The health crisis in Zimbabwe should be the subject of an investigation by the International Criminal Court, campaign group Physicians for Human Rights says.
President Robert Mugabe's government is responsible for the collapse of the health, water and sanitation systems - violating human rights, it says.
With no functioning public hospitals, the cholera epidemic has killed far more than 2,000 people, it added.
The US-based group called for the UN to take control of the health service.
Physicians for Human Rights says the "shocking" findings in its report - Health in Ruins, a man-made disaster in Zimbabwe - should compel the international community to act.
"They wanted only US dollars in cash. $3,000 for the surgeon, $140 for the nurse and $700 for the doctor who puts you to sleep"-
Woman wanting a caesarean
PHR's report Health in Ruins
"These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity," it says in the report's preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda.
New figures from the UN World Health Organization on Tuesday put the death toll from the cholera epidemic which broke out in August at 2,024.
The British Red Cross has warned that with the onset of the rainy season, flooding could seriously exacerbate the rate of infection as sewage may contaminate water sources further.
Health sector politicised
President Mugabe has been facing intensified criticism over the dire economic and humanitarian situation in Zimbabwe.
Robert Mugabe has blamed Zimbabwe's problems on the West
He signed a power-sharing deal with his rival, Morgan Tsvangirai, in September, intended to rescue the collapsing economy but progress has since stalled over who should control key ministries.
Mr Tsvangirai has threatened to pull out of power-sharing talks unless abductions of his supporters stop.
Among its recommendations, the report says the UN Security Council and Southern African Development Community (SADC) should call on Mr Mugabe to accept the first round of last year's presidential election, which was won by Mr Tsvangirai.
The opposition leader withdrew from a run-off in June citing state-sponsored violence.
The report's findings are based on a visit to the country by four human rights investigators and two doctors in December 2008.
It says the scale and scope of the health sector's collapse last year was "unprecedented" and the government deliberately tried to downplay the cholera outbreak at first.
"The Mugabe regime has used any means at its disposal, including the politicisation of the health sector, to maintain its hold on power," the preface says.
The government had ignored warnings from civic organisations in 2006 about the possibility of a cholera outbreak because of a failure to maintain water purification systems, it said.
Mr Mugabe's allies have accused western countries of trying to use the cholera outbreak as an excuse to topple him.
They blame Zimbabwe's problems on Western sanctions.
Dollarization
Physicians for Human Rights says the root of the crisis is the economic collapse - citing in particular the land seizures of 2000 and failure to control hyperinflation.
HEALTH CRISIS
Cholera: 2,204 died since August
Anthrax: Eight deaths since November
HIV/Aids: Estimated 400 deaths a day
TB: Brain-drain has practically closed the national testing laboratory which now has only one staff member
Maternal mortality: Risen from 168 per 100,000 in 1990 to 1,100 in 2005
As a result, there is more than 80% unemployment in the country and those with jobs find their salary is worthless unless they are paid in foreign currency.
A government doctor showed the PHR her payslip for November 2008; she was paid the equivalent of 32 US cents (22 pence) for the whole month.
The dollarization of the economy has meant that only a small elite now have access to healthcare.
There is now enormous pressure on mission hospitals which are having to treat patients from urban areas.
A mother who had her baby at a mission hospital told PHR investigators that she had tried to have a caesarean at the main government hospital in Harare, but it had been closed.
A private clinic would do the operation in November for "US dollars, in cash".
"$3,000 for the surgeon, $140 for the nurse and $700 for the doctor who puts you to sleep," she said.
The report also focussed on other health issues such as an anthrax outbreak, the HIV/Aids crisis, tuberculosis and maternal mortality.
It noted that life expectancy had fallen from 62 years for both sexes in 1990 to 34 years for men and 37 years for women in 2006, the world's lowest.
Thursday, January 15, 2009
Health system problems aggravate cholera outbreak in Zimbabwe
WHO setting up a cholera control centre, seeking US$ 6 million in support
10 December 2008 | HARARE -- A widespread cholera outbreak, under-resourced and under-staffed health system, and inadequate access to safe drinking water and hygiene are threatening the wellbeing of thousands of Zimbabweans. As of 9 December, 16 141 suspected cases of cholera and 775 resultant deaths (case fatality rate of 4.8%) had been recorded since August in two-thirds of the country's 62 districts.
