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Allocate foreign currency towards ARV procurement – CWGH

THE Community Working Group on Heath (CWGH), has called on government to prioritise allocation of foreign currency towards the procurement of Anti Retro Viral medicines ARVs amid revelations of massive ARV stock outs at public health centres and pharmacies.

CWGH Executive director Itai Josh Rusike said it was disheartening that Zimbabwe which over the years made tremendous gains in reducing HIV/AIDS related deaths through multi-sectoral efforts, is now experiencing a serious shortage of Abacavir – a second line ARV drug to the extent that people taking that drug are only being given a week's supply instead of the usual three months' provision.

"As an organization whose primary focus is the enjoyment of quality equitable health services, the CWGH would like to urge the government to quickly avail foreign currency for the procurement of ARVs to save thousands of lives that are under threat. The shortages will definitely compromise the health of the 35% of the estimated one million people on second line treatment as they will default on taking their medication.

"Limited availability of ARVs impedes patient initiation, adherence and poses a major barrier to win against the HIV response as a country. It should be emphasised that optimal adherence is essential to ensure individual treatment access and limit viral resistance. Treatment for HIV/AIDS is threatened when ARV drugs are not available, undermining treatment compliance.

The weekly supply of the drugs will force people to commute regularly to their usual collection points thereby incurring heavy out-of-pocket costs, a situation most people will not afford under the current harsh economic situation. Some will fail to collect their drugs leading to defaulting due to prohibitive costs," said Rusike.

He added that even once drugs reach facilities, there are many other barriers to access which include transport charges and fees to use facilities, and the costs of lost work time.

"When drugs are not available in facilities community members may be forced to buy them from private suppliers. The cost of medications have increased significantly and medical care costs have been the highest rising element of the Consumer Price Index for some time. If the current situation is not addressed urgently, the country will end up losing some of the gains recorded over the past years.

It is important that the government secures access to ARVs for the realization of the 90-90-90 objectives; that is to initiate 90% of diagnosed patients and obtain viral suppressing in 90% of those on ART. What is most disturbing is that the shortages of ARVs comes at a time the World Health Organisation (WHO) has warned of a drug resistant HIV as an emerging threat in developing countries."

Meanwhile, drug interruption has been cited for increased cases of this new strain. According to the WHO, rational drug use implies that "patients receive medications appropriate to their clinical needs, in doses that meet their own requirements, for an adequate period of time, and at the lowest cost to them and their community".

"It is professionally unacceptable that the situation was allowed to deteriorate to these levels when the country has the Ministry of Health and Child Care (MoHCC) and the National AIDS Council (NAC), institutions that jointly superintends over the procurement and distribution of the
living-saving drugs. Both institutions must have raised the red flag well before the situation reaches this crisis point if proper monitoring procedures were in place.

"The major constraint to procurement in 2017 has also been the availability of foreign currency to procure ARVs. Foreign currency supplies from the Reserve Bank of Zimbabwe can lag behind for as much as 4-5 months," said Rusike.

Meanhwile, Rusike added that there was need to advocate for more immediate policy attention to be given to significant obstacles in drug access, including foreign currency supplies to Natpharm, timely payment to Natpharm of debts, adequacy of trained pharmacists in government service, improved management of drugs with an information system that provides timely information on drug availability, improved equity in the distribution of available drugs with greater support of drug supplies to primary care level.

"There are a number of factors affecting drug availability. It appears that at primary care level the level and quality of staffing, expertise and resources is currently too low to provide for the basic requirements of a drug procurement and management system. Higher levels of the health system are also not adequately supporting quality and supply in this level of care.

"Resource constraints and foreign currency shortages have also limited supplies at higher levels. There are also shortages due to losses from supplies that have been obtained. This occur when drugs expire or are stolen."

Government spending on health had declined in real terms and is currently concentrated in hospitals, particularly at central level. There is disproportionately high expenditure on staff and health infrastructure as compared to other recurrent inputs such as pharmaceuticals and maintenance, resulting in the general shortage of medical consumables. The shortage of foreign currency has undermined efforts to maintain a supply of affordable ARVs.

There is evidence that drug access has fallen in recent years, and that drug availability is falling, most sharply at the clinic services that form the frontline of the health care system with the community. This represents an unfair cost burden on poor communities, but also opens the way
for the growth of private unregulated drug markets.

