February 17, 2009

The outbreak continues with a concentration in rural areas


Zimbabwe 2009 © MSF

Patients receive treatment in the MSF cholera treatment center in Kadoma.

The widespread cholera outbreak continues throughout Zimbabwe. As previously reported, the focus of the outbreak has shifted from urban to rural areas, but cities are still a concern. The epidemic generally seems to be following a trend from northeast to southwest of the country. Doctors Without Borders/Médecins Sans Frontières (MSF) has treated nearly 45,000 patients since the outbreak began in August. MSF currently has more than 500 staff working on treating and preventing cholera in Zimbabwe, including national and international staff.

In and around the capital, Harare, MSF continues to support the two main cholera treatment centers (CTCs) in Budiriro and Beatrice. The number of cases is decreasing, but remains significant. Between January 19 and 25, MSF treated 1,161 suspected cholera cases in Harare. Community chlorination and hygiene promotion activities, which began the last week of January, continue with 22 community outreach teams in three locations. The teams have chlorinated more than 178,000 liters of water so far. Some 15 new teams have recently started work in Budiriro, and additional teams are planning to start chlorinating water in other suburbs.

The CTC in Kadoma, a city 130 km (80 miles) southwest of Harare, continues to see a high number of patients. During the last two weeks of January, the CTC saw 2,330 patients with suspected cases. There has been an increase in cases at the CTC in the town of Gweru. Three performing surveillance, assessment, and rapid response are in place in each of the provinces of Mashonaland.

In the rural areas of Masvingo and Manicaland provinces, the teams are still seeing a significant number of cases: for example, during the last week of January, the teams saw more than 1,300 cases. MSF teams are focusing on the ongoing cholera epidemic but are also keeping an eye on other health issues, including nutrition and malaria, as malaria season has begun.

MSF is also working in Gokwe, a rural village in the Midlands province. Two mobile medical teams are traveling around the area, responding to new alerts and supporting 10 health facilities.

The MSF team left Chegutu several weeks ago. Chegutu was the site of a serious outbreak in late December, but continues to monitor the health center periodically and provide supplies.

There are very few cases in Beitbridge and Bulawayo is very quiet.

MSF's other work in Zimbabwe

MSF follows more than 40,000 HIV-positive patients and currently supports 26,000 patients on antiretrovirals (ARVs). MSF also provides nutritional support to severely malnourished children.