April 2011 Key Points Food aid programme faces $20 million shortfall. Malaria kills 140, while cases soar above 91,000. 2011 CAP funding at 14.6%. Spike in asylum seekers entering Zimbabwe through Nyamapanda border post. I. Situation Overview CAP of $415,275,740 was 14.6% funded at $60 million while $1 million had been pledged. This was a slight increase to the 13.2% at $54 million recorded in Zimbabwe’s humanitarian situation remains largely March 2011. At the same time in 2010, $124 million unchanged compared to March 2011. However, there had been committed to the CAP, representing 31.6% are some worrying developments that warrant some coverage of the requirement, which had increased attention from humanitarian players. from $378 million to $394 million due to changing needs. Among these are protection challenges that were reported in April 2011. Further, the uncertain food security situation remains a major concern, particularly in the absence of assessments that should guide assistance by partners. In addition, cholera and malaria outbreaks continue to affect the country, largely because degradation of infrastructure is still unaddressed. Continued concerted efforts remain absolutely essential to help place the country firmly on the road to recovery. This calls for more support towards Beneficiaries of the Safety Net programme in Tsholotsho, Matabeleland coordinated approaches such as the Consolidated North in 2009. Photo courtesy of OCHA. Appeal Process (CAP). The status of humanitarian funding to Zimbabwe is, however, still low and by the However, it is worth noting that the funding cycles of end of the month the country’s CAP was the least some key donors are not aligned to the CAP, hence funded globally. At the end of April 2011, Zimbabwe’s their contributions are anticipated later in the year. A monthly overview of humanitarian issues and activities in Zimbabwe produced by OCHA in collaboration with the humanitarian community. Monthly Humanitarian Update 2 April 2011 Further, some contributions outside the CAP still need The outbreak started in 2010 and continues to to be reflected on the Financial Tracking Service (FTS). increase, albeit at a lower rate than in 2008/9. Health cluster partners report that by end of April 2011 a Humanitarian partners continue to follow up on cumulative 746 cases and 25 deaths had been reported resource mobilisation initiatives such as the 10-country since January this year. Of these cases, 588 were donor mission that visited Zimbabwe from 21 to 22 suspected while 158 were laboratory confirmed. The February 2011, in order to consolidate the gains made. crude case fatality rate is 3.4% and the outbreak has The humanitarian community also continues to appeal to spread to 10 of the country’s 62 districts. Most, 94.9% donors for support as lack of funding could undermine of these cases occurred in rural areas. progress made to date. While supplementary funding like the current $5 million Central Emergency Response In comparison, between February and December 2010 Fund (CERF) grant and efforts to raise $6.5 million for a cumulative 1,022 cases and 22 deaths were reported, the Emergency Response Fund (ERF) increase of which 899 were suspected and 123 laboratory- humanitarian resources, the CAP remains the main confirmed. The outbreak affected 20 districts and the strategic and fundraising tool. case fatality rate was 2.1%. This brings totals to 1,768 cases and 46 deaths with a case fatality rate of 3.3% Lack of funding during this period threatens to reverse since February 2010. gains made over the last three years. Almost halfway through the year, Zimbabwe’s CAP is far from being Summary of cholera indicators 2010 - 2011 50% funded yet the mid-year review is already Indicator 2010 2011 Cumulative underway, with the initial workshop scheduled for 11 May 2011. While the requirement could either increase Districts 20 10 20 or decrease, either way, support will still be required to Affected avert loss of more lives by rebuilding sustainable systems. Cumulative 1,022 746 1,768 Cases II. Humanitarian Action Suspected 899 588 1,487 Cases Cholera Update Confirmed 123 158 281 Cholera Cases Continue to Increase Cases The cholera epi curve is showing an increasing trend in Deaths 22 25 47 the last five weeks. Outbreaks of cholera continue to be reported in Chipinge district, Manicaland province. It Case Fatality 2.1 3.4 2.7 is also the worst affected district currently with 399 Rate cases. [Source: MoH&CW 2011] Districts affected by cholera so far this year are HERU & WERU Cholera Response Update Chiredzi with 126 cases, Mutare with 80, Buhera with Health and water, sanitation and hygiene (WASH) 64, Bikita with 42, Chimanimani with 26, Murehwa with partners continue to coordinate their activities and five, Kadoma with two and Mutasa and Chegutu both respond in a timely and effective manner to with one case each. Cumulative cases and deaths humanitarian emergencies as and when they