WHO is establishing a cholera control and command centre, in conjunction with the Ministry of Health and Child Welfare (MoHCW) and other health partners, to respond in a coordinated manner to Zimbabwe's health challenges. WHO is seeking donor support for a US$ 6 million proposal for its cholera response plan.
Approximately half of cholera cases have been recorded in Budiriro, a heavily populated suburb on the western outskirts of the capital, Harare. Other major concentrations of reported cases include Beitbridge, on the South African border, and Mudzi, on the border with Mozambique.
The outbreak could surpass 60 000 cases, according to an estimate by the Zimbabwe Health Cluster, which is a group coordinated by WHO and comprising health providers, nongovernmental organizations and the MoHCW. The estimate is based on six million people, or half of Zimbabwe's 12 million population, potentially being at risk of contracting cholera, with an estimated 1% of those at risk of actually suffering from cholera. With the rainy season commencing and increased transit of people likely due to the Christmas season, there are risks for further spread of cholera if strong measures are not taken.
There are also serious regional implications, with cholera cases crossing into South Africa and Botswana. On 2 December, South African health authorities said the country had recorded 460 cholera cases and nine related deaths, mostly in border areas near Zimbabwe.
"This outbreak can be contained, but it will depend on many factors, in particular a coordinated approach between all health providers to make sure we are providing the right interventions where they are needed most," said Dr Custodia Mandhlate, WHO Representative to Zimbabwe. "Such interventions include prevention, quick case detection and control, and improved treatment."
The major cause of the cholera outbreak is the inadequate supply of clean drinking water and poor levels of hygiene. Shortages of medicines, equipment and staff at health facilities throughout the country are compounding the health challenges. WHO is advocating for improved access to oral rehydration salts for treating moderate dehydration, which is a symptom of cholera. This could help quickly reduce sickness and deaths.
To help Zimbabwean authorities and partners respond to the health emergency, WHO has sent medical supplies to treat 50 000 people for common conditions for three months, as well as 3200 moderate cases of cholera. WHO has also sent epidemiologists, a water and sanitation expert and a logistician to Harare to strengthen response efforts on the ground.
For more information please contact:
Paul Garwood
Communications Officer
WHO, Geneva
Health Action in Crises (HAC)
Mobile (Geneva): +41 79 475 5546
Mobile (Harare): +263 912 433128
E-mail: garwoodp@who.int
Wendy Julias
Communications officer
WHO Zimbabwe
Telephone: +263 425 3724/30
Mobile: +263 91 243 1408
E-mail: JuliasW@zw.afro.who.int
Gregory Hartl
Team Leader, Information Management and Communications
Department of Epidemic and Pandemic Alert and Response (EPR)
WHO, Geneva
Telephone: +41 22 791 4458
Mobile: +41 79 203 6715
E-mail: hartlg@who.int
10 December 2008 | HARARE -- A widespread cholera outbreak, under-resourced and under-staffed health system, and inadequate access to safe drinking water and hygiene are threatening the wellbeing of thousands of Zimbabweans. As of 9 December, 16 141 suspected cases of cholera and 775 resultant deaths (case fatality rate of 4.8%) had been recorded since August in two-thirds of the country's 62 districts.
WHO is establishing a cholera control and command centre, in conjunction with the Ministry of Health and Child Welfare (MoHCW) and other health partners, to respond in a coordinated manner to Zimbabwe's health challenges. WHO is seeking donor support for a US$ 6 million proposal for its cholera response plan.
Approximately half of cholera cases have been recorded in Budiriro, a heavily populated suburb on the western outskirts of the capital, Harare. Other major concentrations of reported cases include Beitbridge, on the South African border, and Mudzi, on the border with Mozambique.
The outbreak could surpass 60 000 cases, according to an estimate by the Zimbabwe Health Cluster, which is a group coordinated by WHO and comprising health providers, nongovernmental organizations and the MoHCW. The estimate is based on six million people, or half of Zimbabwe's 12 million population, potentially being at risk of contracting cholera, with an estimated 1% of those at risk of actually suffering from cholera. With the rainy season commencing and increased transit of people likely due to the Christmas season, there are risks for further spread of cholera if strong measures are not taken.
