CONCERNS have been raised over the deteriorating state of Mpilo Hospital which is in dire straits with one malfunctioning radiotherapy machine and no accommodation for patients awaiting treatment.
Mpilo is the biggest referral hospital servicing Bulawayo and some parts of Matabeleland and according to senators is taking a strain.
Bulawayo senator, Linda Sibanda said the radiotherapy which has been malfunctioning for four years is disadvantageous to cancer patients.
“The radiotherapy machine at Mpilo Hospital has not been functional since August 2020, which is four years back. When you are doing radiation there, you are given about 23 sessions to do using a radiotherapy machine.
“I had to undergo therapy there and I think I only did 17 sessions and the machine broke down. Up to now, the machine has not been working. We have got so many people suffering from different cancers in Zimbabwe and Mpilo Hospital is one of the biggest referral hospitals. Now, it is four years since the machine broke down,” said Sibanda.
The situation at Mpilo Hospital is a reflection of the state of public healthcare institutions in the country which are buckling under maladministration and lack of proper funding.
Zimbabwe’s health sector has been under strain with hospitals understaffed and lack of medical sundries.
Lilian Mlilo concurred with Sibanda adding that patients at Mpilo Hospital are sleeping on the floor as a result of inadequate accommodation.
“My question has already been asked as part of a question, but I am going to talk about Mpilo Hospital as a referral hospital.
“Looking at the whole of Matabeleland, particularly considering the population and the huge traffic of people who go to Mpilo, what plans has the Minister in terms of assisting people so that they get accommodation instead of sleeping on the floor,” said Mlilo.
The World Health Organisation has set a target of 60% coverage of childhood cancers by the year 2030 and Zimbabwe is still lagging at 20%
Stakeholders in the healthcare sector have decried the late presentation of childhood cancer cases saying that it was a derailing efforts to fight the disease.
The World Health Organisation set a target of 60% coverage of childhood cancers by the year 2030 and Zimbabwe is still lagging at 20%.
Speaking on the sidelines of the Husqvarna Kidzcan Mud Run fundraising event on Saturday last week, cancer care nurse Charity Kawadza said they were making efforts to ensure that the survival rate of childhood cancer patients increases.
“Zimbabwe is a country which has been designated in the low to medium income countries catergory, which means our survival rate is about 20%.
“We want to raise the survival rate as high as possible. If we can get as high as 60%, which is being advocated for by World Health Organisation by the year 2030,” she said.
Kawadza said as a result of the aim to eliminate childhood cancers they had come up with a home for patients where they are given support and shelter as they undergo treatment processes.
“The other part we’ve added recently, which is a year old, is the home, what we call a halfway home. It is called Rainbow Children’s Village.
“It’s under three partners, KidzaCan, Meikles Foundation and Roundtable. Patients who come to stay with us at the village are those who are in between treatment.
“They would have already started treatment and they need a small break, but they cannot go home, which is maybe too far, so we house them until they get to their next appointment.
“We are giving drugs, giving all the support, but the element of treatment adherence is also very important. The number one cancer for children in Zimbabwe is leukemia, which is a blood cancer,” she said.
Mud Run founder Grant Mitchell said they were raising funds for KidzCan, adding that the organisation was doing a great job in the fight against childhood cancers.
“This is the 12th consecutive year. We didn’t stop through COVID. We were able to keep the event going through the years of COVID, obviously under the watchful eye of the SRC and the ministry,” Mitchell said.
The Ministry of Health and Child Care (MoHCC) has reported a total of 1,588 confirmed cases and five fatalities of malaria within a single week.
According to the Disease Surveillance Report for the week concluding on March 24, 2024, the MoHCC highlighted that among the reported cases, 140 affected children were under the age of five.
The report outlined specific locations of the fatalities, notably including Centenary district (1) and Mt Darwin district (1) within Mash Central province, district (2) in Masvingo province, and Mpilo Central Hospital in Bulawayo province.
Mashonaland Central province documented the highest number of cases at 901, followed by Manicaland province with 243 cases.
These statistics contribute to a cumulative total of 10,957 malaria cases and 15 fatalities nationwide.
