public.
Good quality emergency medical services provide an immediate response to a variety of illnesses and injuries and the treatment and transportation of people in health situations that may be life threatening.
They should provide universal quality care to all those who need it at the time they need it to save their lives, prevent suffering or disability. Although the current situation varies from country to country in the region, for many this is not yet delivered.
The situation contradicts the fact that in Zimbabwe, as for seven other countries of the region, according to EQUINET policy brief 27, the constitution guarantees citizens the right to health care, including emergency medical services. Section 76 (3) of Zimbabwe’s Constitution states this as, “No person may be refused emergency medical treatment in any health care institution.”
Of course no service would refuse care, but a situation of inadequate investment in affordable, accessible and good quality emergency services, including ambulances can be understood to be a form of denial, or refusal.
The Zimbabwe Constitution makes this clear in stating that the state must take reasonable legislative and other measures, within the limits of the resources available to it, to achieve the progressive realisation of this right.
While public emergency services offered by state-owned health institutions, the Air Force, the police and Fire Brigade are weak and poorly resourced, people’s rights are violated and they are exposed to high payments for private services, or worse still disability or death.
It is evident that this is a core duty of the state and must be adequately funded. When public emergency care services are not adequately funded, staffed or provided, it leads to a growth of commercial and privatised services.
While this is a private sector response to demand, and can help to minimise morbidity and mortality if of good quality and properly regulated and monitored, it is not appropriate to rely on the private sector for this service, and leads to inequities in access to care. The driving force of private provision is maximising profits and not the needs of the most disadvantaged members of society.
A trend towards privatisation of emergency medical services thus has highest burdens for the poorest, adding to the stresses in often tough economic environments of accessing services and meeting medical bills.
A 2016 study by the Zimbabwe Coalition on Debt and Development on a public-private partnership in one major central hospital in Zimbabwe found that residents faced challenges in realising their right to health care, due to the high cost of services, unfair treatment of those who cannot pay, “ . . . deepening inequality between the haves and have-nots” and report of corruption in the demand by staff for differing levels of cash payments.
They attributed this violation of rights to health care to the “private vendor profit motive” and diminished public control.
Beyond improving public funding of emergency care services, we can
also take advantage of technology advances. For example, health facilities have used mobile phones to alert ambulance services and to support those attending to patients while waiting for an ambulance or medical personnel, improving the possibility of improved outcomes for patients.
A “Dial-a-Doc” initiative by one mobile operator in Zimbabwe works with enlisted services of medical practitioners at a call centre to respond to phone-in requests for information and help from the public. A similar service is available in South Africa, Zambia and Malawi. At the same time, we cannot keep relying on the health services to manage growing risks in the environments we live and work in.
Death and disability from traumatic injuries from road traffic accidents on poor roads, from climate disasters and other accidents, and acute health crises in pregnancy, for children and others, and due to unsafe working conditions are largely preventable and should not be filling our health services.
We need to have a commitment from all sectors that play a role to identify and reduce their role in traumatic injury and illness.
As economies improve they should show marked reductions in such trauma, but even under challenging economic conditions, adequate, affordable and accessible public emergency care

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Chronicle scribe scoops health reporter award

Chronicle reporter Thandeka Moyo (left) receives a certificate and a trophy from Mr Douglas Moyo, the Bulawayo National Aids Council officer (right), while Mr Nobert Dube of the Community Working Group on Health (CWGH) looks on during the CWGH Health reporting journalists awards at a Bulawayo hotel on Friday. Thandeka won the best CWGH health reporter award

Cynthia Dube, Chronicle Reporter
THE Chronicle’s award winning journalist Thandeka Moyo last Friday scooped the 2017 Maternal, Child and Sexual Reproductive Health Rights Award.
Moyo, The Chronicle’s health reporter was named the winner of the inaugural award courtesy of the Community Working Group on Health (CWGH).
She was awarded for a series of stories on maternal health she produced, including a story about a woman who died while giving birth at Mpilo Central Hospital due to negligence.
For her ninth journalism award, Moyo walked away with a certificate, a trophy and cash.
Freelance reporter Jermaine Ndlovu was the first runner-up.
Anastasia Ndlovu and Pamenus Tuso, also freelance reporters were second runner-ups. Addressing guests who attended the presentation ceremony in Bulawayo, CWGH board member Mr Norbert Dube urged journalists to continue reporting on health issues affecting Zimbabweans in order to force authorities to act.
“We value and appreciate your leading role in promoting quality health coverage in Zimbabwe.
“I would like to urge you to continue informing, educating and raising awareness on various issues affecting communities in the country such as bilharzia, intestinal worms, elephantiasis, leprosy and blinding trachoma and other common diseases,” said Mr Dube.
He said media houses should engage health organisations to improve their health reportage.
Veteran journalist who was one of the adjudicators Tapfuma Machakaire said accuracy, truthfulness, fairness and balance had earned the winners the awards.
“We were also looking at the originality of the story and multi-sourcing which is very important if the story is to be informative,” said Machakaire.
He said the judges also assessed the story’s impact on society.
CWGH director Mr Itai Rusike said he was happy that unlike in the olden days, health issues were making it as news.
“It will take efforts by the Government, the private sector and the media to ensure our health sector is revived.
“We also want to appreciate media houses represented here for their effort in spreading health messages,” said Mr Rusike.

