Health round up

According to the 2011 National Health Statistics, diarrhoeal cases went up threefold to those recorded in 2010 to 228 936 cases and 110 deaths reported since the beginning of the year.
Harare remained the worst hit in the country. Water supplies in most parts of the capital continued to be interrupted leaving residents with no option but to turn to unprotected water sources. Subsequently cases of diarrhoea increased the burden on the national health delivery system particularly in urban centres.
According to the Harare City Council, the water cuts, a result of aging infrastructure, pipe leakages and demand meant the city fathers could not provide enough water to its residents. This was worsened by the current situation were demand already out-strips supply. But residents maintained that it is a matter of misplaced priorities, accusing the city fathers of paying themselves extraordinary salaries at the expense.
Harare council is mandated to supply potable water to more than four million residents in Harare and its metropolitan province, including Chitungwiza, Epworth, Ruwa, Hatcliffe and Norton. The demand for water stands at 1 200 megalitres a day with council supplying just above 600 megalitres daily.
“Poor sanitation, agents of these diseases – salmonella typhi (which causes typhoid), shigella dysenteriae (which causes dysentery), vibrion cholera (causes cholera) and rotavirus (causes diarrhoea) are now widely available in the environment where children play and families socialise,” said Health and Child Welfare Minister Dr Henry Madzorera.
He, however, said cholera cases in particular have gone down this year compared to cases recorded during outbreaks of 2009 and 2010 period. Since the beginning of the year, 1 119 suspected cholera cases, 320 confirmed and 45 deaths have been recorded down from about 100 000 suspected cases, 1 357 confirmed and 4 287 deaths recorded between 2009 and 2010.
Still on the dark patches of 2011, the HIV and AIDS sector was dealt a heavy blow following funding cuts by the Global Fund to Fight HIV and AIDS, Tuberculosis and Malaria and pulling out of major donors in response work. The Global Fund cancelled Round 11 of funding because donors failed to deliver previously committed funding.
This has forced the Global Fund to opt for a Transitional Funding Mechanism that will provide emergency relief to current recipients and will run out of money before 2014. But this will apply only to essential services such as HIV treatment, care and prevention.
For Zimbabwe, the crisis has been worsened by pulling out of other major donors in HIV and Aids work. These include expiring of the funding contracts of the Expanded Support Programme which has seen about 80 000 people living with HIV and AIDS being handed over to Government.
The Medecins Sans Frontieres (MSF) is also finalising the process of handing over a further 7 000 people living with HIV it initiated on ARVs to Government.
A challenge faced by the health sector for 2012 is coming up with homegrown solutions of funding other than relying on donor assistance. While the HIV and AIDS scenario calls for more effort from the health sector, there have also been concerns of increased deaths due to non-communicable diseases.
There is now a new realisation across the globe that the continent was putting more resources towards HIV and AIDS response work at the expense of non-communicable diseases. Resultantly, the burden of these diseases has increased across the continent and Zimbabwe included. Statistics showed that between 1990 and 1997 prevalence rates of hypertension increased from 1 000 to 4 000 and rates of diabetes increased from 150 to 550 per 100 000.
Specialist’s services in the health sector remain critical with fields such as midwifery and pathology still understaffed. Shortage of pathologists also affected the solving of mysterious deaths in the country and crimes. This saw among other delays, the identification of the remains of a child picked at the Harare Show Grounds in early November.
The family is waiting for the puzzle to be solved and hopefully bury the child they lost in August.
According to a midwifery conference held in South Africa recently, there is an urgent need to increase the number of people trained in midwifery to enhance Millennium Development Goals four. The MDG4 aims to reduce child mortality, and five, which is to improve maternal health, by ensuring a reduction of the maternal mortality rate to 98 by 2015
Despite these bad phases in the health sector in 2011, there were also positives worth noting. Generally, there has been improvement in service delivery compared to previous years. Some non-Governmental Organisations chipped in to attract professional Zimbabweans working in the diaspora back home.
Although there have been shortages of some anti retroviral drugs in some instances mainly due to logistical problems, drug availability has generally improved in Government institutions. As the campaign for accelerated reduction of maternal mortality roared into life, council clinics reduced maternity fees down from US$50 to US$25.
Women welcomed this move as a positive step towards reduction of maternal mortality as financial problems are a hindrance to accessing skilled attendance at delivery. Zimbabwe’s maternal mortality rates are unacceptably high with 725 deaths per 100 000 live births (maternal and perinatal mortality study, 2007).
In support of the campaign, Government also launched the Health Transitional Fund aimed at raising about US$436 000 in the next five years.