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Situation Report on Cholera in Zimbabwe Issue Number 9 6 January 2009

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Situation Report on Cholera in Zimbabwe Issue Number 9 6 January 2009 UNITED NATIONS NATIONS UNIES Office for the Coordination of Bureau de Coordination des Humanitarian Affairs des Affaires Humanitaires Zimbabwe OCHA Zimbabwe Situation Report on Cholera in Zimbabwe Issue Number 9 6 January 2009 Summary New cholera cases and deaths continue to be reported mainly in the nine (9) out of ten Provinces of Zimbabwe. During the epidemiological reporting period since the outbreak of cholera in August, 2008, all ten (10) Provinces of the country reported to the World Health Organization (WHO) through the Ministry of Health and Child Welfare (MoHCW) a cumulative total of 35,330 suspected cases and 1,753 deaths. The trends of the epidemic are illustrated in figures and maps attached to the report. The humanitarian community has enhanced its response capacity and coordination in order to manage the outbreak; the WWW maps forming part of the report show agency or organization spread and coverage in the country in response to the cholera emergency. Table 1: Cholera impacts by Province. Province Cumulative Cumulative Case Fatality Community Community Death Cases Deaths Rate (CFR)(%) Deaths (part of as % of total total) Harare 11,500 382 3.32 16 4.2 Mashonaland Central 716 50 6.98 42 84.0 Mashonaland East 3,450 258 7.48 155 60.1 Mashonaland West 8,184 377 4.61 152 40.3 Matabeleland North 2 0 0 0 0.0 Matabeleland South 4,191 128 3.05 43 33.6 Manicaland 4,129 280 6.78 233 83.2 Masvingo 2,206 208 9.43 135 64.9 Bulawayo 377 12 3.18 8 66.7 Midlands 575 58 10.09 48 82.8 Grand Total 35,330 1753 4.96 832 47.5 Source: WHO/MoHCW I. Situation analysis As highlighted on the table above, both suspected and death cases have only increased marginally, compared to the previous months, although transmission is continuing in most parts of the country. Preparedness measures and contingencies have to be however strengthened since cholera cases are likely to be on the increase since the rain season has just begun. High priority Provinces for the week are Harare, Mashonaland Central, Manicaland, and Mashonaland West. II. Response Health response The Health cluster in collaboration with the MoHCW has stepped up response activities for cholera outbreak. The Health cluster has enhanced coordination mechanisms from national to local community levels, linking with the Provincial and District Medical Officers. 1 Disclaimer: - The content of this document is for information purposes only and not an official record of the United Nations’ views. WHO aims to link alerts generated by notification and by analysis of data with coordinated response activities; and WHO gives daily updates on the impacts and effects of cholera epidemic. During the week under review, the cluster conducted the following; • Hosted a joint launch of anti‐cholera education material and announced an operational framework where cholera command centres will be established from national to household levels with rapid response teams established at every level (Social Mobilization Campaign) • C4 contacted partners in the field through the health cluster coordinator • Health cluster members, Plan, ACF, and MSF are supporting communities with water and sanitation; and in particular MSF Spain who is operating a CTC in collaboration with the MoHCW in Chegutu, assessed the situation in the district and is assisting the MoHCW with the response. • In collaboration with the MoHCW, a CTC was opened at Nyanombe WASH response The Cluster has stepped up efforts in hygiene promotion country wide; employing different approaches and methodologies including door to door campaigns, distribution of flyers, radio messages, TV talk and road shows, to name but a few. The cluster continues with its water supply activities in various cholera affected areas, and gaps in terms of safe water access are now mostly reported in overall rural areas, where cholera cases have been increasing during the week under review. The focus areas or priority emergency areas for the cluster during the week were; Chegutu: Continues to be a focal spot in terms of cholera outbreak and response, but the situation has quite improved since last week. In terms of response, the efforts in the sector continue with the same actors as of last week and Concern Worldwide being the focal point for and coordinator of the WASH Cluster response in the spot ([email protected]). The water coverage has significantly improved with the opening of the ZINWA network in all wards with the exception of some localised areas in Ward 8 where there are major fractures. Kadoma: Following the sharp increase in the number of cases in Kadoma, WASH assessments took place by UNICEF, GAA, IFRC and IOM. Critical gaps identified are related to PHHP along with distribution of NFIs, decongestion of sewer system, monitoring of water quality. Mudzi: Oxfam and