‘Poor service delivery drives typhoid’
HARARE - Poor service delivery is the key driver of the typhoid outbreak in Harare, city director of health Prosper Chonzi has said.
According to health committee minutes, Chonzi said since January 22, there had been 101 suspected cases, 13 confirmed and no deaths from the disease.
Chonzi said the water and sanitation situation in the city was causing typhoid to resurface after the 2011 outbreak that hit Dzivarasekwa.
In October 2011, the outbreak spread to other suburbs such as Warren Park, Kuwadzana,
Mufakose, Mabelreign and Granary, with 1 175 treated cases.
Contaminated shallow wells were identified as the probable cause due to poor water and sanitation hygiene during the outbreak.
Since the beginning of the year, Harare City Council (HCC) has been having fortnightly water cuts as it conducts repair and maintenance works at Morton Jaffray waterworks and the city’s distribution network.
The city is grappling with poor water distribution in areas such as Greendale, Glen Lorne, Mandara, Mabvuku, Tafara and Budiriro.
“The key drivers are inadequate potable water supply and residents resorting to unsafe water sources like unprotected wells and poor sanitation caused by erratic refuse collection and management resulting in the proliferation of illegal and indiscriminate dumpsites,” Chonzi said.
He added that other causes also included burst sewer pipes, their delayed repairs and sewer outflows into residential areas.
Other drivers of typhoid in Harare also included use of unhygienic sanitation means, like pit latrines in new settlements and emergence of illegal vending and selling of raw fish, meat and sadza under unhygienic open spaces.
Chonzi said to avoid a possible outbreak of the disease, the city had activated its epidemic preparedness and response teams to investigate and trace the origins of all confirmed cases.
“The city will conduct point-of-use treatment of water and distribute aqua tablets to affected households and the community. There will also be water quality monitoring for all water sources,” Chonzi said.
Tafara resident Christine Marenje said the water situation has become so dire that people had begun fighting at the boreholes in the community.
Marenje said her area can go for weeks with no water supply and yet residents are expected to pay for the service.
“Zvinobhowa kuti titerere mvura isipo, kana torwara necholera zvonzi maresidents haasi kuita zvinehutano. Toshanda sei kusina mvura? Haungaudze mwana kuti usarware nemudumbu nekuti hakuna mvura ( It is frustrating to pay for a nonexistent service. When people contract diseases like cholera, they tell us we are being unhygienic yet there is no water. Tell me, how can you tell a child not to get sick because there is no water?,” she said.
Itai Rusike, executive director of Community Working Group on Health, said it is unacceptable that residents continue to be exposed to preventable and treatable diseases like typhoid.
He said the unreliable functioning and prolonged water cuts in Harare leads people to use unsafe alternatives such as unprotected shallow wells.
Rusike added that improving access to water, sanitation and waste disposal should be prioritised in Harare as poor quality water sources undermine health, as do waste disposal in open pits and public sites.
“Harare seems to be hardest hit by typhoid mainly because key dimensions of primary health care (PHC) are much less available and a coherent approach to PHC appears to be missing, despite the increase in preventable and communicable diseases and the rise in urban poverty.
“There is need to develop and implement an efficient and appropriate approach to PHC in Harare through dialogue with urban health services, residents, the local authority and other stakeholders,” he explained.
He also added that waste collection is a billed service by the city, however, residents query whether that money is being channelled to its intended use, or elsewhere.
Rusike said waste management funds should be monitored as such payments should be used for their intended purpose and not abused.
“While residents may contribute to one-off clean-up campaigns to assist with removing waste, this should not replace the HCC’s core obligation,” Rusike told the Daily News on Sunday.
Helen Kadirire • 22 May 2016