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Zim’s public health spending lowest in Sadc

GOVERNMENT spending towards health this year averaged a measly $21 per person, a figure that is lower than $24 per person in 2016, the Community Working Group on Health (CWGH) has said.
BY VENERANDA LANGA
In its contribution to the 2018 National Budget consultations, CWGH said the per capita allocation towards health is one of the lowest in the Southern African Development Community (Sadc) region whose average spending on health per person is $146.
“The per capita allocation stands at $21 down from $24 in 2016 and this implies that the government will spend an average of $21 per person on healthcare in 2017,” CWGH executive director, Itai Rusike said.
“The per capita health allocation is lower than the Sadc average of $146 and per capita health allocation in South Africa is $650, Zambia $90, and Angola $200,” he said.
Rusike said the CWGH is also worried about the total budget allocation to health, which has remained lower than the prescribed 15% of the total budget by the Abuja Declaration and the Sadc target of at least 11,3% of the total budget.
“Countries such as Malawi, Rwanda, Madagascar, Togo and Zambia have managed to reach the Abuja Declaration target, according to the World Health Organisation (WHO), and as of 2015, Rwanda spent at least 23% of its budget on healthcare.”
The CWGH said Zimbabwe has however, made significant gains in the area of HIV prevalence, child and maternal mortality, which have significantly dropped.
Rusike, however, railed against the government’s over-dependence on external donor funding for the health sector at 24,9%, although the bulk of health financing is from employers who contribute 28,4% and government at 21,4%.
“The high dependency on external financing is unreliable, unpredictable, unsustainable and highly dependent on the political environment; raising concerns on the sustainability of health financing institutions and the vulnerability of government’s budget should external funds be withdrawn.”
Other problems noted in the health sector include poor infrastructure and ill-equipped hospitals, as well as a worrying ratio of patients to health personnel which stood at 12,7 health workers to 10 000 patients in 2011 (WHO statistics).
The country is also said to be relying heavily on imports for drugs, equipment and other hospital consumables, while some health institutions have inadequate equipment to carry out diagnosis.
The CWGH said the government must broaden the tax base in order to fund health, by for example introducing tobacco tax, or raising taxes on sugar-sweetened beverages to fight non-communicable diseases and even introduce a wealth tax.

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Parliament To Boycott 2018 Budget Unless It Meets Abuja Target

The Parliamentary Portfolio committee on Health says it will not entertain a flimsy allocation of funds to the health sector in the forthcoming 2018 budget presentation unless the 15% Abuja target is met.
This was said by Matabeleland North senator Sibusisiwe Budha-Masara at the Pre-budget review workshop organized by the Community Working Group on Health (CWGH) held on Wednesday in Harare.
“I think as a country, this is something that I would want Zimbabweans to consider even though there is little time for you to put your input into this budget. But I think this is the opportunity for us to say whatever we feel the budget must look like because a healthy nation in terms of economic development we need healthy manpower and it is our right that we must receive quality health as citizens of this country,” she said.
She added that health must be prioritized in this year’s budget allocation.
“I think we need to lobby and talk to relevant organisations who can assist us that this budget this time around must pay priority to health,” said the Senator.
Zimbabwe is a signatory to the Abuja Declaration of 2001 in which African Union countries pledged to allocate at least 15 percent of their annual budgets to improving the health sector. Since then, the country is yet to meet the target. In the 2017 budget, the health sector only got 7 percent.
She declared that should the budget miss the Abuja declaration on allocating 15 percent of the National Budget, it risks not seeing the light of day.
“If it does not meet the 15 percent Abuja Declaration, I think we have got all the power to deny it that it cannot be passed as long as health in Zimbabwe is not a priority,” she said.
Binga North MP Prince Dubeko Sibanda sharing his experience in Uganda learnt that if a budget ignores the plight of the marginalized it doesn’t get Parliamentary approval to be passed.
“One thing I took in Uganda, they have got a law which says unless the budget meets certain criteria or takes care of people that are generally marginalized that budget should not be passed. Its part and parcel of their law. Its never passed,” the parliamentarian said.
With just three weeks before the 2018 Budget is announced by the new Finance and Economic development minister Dr Ignatious Chombo, the parliamentary portfolio committee, NGOs expect the treasury to meet the Abuja declaration which states that 15 percent of the National budget should be dedicated to Health to show commitment of ensuring a healthy and productive nation.
Presenting the 2017 national budget year, the then Finance and Economic Development Minister Patrick Chinamasa announced that $281,9 million will be channeled towards the sector inclusive of remuneration for the public health care personnel ($223 million), operations and maintenance ($29,6 million), as well as capital expenditure that has been pegged at $29,5 million.

 

October 11, 2017October 11, 2017 NewsRoom By Kudakwashe Pembere
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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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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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TYPHOID DRIVEN BY CORRUPTION AND MISMANAGEMENT

Mfundo Mlilo

Typhoid Driven by Corruption and Mismanagement 

By Byron Mutingwende

A combination of corruption and gross mismanagement on the part of the government and local authorities has led to the outbreak of typhoid, civic organisations have said.

This emerged at a stakeholders’ meeting organised by the Combined Harare Residents Association (CHRA) on Monday, January 6, 2017 held in Harare.