Malaria, an infectious disease transmitted by mosquitoes, continues to pose a significant health threat, particularly in sub-Saharan Africa.
Given Zimbabwe’s warm and humid climate, the nation remains especially vulnerable to malaria outbreaks, particularly during the rainy season.
In other health-related news, this week witnessed the reporting of 525 cases of dog bites, with no recorded fatalities.
Among these incidents, 131 individuals were bitten by vaccinated dogs, 190 by unvaccinated dogs, and 204 by dogs with an unknown vaccination status, as outlined by the ministry in a public notice.
HEALTH and Child Care minister Douglas Mombeshora has admitted that the brain drain has left the health sector on its knees, denying patients access to primary medical attention.
Mombeshora revealed this in Parliament this week, while responding to written submissions made by legislators on the state of the health sector in the country.
He said the ministry is struggling to fill vacant posts.
“The Ministry of Health and Child Care is currently facing challenges with inadequate numbers of staff,” he said.
“This has been exacerbated by the cholera outbreak and building of new facilities which have increased the burden on the staffing levels at institutions across the country.”
“The Health Service Commission continues to engage with the Treasury, seeking creation of new posts to enable the ministry to adequately staff both the existing and new health institutions.”
The health sector has been hard-hit by a mass exodus of doctors, nurses and other experienced personnel protesting poor salaries and working conditions.
Most of the health professionals have left for the United Kingdom in recent years, with estimates putting the figure at over 3 000 since 2022.
In 2018, Vice-President Constantino Chiwenga grabbed international headlines after firing over 15 000 striking nurses.
He was forced to reverse the decision a few days later.
Chiwenga was accused of using “military-style tactics” to intimidate health workers from downing tools.
During his time, the ministry announced plans to ban doctors and nurses from striking for more than three days under proposed amendments to the Health Services Act.
Under the changes, worker representatives charged for inciting nurses and doctors to embark on strike action deemed illegal faced jail terms.
“If we can convince people to partake in prayers, then surely we can convince them to change their mindsets regarding these diseases.”
MUTARE, Zimbabwe – A traditional healer since 1985, Casemore Darare is all too familiar with medicinal herbs. His services are highly sought after in his neighbourhood of Dora Dombo, a rural area on the outskirts of Mutare city.
But regarding cholera or polio, the 54-year-old has a robust solution: he encourages his community and faith members to strictly get vaccinated, maintain good hygiene, and seek modern medicines at the local clinic when symptoms show.
Casemore Darare, a traditional healer, addresses a meeting of interfaith leaders held in Mutare to discuss cholera mitigation measures
“That’s the most effective solution. There is nothing better, trust me,” he said to loud cheers from participants at a March meeting to develop community-led solutions to address the behavioural and social drivers of cholera and polio.
Darare, the provincial secretary of the Zimbabwe National Traditional Healers Association for Manicaland Province, speaks from experience.
A recent outbreak of cholera that struck him forced Darare to change his thinking about how best to tackle the disease.
After showing symptoms of cholera, Darare said he resorted to what he knew best – traditional medicine.
“I dug up all the herbs I thought could help and mixed some concoctions. I did all the spiritual things I thought would ease my condition. It only got worse,” he said.
Eventually, neighbours put him in a wheelbarrow and rushed him to the nearest clinic, where he received medication from nurses.
“I survived to tell the story. Many people who tried the traditional herbs and spiritual ways were not so fortunate,” said Darare, who enrolled in essential community health training after the ordeal.
Darare is still a traditional healer. But he has also taken up another task of becoming a community champion to encourage people to rely on modern medicines, safe water, sanitation, and hygiene practices to fight diseases such as cholera and polio.
He also encourages fellow traditional healers in his area to immediately refer cholera patients to a medical facility for treatment.
In March, Darare was among the interfaith leaders who gathered in Mutare city to collaborate on how best to fight cholera and polio.
Organised by Apostolic Women Empowerment Trust (AWET)and supported by UNICEF, the gathering brought together traditional healers, leaders of various Christian denominations, and the Muslim faith to collaborate and devise ways to use their influence to drive behaviour change.
