By Michael Gwarisa recently in Marange
It’s 12:00 midnight, and two men knock at Cecilia Garira’s door. Cecilia is a famous Village Health Worker from the Johane Marange sect in Marange, Mfararikwa Village, who has volunteered to assist Cholera patients from her sect.
The two men bear bad tidings. One of their members is critical and in need of help as he is exhibiting severe Cholera symptoms including dehydration. Cecilia doesn’t waste time. She packs her bag and joins the two men.
Earlier in the day, the man in question fled his home when Cecilia and other volunteers showed up at his homestead intending to administer Salt and Sugar Solution or Oral Rehydration Solution (ORS). While some members of the Marange apostolic sect are slowly embracing Cholera interventions, some, unfortunately, continue to maintain a hard-line stance towards medicine and any form of health intervention including ORS. This has resulted in high morbidity and mortality from vaccine-preventable diseases among members, especially children.
“Even though he had sent the men to my house for assistance, when I got to the man’s home, to my surprise he refused to be given the salt and sugar solution and told us to leave,” said Cecilia.
“Ndanamwa ini saka ibvai pano, (I have been sealed, you may leave now). That’s what the man told me and I asked what he meant by ndanamwa. The people in the house then explained that a young man from the church had mixed bread flour with water and made a paste that he used to seal the anus to block the Diarrhoea from gushing out and causing dehydration.”
After some time of locking in the Diarrhoea inside, someone then removes the Dough plug from the anus to flush out the trapped rice water Diarrhoea.
Dumbfounded, Cecelia did not listen to the man but administered the salt and sugar solution. She continued for a few days monitoring and giving him more ORS until he regained his health. Unfortunately, a few days later after the man had fully recovered, the young man who had sealed the man’s anal orifice died from severe Cholera symptoms as he refused to entertain any form of intervention.
Such is the grim picture obtaining in the Marange area as some members continue to disregard any form of outside intervention and in some instances bury their loved ones clandestinely without any supervision from health authorities.
Speaking to HealthTimes regarding the challenges faced by members from the apostolic sect as far as Cholera is concerned, Cecelia said ignorance was the biggest threat as people were now using unconventional means to try and plug the Cholera menace.
“Apart from sealing the anus with flour, they are also taking sick patients outside and making them seat in a bathtub or dish. The sick patient excretes and vomits in the water. Another one will be pouring water on the patient. They believe the water miraculously finds its way into the body through either the anus or through the skin pours,” said Cecelia.
“Some have reached the extent of using washing powder, especially the Boom brand which they mix with water and then drink. They are also mixing Vinegar, hot pepper and ginger to make a concoction they believe stops the diarrhoea.”
These strange practices have also spread beyond Marange as they are also being practised in surrounding communities such as Buhera, where the Johane Marange religion is also prevalent. Since the outbreak in September, others have been taking their sick to Save River where they immerse them in water and allow them to poop in the flowing water.
As a result of the low-risk perception disguised as religious beliefs, Cholera has killed more people in Manicaland province than in any other part of the country, with Ministry of Health data showing that the province had recorded 32 confirmed deaths and 108 suspected deaths as of January 11 2024. This is higher than the fatalities recorded in Harare province where only four confirmed and 51 suspected deaths have been recorded.
Community Working Group on Health (CWGH) Executive Director, Mr Itai Rusike said the low health-seeking behaviour in some religions was fertile transmission ground for Cholera.
“Cholera is eliminated by severing the faecal-oral transmission route, that is ensuring that drinking water and food is free from human faecal matter. Other risk factors for cholera include certain religious groups with low health-seeking behaviours and deliberate efforts should be made to engage leaders of the religious groups to encourage their membership to seek treatment whenever they suspect cholera infection,” said Mr Rusike.
Cholera remains a public health problem in predominantly overcrowded areas and public gatherings where access to clean and safe water and sanitation remains a challenge. Weaknesses in water and sanitation infrastructure and services, high-risk hygiene and social practices, and gaps in surveillance and healthcare systems also make the situation worse. Certain tribal practices like washing dead bodies and handshaking at funerals should be discouraged when there is a cholera outbreak.
At the onset of the Cholera outbreak in Buhera Manicaland, the Minister of Health and Child Care (MoHCC), Dr Douglass Mombeshora went on a fact-finding visit to the affected areas. Poor water and sanitation services, risky behaviour by members of white garment sects which included washing of dead bodies, washing of the sick in Save River and refusal to take oral rehydration were among some of the risk factors that were raised by healthcare workers.
Speaking during his visit to Buhera, Dr Mombeshora said there is a need to engage members of the apostolic sects to encourage them to take up cholera health services.
“When we got here, we were shown a map that showed that Cholera was most prevalent in one particular area and we heard that the first case emanated from the funeral of a person who had attended a religious gathering. There is a need to go and speak with members of these religions that do not permit members to seek healthcare services. We want to start with prevention at the community level so that we curb the Cholera spread,” said Dr Mombeshora.
The Ministry of Health has now deployed healthcare workers across all districts where Cholera has been recorded to monitor and facilitate the burial of those who would have died from the disease.
Minister of State for Manicaland Province who accompanied the minister on the fact-finding visit, Honourable Sam Mugadza said members of the apostolic community were slowly embracing measures to prevent and treat Cholera.
“I am happy that the Minister came here and we have seen that if we remain united with the partners working here, we will defeat Cholera. It shows that Cholera started from religions that don’t allow people to access health services. However, we are seeing a change now as members are now coming to get assistance and treatment though there is still some resistance” said Honourable Mugadza.
