Shortages catch the health sector

A cholera epidemic has flared sporadically in Zimbabwe since late last year, but shortages of drugs, staff and serviceable vehicles have prevented the authorities from stamping it out.

The latest outbreak, reported over the weekend, has claimed 15 lives and infected 45 people in the northeastern town of Guruve, 150km from the capital, Harare. A senior disease control officer told IRIN the numbers affected could be much higher, as health teams have been unable to cover the more remote parts of the district.

"The problems we face in Guruve are exactly what we have experienced in all the other areas where cholera outbreaks have been reported since January. There is a crisis in the supply of medicines and essential drugs, personnel, and even cars to get to places we believe need thorough check-ups," said the official, who asked not to be named.

According to Portia Mangazira, acting coordinator of the ministry of health's epidemiology unit, the situation in Guruve was under control, and prevention teams were being dispatched around the district. "We have been responding to outbreaks since the beginning of the year and they have all been contained, although the recurrence rate remains high," said Manangira.

Health Minister Dr David Parirenyatwa admitted that foreign currency shortages and an exodus of specialist staff meant his ministry faced huge challenges in running an effective disease control unit.

"Fuel and transport problems have also crippled a lot of control operations. However, we have managed to deploy the few resources [we have] with some effect over disease-hit areas," Parirenyatwa told IRIN.

He acknowledged the reduced capacity of the disease control unit as a result of Zimbabwe's long-running economic crisis and the exodus of skilled staff. "The rate at which the diseases have been recurring is proof that we are failing in total epidemic control. A lot of work needs to done in rebuilding the unit, but we are not sure if we are going to be able to attract and retain highly qualified staff," Parirenyatwa said.

Blessing Chebundo, chairman of the parliamentary portfolio committee on health and child welfare, said the failure of disease control mirrored the rot in the entire public healthcare system.

"The problem at disease control has been growing with the crisis since 2000. Every year we remind the government about the need to replenish the health sector, but the usual excuses are budgetary constraints, and promises of reforms that never work out or pay. The problem is with government, not the ministry or an isolated department," Chebundo told IRIN.

Since the start of the rainy season in December, hundreds of people have died from recurrent cholera and malaria outbreaks. Six years of unrelieved economic crisis, triggered by the government's land-reform programme and policy blunders, have crippled Zimbabwe's social welfare system, previously one of the best on the continent.