Despite their different spiritual doctrines, they agreed on one overarching message of promoting the uptake of vaccines and other modern medicines and practices to combat cholera and polio.
“Cholera and polio do not discriminate. They affect all of us the same. So, we must work together to deliver the message to the people we lead. Some behaviours must change, and we should lead that campaign,” said Sheik Ishmail Duwa, president of the Supreme Council of Islamic Affairs in Zimbabwe.
The meeting timing was critical as the country grapples with the twin outbreaks of cholera and polio, often affecting poor sanitation and hygiene areas.
The meeting also came as Zimbabwe prepared to roll out a second round of mass polio vaccination of children aged ten years and below following a successful first round of polio vaccinations targeting 4.6 million children.
Leaders of apostolic sects present at the meeting pledged to campaign amongst their members to allow children to get vaccinated and for people to embrace modern medicines.
The desire among the interfaith leaders to work together was palpable during the meeting.
They sometimes broke into various small interfaith groups to discuss the causes of cholera and polio, the main drivers, such as open gatherings with no sanitation and hygiene and traditional funeral rites, and how best to address the situation.
Interfaith leaders recently in Mutare to discuss cholera mitigation measures
A Roman Catholic sister stood beside a female traditional healer and Muslim youth leader in one group. A Pentecostal pastor took notes on a flip chart as they engaged in rigorous debate to develop a common position.
Representatives of the groups then presented their findings to a plenary before drawing up a joint action plan that put vaccination, modern medicines and safe water, sanitation, and hygiene practices at the centre of the fight against cholera and polio.
“This kind of interfaith dialogue helps build trust. By learning from each other, we remove the barriers that stop us from collaborating. Cholera and polio don’t need us to follow the old ways of doing things; we must be dynamic and assist the authorities,” said Brian Nemakanga, a leader with the hugely popular Johanne Marange Mafararikwa apostolic sect.
Belinda Magida, a traditional healer, added, “Together, we can influence millions of people in all the hard-to-reach places where we have followers. If we can convince people to partake in prayers and believe in God, we can surely convince them to change their mindsets regarding these diseases. Let’s take the information to the people; let’s positively use our influence. It is a duty we owe to the nation as responsible leaders. Education is key, and knowledge is power.”
UNICEF and WHO, in collaboration with the Ministry of Health and Child Care and funded by the Government of Japan, the multi-donor Health Resilient Fund (comprising contributions from the UK Government, Irish Aid, European Union, and Gavi), and with implementation support from the Apostolic Women Empowerment Trust (AWET), are jointly spearheading diverse Risk Communication and Community Engagement (RCCE) initiatives to address multi-hazards, encompassing efforts against polio and cholera outbreaks.
MORE than 40 percent of TB patients do not know their status in Zimbabwe as the country continues its fight against the disease which remains a threat even in other parts of the world.
Zimbabwe is still part of the 30 high burden countries and drug-resistant TB remains a threat to achieving set goals towards eradicating the disease.
The Union TB Trust executive director Dr Ronald Ncube said partnerships with the Ministry of Health and Child Care had resulted in the training of community workers who played a key role in screening TB countrywide.
He said to date there were 1 000 community health workers who are going around communities mobilizing members of the public to get screened and also referring anyone with symptoms to clinics for early treatment.
“As Union Zimbabwe Trust we have different programmes like Kunda Nqobi TB that have been implemented after we got US$15 million to help the Ministry in the fight against TB. We wish to extend our gratitude to community health workers as we have a network of almost 1000 workers who educate communities, refer those with symptoms to clinics and do much of mobilizing to ensure everyone knows about the disease,” said Dr Ncube.
“As a country, we have yearly targets that we set in line with WHO and in 2022 it was estimated that we have over 30 000 people with TB, but we managed to find over 18 000 and we need to screen and put them into treatment. This means we have another 15 000 or so people yet to be screened and put on treatment which means work must be done in our communities to ensure everyone with TB starts treatment.”
The Community Working Group on Health director Mr Itai Rusike said although TB is one of the world’s leading Infectious disease killers, Zimbabwe has the lifesaving tools to prevent, diagnose, and treat TB.
