[dropcap][/dropcap]By Michael Gwarisa
THE City of Harare needs to find a permanent solution to the recurring Typhoid outbreaks which have troubled the city since beginning of this year, Community Working Group on Health (CWGH) executive director Itai Rusike has said.
Harare recently registered cases of Typhoid In Mbare, Matapi flats amid growing skepticism and doubt over the City of Harare’s capacity to resolve the issue in the short term.
“The Community Working Group on Health (CWGH) urges the Harare City Council (HCC) to urgently address the key drivers of typhoid in order to permanently stop the current outbreak and future recurrence. Section 77 of the 2013 Constitution guarantees the right to safe, clean and portable water and for the state to take legislative measures to secure these rights.
“Harare residents have reported drinking contaminated water from shallow, unprotected wells and defecating outdoors, violating their right to water and sanitation and raising the risk of typhoid. Already, 21 cases of typhoid fever have been detected in the past week in Mbare high densityarea of Harare, a city which has become the epicenter of the disease for the past decade,” said Rusike He added that their greatest fear as CWGH was the onset of the rainy season and the continued interruption of water supplies to the city’s over populated suburbs could further provide opportune environments for the disease to spread to other locations.
“The situation on the ground indicates that while infrastructures are present, they are old, poorly functioning and poor availability of safe water leads to sourcing of water from less protected, informal sources. It is surprising that the HCC plans to introduce a typhoid vaccine in a bid to prevent future infections without adequately addressing the key drivers of the disease. It has been noted that the recurrent outbreaks of typhoid in Harare are being caused by erratic supply of clean water, supply of contaminated drinking water, burst sewer pipes and poor hygiene.”
[pullquote]CWGH believes that the typhoid vaccination should only complement service provision and should not be taken as the main intervention strategy in the fight against the outbreak. It does not make sense to treat people for preventable diseases and send them back to the conditions that made them ill.[/pullquote]
Meanwhile, Rusike added that vaccines do not come cheap and it raises serious questions about the sustainability of that approach as the major weapon to fight the disease given the current limited national resources Zimbabwe has. “For years now, Zimbabwe has been failing to adequately provide for the health sector.
“It has never met the 15% Abuja target despite acceding to the Declaration over a decade ago. With limited resources, the country will have to rely on the support from development partners such as the Global Vaccine Alliance (GAVI) for the vaccine, which is not sustainable given that donor assistance is never permanent.
“Why is it that the outbreaks always occur or start in Harare and not in Bulawayo, Masvingo or Gweru? It should be noted that Bulawayo faces more water challenges than Harare but there has not been serious cases of either typhoid or cholera in that city for years. It leaves room people to conclude that the continued outbreaks of the waterborne diseases in Harare have more do with poor corporate governance and outright incompetence than anything else.
“It does not need a rocket scientist to know that what Harare needs is uninterrupted supply of clean water to residents, regular collection of refuse, provision of decent accommodation, fixing of leaking sewerage pipes and cleaning up of drainage systems to stop future outbreaks of typhoid and cholera. These archaic diseases were completely eliminated in other parts of the world in the last century.”
Equally worrying is the absence of health education and health promotion by the city fathers even in the wake of this outbreak which will be compounded by the pending rainy season. However, the promotion of hygiene practices (prevention services) has continued to receive inadequate attention, especially in urban areas, despite its potential to prevent the outbreak of water borne diseases and saving lives. It is also worrying that prevention services in the country are still underfunded with the health sector in general always receiving a paltry allocation from Treasury.
Since the cholera outbreak of 2008/9 that killed over 4 500 people, the country’s cities are still dogged by poor sanitation, erratic potable water supplies of questionable quality meaning that as a country, we learnt nothing from that crisis. The majority of the deaths were recorded in Harare, ironically a city vying for World Class City status by 2025.
“CWGH would like to urge the city fathers to urgently put in place long-term and sustainable mechanisms that address the key drivers of typhoid and cholera to prevent further deaths and suffering from these medieval diseases. It also calls for urgent finalization of the Public Health Act Amendment Bill and strengthening of enforcement mechanisms in order to protect the public from poor service provision.
“A recovery in water and sanitation is critical to prevent typhoid, diarrhoeal and other disease outbreaks and their associated human cost, and to address the time and other costs to households, particularly for women and children, to access safe water.”