There are also serious regional implications, with cholera cases crossing into South Africa and Botswana. On 2 December, South African health authorities said the country had recorded 460 cholera cases and nine related deaths, mostly in border areas near Zimbabwe.
"This outbreak can be contained, but it will depend on many factors, in particular a coordinated approach between all health providers to make sure we are providing the right interventions where they are needed most," said Dr Custodia Mandhlate, WHO Representative to Zimbabwe. "Such interventions include prevention, quick case detection and control, and improved treatment."
The major cause of the cholera outbreak is the inadequate supply of clean drinking water and poor levels of hygiene. Shortages of medicines, equipment and staff at health facilities throughout the country are compounding the health challenges. WHO is advocating for improved access to oral rehydration salts for treating moderate dehydration, which is a symptom of cholera. This could help quickly reduce sickness and deaths.
To help Zimbabwean authorities and partners respond to the health emergency, WHO has sent medical supplies to treat 50 000 people for common conditions for three months, as well as 3200 moderate cases of cholera. WHO has also sent epidemiologists, a water and sanitation expert and a logistician to Harare to strengthen response efforts on the ground.
For more information please contact:
Paul Garwood
Communications Officer
WHO, Geneva
Health Action in Crises (HAC)
Mobile (Geneva): +41 79 475 5546
Mobile (Harare): +263 912 433128
E-mail: garwoodp@who.int
Wendy Julias
Communications officer
WHO Zimbabwe
Telephone: +263 425 3724/30
Mobile: +263 91 243 1408
E-mail: JuliasW@zw.afro.who.int
Gregory Hartl
Team Leader, Information Management and Communications
Department of Epidemic and Pandemic Alert and Response (EPR)
WHO, Geneva
Telephone: +41 22 791 4458
Mobile: +41 79 203 6715
E-mail: hartlg@who.int
UN 'should take over control of Zimbabwe's health system'
Control of Zimbabwe's shattered health system should be handed over to the United Nations, an independent doctors group has demanded.
As the official death toll from the country's cholera epidemic yesterday topped 2,000, Physicians for Human Rights said government corruption was killing innocent people. The international doctors' group also called for President Robert Mugabe to be investigated by the International Criminal Court at the launch of a report titled Health in Ruins – A Man-made Disaster in Zimbabwe.
The World Health Organisation confirmed that at least 40,000 people have contracted cholera, a preventable disease, and 2,024 had died. Doctors and nurses working in Zimbabwe, as well as senior officials at the health ministry, have privately said that the real death toll is likely to be much higher. The report says: "These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity."
The findings of the US-based group were signed by the South African Nobel peace laureate Desmond Tutu and the former UN High Commissioner for Human Rights Mary Robinson among others.
The ongoing international outcry has had little impact on President Mugabe. Power-sharing talks with the opposition MDC have been deadlocked since last September, with the government refusing to dilute its control over the security services. "The Mugabe regime has used any means at its disposal, including the politicisation of the health sector, to maintain its hold on power," the report says.
The cholera crisis has brought renewed attention to the collapse of infrastructure in what was among Africa's wealthiest countries only 15 years ago. The doctors also accuse the government of deliberately using food shortages to political advantage, with supplies being denied to people who do not support Mr Mugabe and his party
"There is a lot of evidence that it [food] is being used as a political weapon," said David Sanders, a Zimbabwean doctor.
Malnutrition which has reached epic proportions, with five million people requiring food aid this year, has compounded existing health problems such as HIV and made curable diseases such as cholera fatal.
Zimbabwe is suffering the worst cholera outbreak in Africa since 1999 when 2,085 people died in Nigeria, according to UN data. The waterborne disease, which causes severe diarrhoea and dehydration, has spread to all 10 provinces of Zimbabwe.
The British Red Cross yesterday expressed concern that the continuing rains are making things worse, while the custom of returning the dead to their rural areas for burial was helping to spread the disease.
While Zimbabwe's government belatedly admitted the existence of the epidemic and called for international assistance, the economic meltdown in the country has destroyed its health system and left ordinary people without medical assistance. A government doctor's pay slip seen by Physicians for Human Rights showed she had been paid a monthly salary equivalent to 22p in sterling.
By Daniel Howden, Africa Correspondent
Wednesday, 14 January 2009
As the official death toll from the country's cholera epidemic yesterday topped 2,000, Physicians for Human Rights said government corruption was killing innocent people. The international doctors' group also called for President Robert Mugabe to be investigated by the International Criminal Court at the launch of a report titled Health in Ruins – A Man-made Disaster in Zimbabwe.