The meeting was a culmination of CHRA’s engagement with various civic society organizations and State actors following the typhoid outbreak in Harare that has so far claimed two lives since December 2016.

Various civic society organisations that included the Zimbabwe Association of Doctors for Human Rights (ZADHR), Chitungwiza Residents Trust (Chitrest), the Combined Harare Residents Association (CHRA), Vendors Initiative for Socio-Economic Transformation (VISET) and the Zimbabwe Lawyers for Human Rights (ZLHR) made presentations on the poor state of affairs in Harare.

The organisations challenged the Zimbabwe Human Rights Commission to act and prevent needless loss of lives arising from poor service delivery in Harare.

CHRA Chief Executive Officer, Mfundo Mlilo blamed erratic water supplies and poor waste management for the typhoid outbreak in Harare. He added that as a result of the allocation of housing stands on wetlands, residents had been exposed to flooding.

Mlilo said it was imperative for residents to stand up and hold the City of Harare to account.

“People have accepted that this is the norm and no one is taking about the deaths coming as a result of poor service delivery in Harare. As civil society organizations, we are concerned about this and one of our resolutions is to engage state actors so that we find a lasting solution. We believe the Zimbabwe Human Rights Commission has a role to play in holding the Harare City Council as well as other local authorities to account,” said Mlilo.

Dzimbabwe Chimbga from the Zimbabwe Lawyers for Human Rights said that the dire situation in Harare called for urgent state intervention.

“There is an obligation on the part of the State to ensure that some of these things do not happen Section 44 of the Constitution is clear that there is an obligation on all arms of the government to ensure that human rights are protected,” said Chimbga.

The Harare City Council has come under fire for its misplaced priorities amid revelations that of the $13 million the local authority is collecting monthly, $9 million is going towards salaries while $1 million is going towards service delivery.

Community Working Group on Health (CWGH) Executive Director, Itai Rusike said that as long as the water crisis in Harare is not addressed, residents will continue to be exposed to diseases such as cholera and typhoid.

“The causes of the 2008 outbreak have not been addressed and the main reason for the typhoid outbreak is the unavailability of water. People are resorting to alternative sources of water which are not very safe,” said Rusike.

Community Water Alliance Programmes Manager Hardlife Mudzingwa said that there was the need to increase the national budget allocation for water projects from the current 0,4% upwards and deal with water quality which stands at 89% at Morton Jaffray which could further deteriorate due to obsolete water infrastructure.

“Harare’s western suburbs that have been affected by typhoid receive water directly from Morton Jaffray which has 89% water quality unlike Eastern suburbs whose water receives further chlorination at Warren Control water works. City of Harare cannot fulfill its obligation as defined in Section 44 of Constitution Amendment 20, if a paltry 0,4% is allocated to water in the national budget. It is unfortunate that the City of Harare is using the 1913 Water Regulations By-law to un-procedurally disconnect water in violation of the responsibility to protect and the responsibility to respect as well as the right to administrative justice. Bond notes have also made it difficult for City of Harare to purchase water purification chemicals which need foreign currency,” Mudzingwa said.

The destruction of wetlands (which are the sources of raw water and purifiers, provide flood attenuation services) has greatly contributed to the spread of typhoid. Floods in Harare are mainly caused by a depleted wetland ecosystem.

More than 4 000 people died as a result of a 2008 cholera outbreak in Zimbabwe. According to the Community Working Group on Health, Greater Harare has since October 2016 recorded 348 cases of typhoid of which 24 were confirmed cases while two people died as a result of the outbreak. In Mbare there were 26 confirmed cases and two deaths.

According to the Director of the Vendors Initiative for Socio-Economic Transformation, Samuel Wadzai, the Harare City Council must address the major drivers of typhoid such as water unavailability rather than to concentrate on window dressing measures such as the ongoing crackdown on illegal vending in Harare’s Central Business District (CBD).

Zimbabwe Human Rights Commission Chairperson, Elasto Mugwadi welcomed efforts by civic society organizations to hold the Harare City Council to account adding that they would act on recommendations by the organizations.

He bemoaned that typhoid was becoming a chronic disease in Harare as a result of poor service delivery.

“It is important for local authorities to adhere to and respect the constitution of Zimbabwe in discharge of their duties. They need to ensure that they respect the rights of citizens. The issue of the right to health, clean water and a clean environment adds up to the right to life. We would need to take it upon ourselves to educate city fathers on their responsibilities. Diseases like typhoid should not be chronic diseases,” said Mugwadi.

He also expressed concern that housing stands continue to be allocated on wetlands while admitting that the current crisis facing Harare could be a localized problem of a wider national crisis.

Whilst recognizing that the country has made strides in including environmental rights in the Constitution, which were hitherto unpronounced in the previous Constitution, ZHRC said that there was need for adherence to these provisions for the enjoyment of these rights by all citizens.

