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Helping an overwhelmed clinic respond to cholera in Chirundu, Zimbabwe

© UNICEF Zimbabwe/2009
UNICEF has brought urgently needed assistance to a clinic in Chinrundu, Zimbabwe to help them deal with the overwhelming cholera epidemic.

By Thomas Myhren

CHIRUNDU, Zimbabwe, 9 January 2009 – Cholera victims were in agony on the damp grass outside an overfilled clinic in Chinrundu, a small community in the Northwest region of Zimbabwe. The rural clinic, which only has the capacity to treat eight patients, has been overwhelmed by the cholera emergency; its staff has already witnessed 185 cases and 16 deaths.

These figures are a testimony to the difficult circumstances found by UNICEF Zimbabwe Water, Sanitation and Hygiene Specialist Boniface Nzara when his team arrived at the site.

Only three courageous nurses and a handful of volunteers were on hand to operate the clinic.

“When we arrived at the clinic we were met by a frightening sight. People with cholera were just lying outside the clinic with very little assistance” said Mr. Nzara. “The hygiene situation inside was literally a cholera breeding ground.”

Mr. Nzara added that there were very few latrines, and that all patients were being treated side by side, posing a major risk for those who had been admitted for illnesses other than cholera. “The clinic was infested with flies and had a terrible smell. It was a struggle and inconvenience for the understaffed nurses to move around to assist patients,” he recalled.

Large and aggressive outbreak

The current cholera outbreak here is, by far, the largest and most aggressive one in the country’s recent history. A major contributor to the emergency is the breakdown of health systems, coupled with soaring inflation, which has weakened Zimbabwe’s ability to provide basic social services. Health workers are severely affected by the economic climate, as their monthly salaries do not cover the cost of transportation to work.

Last month, with supplies running short, clinic representatives made the journey to the UNICEF office in Harare, seeking urgent assistance. Within 24 hours, the first truck carrying assistance was deployed.

In response, said Mr. Nzara, the UNICEF team “travelled for nearly five hours to reach the clinic, which is close to the Zambian border. We brought a cholera kit, which contains everything a clinic needs to provide treatment.”

Cholera kits arrive

Each cholera kit includes two treatment tents large enough to house 50 patients, beds and pit latrine equipment, as well as IV fluids and oral rehydration salts. Decontaminating foot baths and handwashing points were set up in strategic areas as precautionary measures.

UNICEF also supplied a 5,000-litre water tank and 500,000 water-purification tablets to secure safe drinking water in the short term.

“We had to do on-the-job training on hygiene education while setting up the centre. We could not waste any time,” said Mr. Nzara. “Children often see water puddles and want to play in them, or put their fingers in their mouth without washing them with soap first. We have raised awareness that these actions could seriously harm the child.”

New clinic set up

Due to the lack of personnel, the team had to rely on community members to assist in setting up the new facilities.

“Since there was limited manpower, the team and I had to wear two hats – both as coordinators and construction workers,” said Mr. Nzara. “We spent two days setting up the Cholera Treatment Clinic to make it function and have all the requirements such a clinic should have. It was a hectic job, but seeing the relief on the faces of both patients and nurses provided all the motivation we needed.”

The new clinic is providing tangible hope for Chinrundu and its surrounding communities. Mr. Nzara said UNICEF expected an increase in admissions at the clinic and a decrease in fatality rates, as patients will no longer be prematurely sent home to make room for incoming cholera cases.

“Our colleagues are doing a remarkable job, working around the clock to provide assistance in a very difficult operating environment,” said UNICEF Acting Representative in Zimbabwe Roeland Monasch. “We are further scaling up our efforts with increased supplies and will continue to battle cholera as long as it takes.”



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