The World Health Organisation confirmed that at least 40,000 people have contracted cholera, a preventable disease, and 2,024 had died. Doctors and nurses working in Zimbabwe, as well as senior officials at the health ministry, have privately said that the real death toll is likely to be much higher. The report says: "These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity."
The findings of the US-based group were signed by the South African Nobel peace laureate Desmond Tutu and the former UN High Commissioner for Human Rights Mary Robinson among others.
The ongoing international outcry has had little impact on President Mugabe. Power-sharing talks with the opposition MDC have been deadlocked since last September, with the government refusing to dilute its control over the security services. "The Mugabe regime has used any means at its disposal, including the politicisation of the health sector, to maintain its hold on power," the report says.
The cholera crisis has brought renewed attention to the collapse of infrastructure in what was among Africa's wealthiest countries only 15 years ago. The doctors also accuse the government of deliberately using food shortages to political advantage, with supplies being denied to people who do not support Mr Mugabe and his party
"There is a lot of evidence that it [food] is being used as a political weapon," said David Sanders, a Zimbabwean doctor.
Malnutrition which has reached epic proportions, with five million people requiring food aid this year, has compounded existing health problems such as HIV and made curable diseases such as cholera fatal.
Zimbabwe is suffering the worst cholera outbreak in Africa since 1999 when 2,085 people died in Nigeria, according to UN data. The waterborne disease, which causes severe diarrhoea and dehydration, has spread to all 10 provinces of Zimbabwe.
The British Red Cross yesterday expressed concern that the continuing rains are making things worse, while the custom of returning the dead to their rural areas for burial was helping to spread the disease.
While Zimbabwe's government belatedly admitted the existence of the epidemic and called for international assistance, the economic meltdown in the country has destroyed its health system and left ordinary people without medical assistance. A government doctor's pay slip seen by Physicians for Human Rights showed she had been paid a monthly salary equivalent to 22p in sterling.
By Daniel Howden, Africa Correspondent
Wednesday, 14 January 2009
Cholera Watch- In Zimbabwe
The cholera epidemic in Zimbabwe has now killed more than 2,000 people, it was confirmed today.
Almost 40,000 have also now contracted the normally preventable disease as the crisis resulting from a collapsed health service threatens the entire region.
The World Health Organisation (WHO) said the outbreak in Robert Mugabe’s shattered nation now represented the worst in Africa in nearly a decade.
Meanwhile, the respected campaign group Physicians for Human Rights (PHR) said the death toll from the disease was much higher than official data showed and accused Mr Mugabe’s government of responsibility for the crisis. It called for an official investigation by the International Criminal Court and said the United Nations should take control of health in the country.
Its report, entitled “Health in Ruins, a man-made disaster in Zimbabwe”, followed a visit by a team of six specialists, four human rights experts and two doctors to the country last month. PHR, which won the Nobel Peace Prize for its work lobbying against land mines, said the team was shocked by what they found.
The analysis found that the scale of the health sector's collapse was "unprecedented" and that government had deliberately tried to downplay the cholera outbreak.
"These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity," states the report's preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda.
The government had ignored warnings from civic organisations in 2006 about the possibility of a cholera outbreak because of a failure to maintain water purification systems, it said.
Mr Mugabe's allies have accused western countries of trying to use the cholera outbreak as an excuse to topple him. They blame Zimbabwe's problems on Western sanctions – an assertion dismissed by the team which said the root of the crisis was economic collapse, citing in particular the land seizures of 2000 and failure to control hyperinflation.
The WHO update showed 2,024 people had been killed by cholera from 39,806 cases. It is the worst outbreak of the disease in Africa since 1999. In normal cholera outbreaks the death toll is around one in every 100. In Zimbabwe, it is between four and five in every 100.
The waterborne disease has also spread to Zimbabwe’s neighbours with at least 13 deaths and 1,419 cases in South Africa. Botswana, Mozambique and Zambia have also reported cholera cases.
Almost 40,000 have also now contracted the normally preventable disease as the crisis resulting from a collapsed health service threatens the entire region.
The World Health Organisation (WHO) said the outbreak in Robert Mugabe’s shattered nation now represented the worst in Africa in nearly a decade.