“Section 73 of the Constitution of Zimbabwe provides for the rights of citizens to an environment that is not harmful to their health and wellbeing. International law recognises that environmental degradation results in the violation of human rights such as the right to life and the right to health. These rights are protected by a number of human rights instruments which Zimbabwe is party to. Article 24 of the African Charter on Human and Peoples’ Rights.”

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Floods to worsen Zimbabwe’s health woes

FLOODED rivers and homes, collapsing infrastructure, uncollected garbage, rotting vegetables at vegetable markets, clogged storm water drains and traffic jams caused by flooded streets have all become talking points on social media as Zimbabweans try to laugh off their otherwise appalling conditions.
The incessant rains, some of the heaviest the country has seen in recent times — though a welcome relief after two consecutive seasons of erratic rainfall — have triggered heavy flooding countrywide and has given the largely jobless population something to yap about on social media.
But, many are probably oblivious to the grave health dangers the incessant rains are posing.
For instance Harare’s Mbare, one of the country’s oldest suburbs, has become an eyesore with muddy streets skirted by pools of sewerage outflows testifying why indeed the overcrowded residential area became the epicentre of the current typhoid outbreak.
The floods have increased the potential for other waterborne diseases such as cholera and hepatitis A; while the stagnant pools of water countrywide will propagate vector borne diseases such as malaria, bilharzias and yellow fever.
Other health risks, which can be caused by flooding, include drowning, hypothermia, electrocutions and respiratory infections such as pneumonia and asthma.
The Southern African Development Community Regional Early Warning Bulletin for the 2016/17 highlights that the normal to above normal rainfall condition may induce surface water stagnation and flooding that may cause physical havoc in many countries with many people getting ill (morbidity) and many more dying (mortality).
Flooding due to too much stagnating water, according to the bulletin, increases the chances of water borne diseases such as cholera and other diarrhoeal illnesses.
“There is also the increase of rodent-borne diseases such as plague. Vector-borne diseases such as malaria, dengue fever, and others have also increased in times of floods. Malaria increases maternal and child health morbidity and mortality. There has been a noticeable increase particularly in our region of rift valley fever, bacterial meningitis and yellow fever,” reads the bulletin in part.
Lack of sanitation and hygiene due to floods has been identified as the immediate cause of illness and mortality.
Zimbabwe Association of Doctors for Human Rights (ZADHR) secretary general, Evans Masitara, said the incessant rains in the New Year have complicated matters for the country, which is currently grappling with the typhoid outbreak.
The outbreak of typhoid could get out of control because of the country’s shambolic emergency response mechanisms.
“Our health sector has been suffering a steady decline over the years due to poor management and lack of adequate resources…The typhoid outbreak is not under control and is actually spreading to other towns and cities with cases being reported in Marondera, Mutare and Masvingo,” said Masitara.
Given poor service delivery, especially in Harare where garbage goes for months without being collected, the country is sitting on a health time bomb which could explode soon, leading to unnecessary loss of lives.
Apart from the heaps of uncollected garbage, Harare is also grappling with erratic water supplies, burst sewer pipes and poor drainage due to haphazard construction of houses on wetlands.
“Meanwhile, the blame game continues as departments shift responsibility for the crisis, and then we have some wise politicians who lack common sense, blaming all this on the poor vendors,” Masitara said.
Without the capacity to deal with the looming disaster, the health sector is overwhelmed, chiefly because of human, financial and material resource constraints.
This is being compounded by low salaries, poor working conditions as well as dilapidated infrastructure.
The population of Zimbabwe continues to expand while the healthcare delivery infrastructure deteriorates.
Government has over the years failed to comply with the Abuja Declaration concerning healthcare funding with the last National Budget allocation for health representing a measly six percent of the total budget.
“The issue is not really a resources issue, but that of misplaced priorities. A week ago it was reported that Atracurium, a drug used for anaesthesia in life saving operations, was running out because the Reserve Bank of Zimbabwe was not making payments to suppliers on time. This just shows how skewed our leaders priorities are. How can they choose to ignore the fact that health is a basic human right, provided for in our constitution?” Masitara added.
The country’s poor living environments have affected a wide range of health outcomes leading to recurrent epidemics such typhoid.
ZADHR has thrust the entire blame for the country’s recurrent disease outbreaks on the Ministry of Health and Child Care which it says has not instituted proper systems to prevent disease recurrences and avoidable loss of lives.
In the absence of a proactive Health Ministry, Community Working Group on health executive director, Itai Rusike, believes the health burden for local authorities has been especially unbearable given the fact that most of the council are broke, having very little capacity to address the challenges they are facing due to the failure by the residents to pay their bills.
“The local authorities face a lot of interference from an equally struggling central government incapable of bailing them out due to a tight fiscal space,” said Rusike.

newsdesk@fingaz.co.zw