arise reported now surpass those of best case scenario, in throughout the country. which it was anticipated that 553 cases and 12 deaths would be reported in 16 districts. In the most likely Health Emergency Response Unit (HERU) partner scenario, cases ranging from 553 to 20,471 and deaths Medicins du Monde (MdM), working closely with from 12 to 430 in between 16 and 57 districts are WASH Emergency Response Unit (WERU) partner, expected. Males account for 48.4% of all line listed Action Contre la Faim (ACF) continue to lead the cases (n=312), females for 51.6% (n=344), within an age cholera response in Chipinge district. Activities include range of 0.75 to 85 years, with a median age of 27 contact tracing, support to community health years. promotion programmes using Village Health Workers (VHW) and provision of fuel for the district health team A monthly overview of humanitarian issues and activities in Zimbabwe produced by OCHA in collaboration with the humanitarian community. Monthly Humanitarian Update 3 April 2011 to reinforce active surveillance and other actions. Summary of Current Malaria Information Affected areas in Chipinge are Checheche and the Indicator Cumulative Agricultural Rural Development Association (ARDA) farm. ACF has also requested other WERU partners to support widespread participatory health and hygiene Cases 91,648 (PHHP) in surrounding wards as a preventative measure to reduce the spread into new areas. Deaths 140 Advocacy is in progress to intensify at the district and provincial level for the disinfection and awareness Case Fatality Rate 0.2 raising at the commercial farm, and also for them to Source: NMCP/HIS, MoH&CW (2011) install permanent water supply treatment infrastructure. Brief on Cluster Activities However, challenges are still being faced in the During April, all provinces with the support of partners response to cholera in the ARDA/MACDOM area, carried out immunisation strengthening activities as a particularly with reference to supply of safe water and way of commemorating the proposed African sanitary facilities for the workers and support of the Immunisation week. The week is aimed at raising the health response to cholera. These challenges are mainly profile of the expanded programme on immunisation due to the fact that management of health in the (EPI). The emphasis was on outreaches to both old and plantation is the prerogative of the farm’s management, newly identified sites at district level with the goal of not MoH&CW. The health ministry is engaging with the improving coverage and increasing the proportion of Joint Operations Command (JOC) at national level to fully immunised children. ensure that management implements recommendations for improvement of sanitation within the plantation. WHO and UNICEF are supporting the National EPI programme to develop a proposal for the introduction WERU partner Mercy Corps is assisting the response in of Rotavirus and Pneumoccocal vaccines into Zimbabwe Chimanimani district, Manicaland province. In the first in 2012. A comprehensive five year EPI programme half of April, two community deaths of members of the from 2012 to 2016, including the new vaccines, is also Apostolic sect were reported in Ndakopa village, ward being developed. 21 of the district. However, influencing belief change within the Apostolic sect community remains a Health cluster members have taken forward the challenge as cases are usually concealed and where discussion on moving away from a strictly humanitarian illness is suspected patients are hidden, including being response to early recovery. The discussions are being taken out of the area. This poses great risk and danger held through a consortium of NGOs that have shown a in introducing cholera in other areas. [Sources: Health and keen interest in formally taking the cluster mandate to WASH Clusters] the next stage, removing the focus from mainly humanitarian response and mainstream support more Health Update fully with the National Health Strategy of 2009 to 2013. In this regard, the strategic working group (SWG) has 130 Malaria Deaths Reported been tasked to accordingly revise cluster and sub- Throughout April 2011, the health cluster addressed cluster terms of reference (ToR) which will then be malaria outbreaks in Manicaland, Matabeleland North, discussed with the cluster and the Humanitarian Midlands and Mashonaland East. By 24 April 2011, a Country Team (HCT). [Source: Health Cluster] cumulative 91,648 malaria cases and 140 deaths had been reported with a case fatality rate of 0.2. Health Partner Updates IOM provided logistical support for surveillance and Affected areas include Burma valley, Goromonzi, supply delivery for emergency response to cholera in Hurungwe, Mudzi, Mutoko, Uzumba-Maramba-Pfungwe Manicaland province’s Chipinge and Mutare districts. In (UMP) and Mhondoro-Ngezi, while seasonal increases addition, the organisation supported training of 54 were recorded in Mazowe and Mt.