Meanwhile, the respected campaign group Physicians for Human Rights (PHR) said the death toll from the disease was much higher than official data showed and accused Mr Mugabe’s government of responsibility for the crisis. It called for an official investigation by the International Criminal Court and said the United Nations should take control of health in the country.
Its report, entitled “Health in Ruins, a man-made disaster in Zimbabwe”, followed a visit by a team of six specialists, four human rights experts and two doctors to the country last month. PHR, which won the Nobel Peace Prize for its work lobbying against land mines, said the team was shocked by what they found.
The analysis found that the scale of the health sector's collapse was "unprecedented" and that government had deliberately tried to downplay the cholera outbreak.
"These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity," states the report's preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda.
The government had ignored warnings from civic organisations in 2006 about the possibility of a cholera outbreak because of a failure to maintain water purification systems, it said.
Mr Mugabe's allies have accused western countries of trying to use the cholera outbreak as an excuse to topple him. They blame Zimbabwe's problems on Western sanctions – an assertion dismissed by the team which said the root of the crisis was economic collapse, citing in particular the land seizures of 2000 and failure to control hyperinflation.
The WHO update showed 2,024 people had been killed by cholera from 39,806 cases. It is the worst outbreak of the disease in Africa since 1999. In normal cholera outbreaks the death toll is around one in every 100. In Zimbabwe, it is between four and five in every 100.
The waterborne disease has also spread to Zimbabwe’s neighbours with at least 13 deaths and 1,419 cases in South Africa. Botswana, Mozambique and Zambia have also reported cholera cases.
Thursday, January 1, 2009
Social Welfare background information for African Immigrants living in the U.S.
Federally funded and governed US welfare began in the 1930’s during the Great Depression. The US government responded to the overwhelming number of families and individuals in need of aid by creating a welfare program that would give assistance to those who had little or no income.
The US welfare system stayed in the hands of the federal government for the next sixty-one years. Many Americans were unhappy with the welfare system, claiming that individuals were abusing the welfare program by not applying for jobs, having more children just to get more aid, and staying unmarried so as to qualify for greater benefits. Welfare system reform became a hot topic in the1990’s. Bill Clinton was elected as President with the intention of reforming the federally run US Welfare program. In 1996 the Republican Congress passed a reform law signed by President Clinton that gave the control of the welfare system back to the states.
Eligibility Requirements for State Welfare Program
Eligibility for a Welfare program depends on numerous factors. Eligibility is determined using gross and net income, size of the family, and any crisis situation such as medical emergencies, pregnancy, homelessness or unemployment. A case worker is assigned to those applying for aid. They will gather all the necessary information to determine the amount and type of benefits that an individual is eligible for.
The Federal government provides assistance through TANF (Temporary Assistance for Needy Families). TANF is a grant given to each state to run their own welfare program. To help overcome the former problem of unemployment due to reliance on the welfare system, the TANF grant requires that all recipients of welfare aid must find work within two years of receiving aid, including single parents who are required to work at least 30 hours per week opposed to 35 or 55 required by two parent families. Failure to comply with work requirements could result in loss of benefits.
Types of Welfare Available
The type and amount of aid available to individuals and dependent children varies from state to state. When the Federal Government gave control back to the states there was no longer one source and one set of requirements. Most states offer basic aid such as health care, food stamps, child care assistance, unemployment, cash aid, and housing assistance.
How to Apply for a Welfare Program
To apply for a welfare program one must contact the local Human Service Department located in the government pages of the phone book. It may be listed as Human Services, Family Services or Adult and Family Services. An appointment is made with a case worker. The case worker will give a list of required documents needed at the appointment. Common documents asked for are proof of income, ID, and utility bills or other proof of residency.
Once an appointment is completed a case worker will review all required documents, applications and information provided at the meeting. They will use this information to determine eligibility and the amount of assistance.
http://www.welfareinfo.org/
The US welfare system stayed in the hands of the federal government for the next sixty-one years. Many Americans were unhappy with the welfare system, claiming that individuals were abusing the welfare program by not applying for jobs, having more children just to get more aid, and staying unmarried so as to qualify for greater benefits. Welfare system reform became a hot topic in the1990’s. Bill Clinton was elected as President with the intention of reforming the federally run US Welfare program. In 1996 the Republican Congress passed a reform law signed by President Clinton that gave the control of the welfare system back to the states.