He said breaking down barriers and inequities that cause millions of people to suffer and die from TB every year will help the country continue posting more wins in the fight.
“Inequity is the biggest barrier to ending TB, often those living in poverty or with environmental risk factors, can face catastrophic costs to access diagnosis and treatment. Scaling up progress in the fight against TB is crucial to win the battle against this disease. We must bring focused testing, treatment and care services to the people who most need them,” he said.
“When we fight TB, we fight other deadly diseases and prepare for the next pandemic. The same lab workers, diagnostic machines, supply chains, primary health care facilities, disease surveillance capabilities, and community health workers that fight TB prepare the world for future health threats.”
Zimbabwean health authorities have urged parents to vaccinate their children against polio.
This comes after two healthy children tested positive for the virus in a routine environmental surveillance.
The World Health Organization (WHO) and the Ministry of Health and Child Care said that the children who are below five years old, did not show any signs or symptoms of polio.
In an interview, WHO Polio Eradication Initiative co-ordinator,Sadiq Umar said the two polio positive children could still infect others who are not immunized.
“This is evidence that we must do a campaign to make sure other children are not affected,” said Umar.
Umar said the environmental samples were taken from a sewer system near the children’s houses and tested positive for polio type 2, which was eradicated globally in 2015.
He said the virus was likely a result of vaccine-derived polio, which occurs when the weakened virus used in oral polio vaccines mutates and regains the ability to cause disease.
Umar emphasized the urgent need to launch a comprehensive vaccination campaign to protect other children from falling victim to vaccine-derived polio.
He stressed that if infected children come into contact with those who have low vaccine uptake or remain unvaccinated, there is a significant risk of paralysis development in the latter group.
According to WHO, approximately 90 per cent of children infected with polio will not display any signs or symptoms. Only 10 per cent will experience paralysis and other related symptoms.
However, even children who test positive for polio without exhibiting symptoms can reduce the shedding of the virus over time through natural processes and a robust immune response.
However, children with compromised immune systems due to conditions such as HIV, cancer, or malnutrition are at a higher risk of paralysis.
Furthermore, Umar stressed the essentiality of vaccinating even children already paralyzed by polio. He highlighted a specific case in Sanyati where a child was paralyzed by polio type 2.
“It is crucial to protect against other polio types as well. The child in question had only received one dose of the vaccine throughout their life, emphasising the ongoing need for vaccination,” he said.
Polio is an extremely infectious disease caused by a virus that invades the nervous system, potentially resulting in complete paralysis within a matter of hours.
The virus primarily spreads through person-to-person contact, often through contaminated water or food. Initial symptoms include fever, fatigue, headache, vomiting, stiffness of the neck, and pain in the limbs.
Approximately 1 in 200 infections lead to irreversible paralysis, with 5-10% of paralyzed individuals succumbing to the disease when their breathing muscles become immobilized.
Umar also said there is a polio vaccination campaign currently running in Zimbabwe, and urged the public to vaccinate their children.
“Vaccination is the only way to stop polio and protect children from this crippling disease,” he said.
To avoid complacency and cholera outbreak recurrence, Community Health Promoters encourage safe water, sanitation and hygiene practices
Chitungwiza, Zimbabwe – Many people in Chitungwiza town’s St Mary’s suburb have received the cholera vaccine, in large part thanks to mobilisation efforts by community health promoters such as Ellen Nhambura.
But, even as infections show signs of receding, Nhambura and her team are still moving from house to house to keep people safe.
“We managed to get people to accept the vaccine despite pockets of resistance. Our mission is to teach them to continue practising healthy behaviour after getting vaccinated. The vaccination period is a critical moment because people may relapse into thinking that the vaccine is a replacement for safe and healthy behaviour,” said the 39-year-old who has been a community health promoter for three years.
The Ministry of Health and Child Care, in partnership with UNICEF and the World Health Organisation (WHO), launched a vaccination campaign against cholera on January 29.
The campaign targeted 2.3 million people.
According to the Ministry of Health and Child Care, 2,099,497 people had been inoculated as of February 20, 2024, which signals broad acceptance of the Oral Cholera Vaccine and the success of the campaign.
