Oods, cholera and ailing economy
Zimbabwe’s humanitarian situation remains fragile and complex as it grapples with climate-induced shocks that include floods and drought, and exacerbated by economic instability and public health emergencies of cholera, polio and measles.
This is according to a United Nations Children’s Fund (Unicef) report titled Multi-hazard Situation Report #5 September 1– October 31, 2023 released recently.
The report says 8 676 children (3 917 girls and 4 759 boys) were treated for wasting between January and October 2023.
At least 2 648 898 people, 1 218 493 being children, accessed essential primary health care against an annual target of 1 559 735 during the same period.
Child wasting refers to a child who is too thin for his or her height as a result of rapid weight loss or the failure to gain weight.
A child who is moderately or severely wasted has an increased risk of death, but treatment is possible.
Zimbabwe continues to grapple with such climate-related disasters as floods and extremely dry weather phenomena, including the anticipated El-Niño-induced drought.
The drought is projected to result in livelihood loss, water scarcity and disruption of social protection services and healthy food environments that support good diets.
Humanitarian agencies say about 2,7 million people are projected to be food insecure during the peak hunger period.
“Malnutrition remains a key cause of the health burden in Zimbabwe, with a quarter of children stunted,” Unicef said.
“Wasting significantly increased during the lean season of 2022–23, from 4,5% in 2020 to 7,2% in 2022, the highest prevalence in the last 15 years.
“Currently, stunting prevalence is 26%, while wasting prevalence is 4%. In 2022, Zimbabwe also experienced a measles outbreak, which resulted in a total of 7 744 suspected measles cases, with 747 suspected measles deaths recorded.”
Zimbabwe is currently in the throes of a cholera pandemic, with 62 confirmed deaths and 211 suspected deaths by December 18, 2023.
The first case was detected on February 12, 2023 in Chegutu, Mashonaland West province.
Unicef said during the reporting period, there was a resurgence of cholera cases, particularly in Harare, Manicaland and Masvingo provinces.
As of December 18, 2023, 12 287 suspected cases including 1 527 culture confirmed cases had been reported in all the 10 provinces of the country.
“The determinants of the outbreak are linked to poor WASH [water, sanitation and hygiene] infrastructure, regular sewer bursts, erratic water supply exacerbated by regular power cuts, shortage of bulk water treatment chemicals, sub-optimal solid waste management and unsafe hygiene practices,” Unicef said.
The global humanitarian and developmental aid organisation said compounding the situation is the rapid population growth in urban settings which has resulted in communities settling in areas which are not serviced with water and proper sewer systems.
It said this has resulted in the at-risk communities looking for alternative water sources such as shallow wells, river water, which are contaminated.
Sewer blockages, open defecation in unserviced areas and septic tanks are to blame for groundwater contamination, according to Unicef.
Harare, in particular, has seen an uptick in sewer blockages due to antiquated infrastructure, nonavailability of water on taps leading to clogging in sewer systems and increased use of septic tanks as peri-urban areas develop.
Areas such as Seke, Domboshava and Goromonzi have seen increased populations as homeseekers move away from the capital and set base in the former rural areas.
“Perennial sewer blockages in urban residential areas have also been noted and with the sprouting of illegal settlements that are under served,” Unicef said.
“This has exacerbated open defecation, and or the use of septic tanks leading to groundwater contamination.”
The country is currently experiencing waterborne-related disease outbreaks linked to poor WASH services, including cholera and typhoid.
Furthermore, the 2023-24 seasonal forecast is for normal to below-normal rainfall, with an El Niño cycle.
The decrease in rainfall will lead to a decrease in the availability of water.
Water scarcity can force people to travel even further to seek drinking water from unsafe sources, which leads to increased diarrhoeal disease outbreaks.
Nationally, 17% of households travel more than 1km to fetch water, and only 3,1% of households treat their drinking water, Unicef said.
“As evidenced by the ongoing cholera outbreak in Zimbabwe, water scarcity will only increase the continued spread of diarrhoeal diseases, which are a cause of morbidity and mortality especially among children under five years of age.”
While new infections are fuelled by suboptimal WASH facilities, the high cholera case fatality rate is driven by an overburdened health system and insufficient skills saturation following three years of escalated attrition of skilled health workers.
As a result of meaningless salaries, low morale, lack of medicines in hospitals, a tight political and socioeconomic environment, Zimbabwe has seen a huge number of healthcare workers leaving the country for greener pastures, with most of them ending up in the United Kingdom.
Data released by the United Kingdom (UK) in November said the number of Zimbabweans who moved there to do health and care work rose by 169% in the year to September, deepening the skills crisis in the southern African country.
Migration is rising as Zimbabweans seek refuge from high inflation and unemployment.
Critical workers such as healthcare professionals and teachers are among those leaving in numbers, escaping poor pay and work conditions at home.
The UK said in the 12 months to September, 21 130 Zimbabweans were given visas to work in the UK health system.
That is 13 284 more Zimbabweans than in the year to September last year, a 169% increase.
“Unprecedented attrition of health frontline workers has also resulted in a shortage of staff to manage the outbreak,” Unicef said.
“Insights from community social listening underscore some of the behavioural and social drivers of cholera that include unsafe burial practices involving washing of the deceased’s bodies before burial, poor food handling and hygiene practices at large funeral or religious gatherings.”
Unicef said in collaboration with government and implementing partners, they reached 246 500