Eligibility Requirements for State Welfare Program
Eligibility for a Welfare program depends on numerous factors. Eligibility is determined using gross and net income, size of the family, and any crisis situation such as medical emergencies, pregnancy, homelessness or unemployment. A case worker is assigned to those applying for aid. They will gather all the necessary information to determine the amount and type of benefits that an individual is eligible for.
The Federal government provides assistance through TANF (Temporary Assistance for Needy Families). TANF is a grant given to each state to run their own welfare program. To help overcome the former problem of unemployment due to reliance on the welfare system, the TANF grant requires that all recipients of welfare aid must find work within two years of receiving aid, including single parents who are required to work at least 30 hours per week opposed to 35 or 55 required by two parent families. Failure to comply with work requirements could result in loss of benefits.
Types of Welfare Available
The type and amount of aid available to individuals and dependent children varies from state to state. When the Federal Government gave control back to the states there was no longer one source and one set of requirements. Most states offer basic aid such as health care, food stamps, child care assistance, unemployment, cash aid, and housing assistance.
How to Apply for a Welfare Program
To apply for a welfare program one must contact the local Human Service Department located in the government pages of the phone book. It may be listed as Human Services, Family Services or Adult and Family Services. An appointment is made with a case worker. The case worker will give a list of required documents needed at the appointment. Common documents asked for are proof of income, ID, and utility bills or other proof of residency.
Once an appointment is completed a case worker will review all required documents, applications and information provided at the meeting. They will use this information to determine eligibility and the amount of assistance.
http://www.welfareinfo.org/
Zimbabwe child malnutrition rises
Some five million Zimbabwean rely on food aid, the aid agency says
Acute child malnutrition in parts of Zimbabwe has increased by almost two-thirds compared with last year, aid agency Save the Children says.
In a report, the UK-based agency concluded that some children were "wasting away from lack of food".
It said there was a shortage of 18,000 tonnes of food needed for January and urged world donors to increase aid.
The agency said innocent Zimbabweans should not suffer because of a political crisis out of their control.
"There is no excuse for failing to provide this food," said Lynn Walker, programmes director for Save the Children in Zimbabwe.
The agency said some five million people in Zimbabwe - or about 50% of the country's population - were now in need of food aid.
Zimbabwe's farming sector collapsed after President Robert Mugabe launched a controversial land reform programme more than five years ago.
As well as suffering economic meltdown, Zimbabwe is experiencing a cholera outbreak, fuelled by the collapse of its health, sanitation and water services.
Aid agencies have warned that the disease, which has already claimed more than 1,100 lives, could infect more than 60,000 unless its spread is halted.
President Mugabe has blamed the West for his country's problems.
Acute child malnutrition in parts of Zimbabwe has increased by almost two-thirds compared with last year, aid agency Save the Children says.
In a report, the UK-based agency concluded that some children were "wasting away from lack of food".
It said there was a shortage of 18,000 tonnes of food needed for January and urged world donors to increase aid.
The agency said innocent Zimbabweans should not suffer because of a political crisis out of their control.
"There is no excuse for failing to provide this food," said Lynn Walker, programmes director for Save the Children in Zimbabwe.
The agency said some five million people in Zimbabwe - or about 50% of the country's population - were now in need of food aid.
Zimbabwe's farming sector collapsed after President Robert Mugabe launched a controversial land reform programme more than five years ago.
As well as suffering economic meltdown, Zimbabwe is experiencing a cholera outbreak, fuelled by the collapse of its health, sanitation and water services.
Aid agencies have warned that the disease, which has already claimed more than 1,100 lives, could infect more than 60,000 unless its spread is halted.
President Mugabe has blamed the West for his country's problems.
Cholera in Zimbabwe - update
26 December 2008 -- As of 25 December 2008, a total of 26 497 cases, including 1 518 deaths, have been reported by the Ministry of Health in Zimbabwe. Cases are now being reported from all 10 of the country's provinces. Harare, particularly Budiriro suburb in the south west, accounts for the majority of cases, followed by Beitbridge in Matabeleland South and Mudzi in Mashonaland East. The current outbreak is the largest ever recorded in Zimbabwe and is not yet under control. In fact, the epidemiological week ending 20 December saw over 5 000 new cases - an increase in the number of weekly cases relative to previous weeks - and an increase in deaths outside treatment/health centres.
