Zim must up its cholera response mechanisms

THE Zimbabwe Red Cross Society (ZRCS) is using its network of community volunteers who receive training and help to respond to the cholera outbreak. ZCRS is also working to ensure that the response is inclusive and that specific needs are taken into consideration about gender, ethnicity, age, disability, people living with HIV and Aids, and other factors that may increase vulnerability.

The volunteers are also ensuring that sphere standards are respected in the response plan and that mechanisms are put in place to enhance transparency and accountability, such as monitoring, reviews, audits, etc.

Data, information and lessons learned from the response will be captured, analysed and shared with partners involved in the response and beyond.

With the launch of the Emergency Appeal, which aims to contribute to the government of Zimbabwe’s Cholera Response Plan in controlling and reducing the cholera outbreak, thereby reducing morbidity and mortality, reaching at least 550 455 people from November 2023 to August 2024, the following activities have been taking place.

Seven oral rehydration points (ORPs) have been set up. Three of these having been set up in Harare (Glen View, Hopley and Budiriro) upon request from City of Harare health department with support from Finnish Red Cross under the DG ECHO-funded cholera preparedness project as part of the federation’s wide approach.

Then four were strategically placed in Mutare district, with three in Zvipiripiri and one in Chiadzwa. These locations in Mutare district were chosen based on the presence of trained volunteers conducting door-to-door cholera awareness sensitisation.

Thirty-four volunteers, a mix of trained individuals and new recruits from the community, are now involved in operating these ORPs in Mutare after training.

ZRCS instructors conducted one-day refresher training for all volunteers, followed by a monitoring day to observe and assess their teaching effectiveness.

Identification of ORP locations involved collaboration with main clinics, environmental health officers and community leaders. Selection criteria included a reliable water source and community acceptance.

The water supply rehabilitation and emergency response unit team leader ensured water accessibility. Community engagement was prioritised by recruiting volunteers from the same communities, fostering participation and adaptation to local contexts.

In Zvipiripiri, where a significant number of cases originated from the initially, ORP implementation was tailored to the unique needs of the apostolic faith group, resulting in increased community engagement.

Despite the remote placement of ORPs, up to December 29, they recorded 179 cases and referred 22 individuals to clinics through an established referral system.

Notably, communities actively contributed to the referral system cost in one instance, while two communities volunteered to construct latrines for free.

This exemplifies growing community interest, with individuals expressing a desire to join as volunteers to contribute to the protection of others.

Overall, the ORP strategy demonstrates effective community engagement and adaptation to local dynamics, enhancing cholera awareness and response efforts.

In Harare, ZRCS is implementing a DG ECHO-funded two-year cholera preparedness project. The project has trained 20 trainers and 200 volunteers in the Branch Outbreak Response Team (BORT) approach.

Following the resurgence of cholera cases, BORT teams have been deployed in Harare South (Hopley, Southlea Park and Stoneridge) and Harare West (Budiriro and Glen View) to do targeted household visits to increase community awareness of cholera and to identify actions that can be taken at household level to interrupt transmission.

The forecasted El Niño-induced drought will cause further water scarcity, complicating the situation. Cholera caseloads reported thus far are higher than the 2018/19 outbreak, with fears of a comparable situation to the major outbreak of 2008/9.

Based on the updated assessment data, the following needs have been identified:

Social mobilisation: There is a need for personnel to assist in social mobilisation efforts, as well as training of village health workers/ volunteers on how to share information on cholera prevention.

Community-based surveillance: Strengthening community surveillance through sensitisation of village health workers/volunteers, and village heads is needed to better track the spread of the disease.

Risk communication and community engagement: Behaviour change communication is needed to tackle hygiene promotion.

Logistical support for the Health and Child Care ministry cholera response teams: Vehicles, fuel and other logistics are needed to support the campaigns and social Mobilisation exercises.

Distribution of hygiene kits: Water, sanitation and hygiene non-food items are needed to support hygiene in households and help prevent the spread of the disease.

International Federation of Red Cross and Red Crescent

Societies