But vaccination is only part of the response by the government and its partners such as UNICEF.
At the vaccination campaign’s launch, Health and Child Care minister Dr Douglas Mombeshora and UNICEF country representative Dr Tajudeen Oyewale warned against post-vaccination complacency.
They emphasised that while vaccines work, they are not a replacement for safe water, sanitation and hygiene practices that are key to eradicating conditions that cause cholera.
Social and behaviour change campaigns driven by health promoters underpin the efforts to adequately prevent a recurrence of waterborne disease outbreaks.
This involves health promoters such as Nhambura fanning out across communities to raise awareness for people to change their attitudes towards water, sanitation and hygiene issues and share knowledge on effective practices to keep cholera at bay.
On a recent day, Nhambura joined about a dozen other health promoters to traverse the length and breadth of St Mary’s, one of the suburbs affected by the cholera outbreak.
One used a loud hailer to broadcast messages.
They carried and distributed leaflets on the streets and stopped at vegetable markets, shopping centres and bus termini to discuss water, sanitation and hygiene practices necessary to prevent the spread of cholera.
In one street, a group of women and men trooped out of their houses with their children to interact with Nhambura’s team.
Because the area lacks reliable running water, the health promoters emphasised the need for residents to fetch water from safe sources, keep it in clean containers and treat it with water purification tablets or by boiling it before drinking.
Residents listened attentively and asked questions as Nhambura used a flip chart with messages and illustrations on water treatment and storage, toilet and household hygiene, safe food handling, refuse management, oral rehydration and the importance of seeking treatment early.
“I know you are vaccinated, but for a permanent solution, please do these things we are teaching each other here,” said Nhambura, going through pages of the flip chart laden with colourful images of water, sanitation, and hygiene.
Paidamoyo Mhandu (27), one of the residents, said she ensured she and her three-year-old daughter were vaccinated when mobile vaccination teams moved around the area.
She said witnessing some fellow residents falling sick or dying from the disease, as well as the encouragement from health promoters, motivated her to get inoculated.
“But I was no longer treating our drinking water; I thought it was no longer necessary since we had been vaccinated. These health promoters opened my eyes,” she said, reading a flier on cholera prevention.
Community Health Promoters are a vital cog in the health delivery system because of their interpersonal links with communities, said Gertrude Zhakata, the Sister-in-Charge at the St Mary’s Cholera Treatment Centre, where two tents provided by UNICEF have ten beds each to cater for cholera patients.
“These campaigns would not be successful without the assistance of community health promoters. They are the people on the ground; they live within the communities they serve; so, people trust their word. They are a vital bridge between us and the people,” said Zhakata.
She said the health promoters undergo regular refresher courses to keep them updated on disease surveillance and control trends.
The dedication to saving lives beyond the vaccination campaign is palpable as Nhambura and her team move around the suburb wearing sun hats or carrying umbrellas to shield themselves from the searing heat.
She is part of a team of 25 community health promoters who collaborate with the Ministry of Health and Child Care and Oxfam, a partner of UNICEF in Chitungwiza.
They usually leave their homes around 8am to make rounds in the suburbs.
They often return home late in the afternoon after walking between 10 and 15 kilometres and reaching about 200 households daily.
“Yes, it seems like a tough job. But we are a dedicated group, and we know the importance of this work, especially for women and children, because they are the most vulnerable. We do our best to help them stay safe,” said Nhambura.
According to authorities, the door-to-door campaigns have reached over 300,000 people in Chitungwiza town alone.
In Chitungwiza, like other areas across the country, community health promoters are part of a wider more comprehensive social behaviour change campaign that includes radio programmes, road shows, water point committee training and the establishment and promotion of school health clubs.
UNICEF’s cholera response is funded by multiple donors, including the Centres for Disease Control and Prevention (CDC); the European Civil Protection and Humanitarian Aid Operations (ECHO); the Health Resilience Fund (HRF), a Zimbabwean pooled fund supported by the Governments of Ireland, the United Kingdom, the European Union, and GAVI, the Vaccine Alliance; Japan; the UN Central Emergency Response Fund (CERF) and UNICEF Global Humanitarian Funding, and with in-kind support from private sector partners such as Alliance Media & JCDecaux for digital billboards, and Cash-In-Kind logistics support for commodities from United Parcel Service (UPS) Foundation.