The overall Case Fatality Rate (CFR) has risen to 5.7% - far above the 1% which is normal in large outbreaks - and in some rural areas it has reached as high as 50%. Mortality outside of healthcare facilities remains very high. This is a clear indication that better case management and access to healthcare is needed - in particular an increased use of oral rehydration therapy with Oral Rehydration Salts in communities very early after onset of the disease.
The outbreak has taken on a subregional dimension with cases being reported from neighboring countries. In South Africa as of 26 December, 1 279 cumulative cases and 12 deaths (CFR of 0.9%) had been recorded, with the bulk of the cases (1 194) in the Limpopo area. Cases have also been reported in Botswana (Palm Tree).
The current situation is closely linked to the lack of safe drinking water, poor sanitation, declining health infrastructure, and reduced numbers of healthcare staff reporting to work. Other current risk factors include the commencement of the rainy season and the movement of people within the country, and possibly across borders, during the Christmas season. WHO, together with the Ministry of Health and partners from the health and Water and Sanitation clusters, has established a cholera outbreak response coordination unit in order to strengthen the reporting and early detection of cases, improve the response mechanism and access to healthcare and ensure proper case management. WHO has also deployed experts in public health, water and sanitation, logistics and social mobilization. In light of the extent and pace of expansion of the outbreak, reinforcing all control activities across the country is critical.
Given the current dynamic of the outbreak and the context of the collapsed health system, a cholera vaccination is not recommended. Moreover, the use of the internationally available WHO prequalified oral cholera vaccine is not recommended once an outbreak has started due to its 2-dose regimen and the time required to reach protective efficacy, high cost and the heavy logistics associated to its use. The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the occurrence of severe adverse events.
In controlling the spread of cholera WHO does not recommend any special restrictions to travel or trade to or from affected areas. However, neighboring countries are encouraged to reinforce their active surveillance and preparedness systems. Mass chemoprophylaxis is strongly discouraged, as it has no effect on the spread of cholera, can have adverse effects by increasing antimicrobial resistance and provides a false sense of security.
The overall Case Fatality Rate (CFR) has risen to 5.7% - far above the 1% which is normal in large outbreaks - and in some rural areas it has reached as high as 50%. Mortality outside of healthcare facilities remains very high. This is a clear indication that better case management and access to healthcare is needed - in particular an increased use of oral rehydration therapy with Oral Rehydration Salts in communities very early after onset of the disease.
The outbreak has taken on a subregional dimension with cases being reported from neighboring countries. In South Africa as of 26 December, 1 279 cumulative cases and 12 deaths (CFR of 0.9%) had been recorded, with the bulk of the cases (1 194) in the Limpopo area. Cases have also been reported in Botswana (Palm Tree).
The current situation is closely linked to the lack of safe drinking water, poor sanitation, declining health infrastructure, and reduced numbers of healthcare staff reporting to work. Other current risk factors include the commencement of the rainy season and the movement of people within the country, and possibly across borders, during the Christmas season. WHO, together with the Ministry of Health and partners from the health and Water and Sanitation clusters, has established a cholera outbreak response coordination unit in order to strengthen the reporting and early detection of cases, improve the response mechanism and access to healthcare and ensure proper case management. WHO has also deployed experts in public health, water and sanitation, logistics and social mobilization. In light of the extent and pace of expansion of the outbreak, reinforcing all control activities across the country is critical.
Given the current dynamic of the outbreak and the context of the collapsed health system, a cholera vaccination is not recommended. Moreover, the use of the internationally available WHO prequalified oral cholera vaccine is not recommended once an outbreak has started due to its 2-dose regimen and the time required to reach protective efficacy, high cost and the heavy logistics associated to its use. The use of the parenteral cholera vaccine has never been recommended by WHO due to its low protective efficacy and the occurrence of severe adverse events.
In controlling the spread of cholera WHO does not recommend any special restrictions to travel or trade to or from affected areas. However, neighboring countries are encouraged to reinforce their active surveillance and preparedness systems. Mass chemoprophylaxis is strongly discouraged, as it has no effect on the spread of cholera, can have adverse effects by increasing antimicrobial resistance and provides a false sense of security.
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