World Vision released this week WASH cholera response review on Mudzi. While the reviews acknowledged the massive support going on and a strong partnership between the actors there (World Vision, Oxfam GB, Oxfam SPWSNet, MSF and I.OM), they also highlighted about the still huge needs in term of borehole rehabilitation, Mass media and communication systems. Beitbridge UNICEF conducted a review/monitoring of the WASH cholera response in Beitbridge. While the situation is improving in the town, the review indicates that cholera cases are increasing in the rural areas, in villages located along the Bubi River. Eventually it is insisted that drilled boreholes be equipped and more drilling undertaken as the only alternatives to the water trucking and the ZINWA reticulation system, which is not functioning adequately. Gokwe North and South This week there has been cholera alert in these two districts. GAA, Concern and the British red cross are there to follow up for the cluster. Coordination The cluster continues to have its weekly meetings and Health/WASH inter cluster meetings on a weekly basis. A working group from WASH and Health clusters (UNICEF, PSI, OXFAM, WHO and MoHCW) met and mapped out strategies that will make 180‐day cholera campaign successful. 2 Disclaimer: - The content of this document is for information purposes only and not an official record of the United Nations’ views. Nutrition The Cluster has developed some IEC material for CTCs in cholera affected areas. The cluster projects 44,000 U5s who are likely to be affected by acute malnutrition in 2009. In December 2008, Save the Children UK conducted nutrition assessment in Binga district in Matabeleland North, and the major findings were; • The Global Acute Malnutrition (GAM) was found to be 7.6%. According to the national cut‐off points the level of acute malnutrition was above the Zimbabwe national threshold levels of 7%. • The nutrition survey was conducted from 5‐ 12 December, 2008, that is, just at the beginning of the hunger season; and therefore the situation is likely to further deteriorate unless appropriate preventive measures are taken immediately • High levels of diarrhoea and fever in Binga district were strongly associated with malnutrition highlighting that the sources of drinking water in the district remain very poor and need urgent attention. NB. The full nutrition assessment report for Binga can be accessed on OCHA website http://ochaonline.un.org/zimbabwe For more information contact: Steven Maphosa at [email protected] (for Health) and Souleyman Sow at [email protected] for WASH. NB. Tables on this document are work in progress and information should be sent to OCHA for continuous update and for detailed donor response please visit the FTS website III. Coordination The following arrangements have been put in place by the IASC to facilitate effective humanitarian coordination: • The cholera emergency focal points for all agencies need to be reachable during the festive holidays • Coordinated response to the emergency need to be enhanced • Logistical capacities of responding agencies need to be continually assessed for effective and reliable response 1. WASH and Health clusters mobilised and coordinating the response. 2. Possible gap areas in coordination support are being monitored by the country IASC, as well as needs for surge capacity from HQ and the regional level. Agencies requested to look into the possibility of gearing up to emergency mode and divert available funds from development towards humanitarian aid. 3. WFP to coordinate local logistical support to the cholera response 4. Daily Cholera Updates to be issued by WHO on figures (not including gaps/response), Weekly Cholera Situation Report to be issued by OCHA on humanitarian gaps analysis, needs and response. 5. Weekly IASC CT Cholera meetings every Wednesday at 11:00am ‐ Bi‐weekly Donor/IASC CT Cholera meetings on Fridays at 10:30 (next meeting at 10:30am on 19 December at Takura House) ‐ Weekly Inter‐Cluster Task Force meetings led by OCHA on Tuesday afternoons CONTACT DETAILS Georges Tadonki Head of Office (Harare), +263 4 792681 Sofie Garde Thomle Desk Officer (New York), +1 917 535 5182 Elizabeth Byrs Press contact (Geneva), +41 22 917 2653 Stephanie Bunker Press contact (New York), +1 917 367 5126 3 Disclaimer: - The content of this document is for information purposes only and not an official record of the United Nations’ views. Cumulative Cases and CFR% by Province 14000 12.00 12000 10.00 10000 8.00 8000 % 6.00 Cases CFR Cases 6000 CFR% 4.00 4000 2.00 2000 0 0.00 Harare Bulawayo Mashonaland Mashonaland Mashonaland Manicaland Matabeleland Matabeleland Masvingo Midlands Central East West South North Daily Cholera Cases (Ave. 80% Reported) 2500 2000 1500 1000 500 0 26‐Dec 27‐Dec 28‐Dec 29‐Dec 30‐Dec 31‐Dec 1‐Jan 2‐Jan 3‐Jan 4‐Jan 5‐Jan 6‐Jan 4 Disclaimer: - The content of this document is for information purposes only and not an official record of the United Nations’ views.
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