March 06, 2009

Patient numbers increasing in Harare

MSF has treated nearly 56,000 patients for cholera since the outbreak began in August 2008. The cholera epidemic in Zimbabwe is still far from being over, and MSF is finding increasing numbers of cholera patients in Harare for the third week in a row.

Doctors Without Borders/Médecins Sans Frontières (MSF) has treated nearly 56,000 patients for cholera since the outbreak began in August 2008. According to the World Health Organization (WHO), the total number of cases in Zimbabwe is approximately 88,000, and there have been nearly 4,000 deaths.

The cholera epidemic in Zimbabwe is still far from being over, and MSF is finding increasing numbers of cholera patients in Harare for the third week in a row. “There seems to be a reverse trend: while case numbers in rural areas are going down, the epidemic is once again heating up in the capital,” said Marcus Bachmann, MSF emergency coordinator in Harare. During the week of February 16, the number of patients treated rose 12 percent to 511; the following week, a 20 percent rise brought a total of 611 patients.

MSF has seen a continuation of the trend this week as well. The cholera treatment center at Beatrice Road Infectious Disease Hospital, which had been partially shut down, was reopened to increase capacity for new patients.

“The problem is the intermittent to completely failing water supply in the southwestern high-density suburbs of Harare, leaving about 65,000 households at highest risk without access to safe drinking water. In order to break the vicious circle, the MSF teams scale up bucket chlorination and hygiene promotion. Complementary to that, hygiene kits will be distributed in the most affected areas,” says Bachmann.

Outside of Harare, Patient Numbers Dropping in Many Areas

The situation seems to be improving in much of the country. In Gokwe, located in the Midlands Province southwest of Harare, MSF teams still respond to new alerts, monitor existing structures and carry out preventive activities, such as the analysis of water sources. In both Gokwe North and South districts, however, there is a general decrease in patient numbers. The same holds true for Kwekwe, also in Midlands Province, where the situation seems to be under control at the moment with a decreasing trend compared to previous weeks.

Yet, in several rural locations some new cases are still being reported. Regarding the current situation, the team has been working on a preparedness plan for an outbreak scenario in Harare.

Also in the eastern districts Chimanimani, Buhera, Bikita, and Gutu, MSF teams have seen a significant decrease in the number cholera cases, and have been able to hand over six Cholera Treatment Units (CTUs) to the Ministry of Health and close one. In two other clinics, MSF was able to scale down its numbers of workers. It appears that in these districts MSF is coming closer to the end of the project. However, MSF recently started new activities in Mutare, in Manicaland Province in western Zimbabwe. So the situation is not yet stable.

In Masvingo Province, in central Zimbabwe, MSF is not seeing any significant spikes in the number of cases, but is still opening CTUs in some places. MSF will keep track of the situation in the schools, which are starting to reopen after weeks of closure due to a teacher's strike. After an assessment in Masvingo prison on February 20, MSF found there was no need to restart activities there. In the whole district of Beitbridge at the South African border, no more cholera admissions have been reported over the last two weeks. MSF continues to monitor the situation.