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Media Awards Invitation

The Community Working Group on Health (CWGH) invites journalists to submit fresh stories on public health,maternal, child and sexual reproductive health rights for publication in an on-line magazine that will be published at the end of May 2017.
As discussed in earlier meetings, each journalist is invited to submit one well-researched, balanced and well written story on health issues to do with public health, maternal, child and sexual reproductive health rights in Zimbabwe. The stories must be between 500 and 800 words. Pictures must accompany the stories.
A small stipend will be paid for stories that will have been published.
The articles must be submitted to: nonjie@cwgh.co.zw and caiphas@cwgh.co.zw not later than 18 May 2017.

The Community Working Group on Health (CWGH) invites entries from journalists in Matabeleland and Midlands regions for the maiden Maternal, Child and Sexual Reproductive Health Rights Media Awards to be held in Bulawayo on the 26 th of May 2017.
Each journalist is supposed to submit at least three articles published or broadcasted between 1 January 2015 and 30 April 2017 on issues to do with Public Health, Maternal, Child and Sexual Reproductive Health Rights in Zimbabwe. The awards, which will be held under the theme “Professional Health Reporting for Positive Change”, will be adjudicated by a team of renowned professional journalists.
The three article limit can only be waived if the articles are part of a series of stories in a campaign or investigation.
The articles must be submitted to: nonjie@cwgh.co.zw and caiphas@cwgh.co.zw not later than 17 May 2017.

For electronic media, journalists are required to present three articles on DVD format at

11 Coghlan Road,Khumalo, Bulawayo or 312 Samora Machel Avenue, Eastlea in Harare.

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Council must do more to contain typhoid: Experts

Failure by Harare City Council to provide basic water and sanitation services to its residents is fuelling the outbreak of water borne diseases such as typhoid and cholera, health experts have said. Water-borne diseases, the experts said, were primitive in this era. As such, the specialists called for the city to venture into private partnerships with developmental partners in order to resuscitate infrastructure which is failing to cope with the growing population.
The sentiments by the experts come after the death toll from typhoid in Harare has since risen to three from December last year.
The deaths have been recorded in Hatcliffe (1) and Mbare (2), while hundreds have been treated.
Parliamentary Portfolio Committee on health member Dr Paul Chimedza said the prevention and control of water-borne diseases depends entirely on the provision of clean water and best sanitation practices.
Dr Chimedza, who is former Deputy Minister of Health and Child Care, said the conditions in Harare were breeding ground for the bacteria as most areas do not have water.
He said even if medical personnel intervened, the outbreaks would be difficult to control.
Community Working Group on Health executive director Mr Itai Rusike said the solution rests on the city in not only consistently supplying clean water, but must be coupled with regular refuse collection, and ensuring that burst pipes are fixed and replaced.
“Typhoid is a primitive disease, which council should not struggle to contain. In Harare, we are not supposed to have alternative sources of water such as boreholes and unprotected wells, but if the need arises, the city should make sure that all the alternative sources are chlorinated,” he said.
Zimbabwe College of Public Health Physicians Dr Vonai Chimhamhiwa echoed similar sentiments saying: “The city’s water supply is highly susceptible to contamination because of the old pipe system that is still in use, hence any pipes that burst, get contaminated and the risk of transmission is very high.”
Ultramed Health medical Aid Society chief executive officer Dr Sydney Mukonoweshuro called for the revival of the city’s infrastructure and spirited campaigns that will educate residents to follow strict hygiene practices.
“The water-borne disease outbreaks must be understood from the acute migration that happened to Harare. The city that had an infrastructure to handle one million people woke up accommodating millions of people. The authorities have tried their best, but it is a problem that will require huge capital investment to expand and resuscitate infrastructure,” he said.
Harare City Council Health Services director Dr Prosper Chonzi said he was in agreement with the health experts that the permanent solution for the outbreaks will be to address all the environmental issues. He said instead of him battling chronic ailments such as HIV and Aids, tuberculosis and others, he was being left to react to diseases, which could be eliminated through the provision of water and sanitation.
On Hatcliffe, Dr Chonzi said the situation had improved as only three people had presented themselves with similar symptoms of typhoid.

Harare Water director Engineer Hosiah Chisango said council had been facing technical challenges in its bid to improve water supplies.
Harare needs at least 1 200 mega-litres to enable every household to have water everyday.
The city’s water department has been failing to cope with water demand over the years, mainly because the original infrastructure was designed to serve a population of 300 000.
The city’s population has since increased to almost 2,5 million without a corresponding expansion of water infrastructure.