Zimbabwe began an emergency campaign to inoculate more than 4 million children against polio on Tuesday after health authorities detected three cases caused by the rare mutation of the weakened virus used in oral vaccines, including a 10-year-old girl who was paralysed in January.
The health ministry said laboratory tests from samples collected from sewage sites in several areas of the capital, Harare, late last year showed the presence of a mutated polio virus that originated in an oral vaccine used in the global eradication effort.
In rare instances, the live polio virus in vaccines can mutate into a form capable of sparking new outbreaks, especially in places with poor sanitation and low vaccination levels.
The number of polio cases globally has dropped by more than 99% since the global effort to wipe out the disease led by the World Health Organization and others began in 1988.
But the majority of children being paralyzed by polio these days are being crippled by a virus that was originally linked to a vaccine.
Vaccination teams in Zimbabwe are moving from house to house to deliver more doses to protect children, while others will be stationed at health facilities, authorities said.
Officials said it was the first time Zimbabwe would be using a new oral polio vaccine specifically designed to reduce the risk of the virus within it mutating into a dangerous form.
Zimbabwe aims to roll out more than 10 million new vaccine doses targeting just over 4 million children below the age of 10 in two rounds in February and March.
More than 95% of that population needs to be immunised against polio to stop new outbreaks.
Last year, the wild polio virus caused a dozen cases in Afghanistan and Pakistan, the only countries that still have that virus.
In comparison, polio viruses linked to the vaccine caused more than 500 cases in nearly two dozen countries globally, mostly in Africa.
Zimbabwe last reported a wild polio virus case in 1986, according to the United Nations children’s agency.
Zimbabwe Health Minister Douglas Mombeshora called the new detection of polio “a serious concern” but said they were prepared to respond swiftly.
The health ministry said it was collaborating with health authorities in at least five other African countries that had recently detected polio viruses through environmental sampling and routine surveillance.
Polio can cause total paralysis, and children under 5 are especially vulnerable.
It is transmitted from person to person, mainly through contact with contaminated faeces, water or food, as well as through droplets from a sneeze or cough of an infected person.
Zimbabwe detected seventeen (17) circulating vaccine derived polio virus type 2 (cVDPV2) from environmental samples in Harare since October 2023. The samples were from four polio environmental surveillance sites in Harare.
Polio outbreak was declared a public health emergency (PHE) by the Minister of Health and Child Care in October 2023.
An index human cVDPV2 was reported in a 10-year-old female AFP case in January 2024.
Two newly confirmed AFP cases (samples from contacts) have been reported this week (cumulative 23) with a NPAFP rate at 1.3 per cent children over 15 years.
A total of 10,517,500 doses of nOPV2 were received on 29 January 2024 for the planned two supplementary immunization activities (SIAs). Expiry date 14/08/2025.
A joint press release on Round 1 national nOPV2 polio SIA done by the Honorable Deputy Minister of Health and Child Care (MoHCC) with UNICEF, WHO and Partners on 16 Feb 2024.
Situation Overview & Humanitarian Needs
Zimbabwe last reported a case of indigenous wild polio virus (WPV) in 1986 and had been certified polio free in 2005.
Following the detection of WPV1 in Mozambique and Malawi, in 2022, Zimbabwe also undertook the multi-country supplementary immunization activities (SIAs) with bOPV2 and managed to conduct four rounds of SIA.
In 2023, Zimbabwe detected seventeen circulating vaccine derived polio virus type 2 (cVDPV2) from environmental samples in Harare since October 2023.
The samples were from the 4 polio environmental surveillance sites in Harare.
Two newly confirmed AFP cases (samples from contacts) have been reported this week (cumulative 23) with a NPAFP rate at 1.3 per cent children >15 years.
The cVDPV2 outbreak was declared a public health emergency by the Minister of Health and Childcare (MOHCC) in October 2023.
Polio outbreak response activities commenced with plans to conduct two supplementary immunization activities (SIAs) using novel oral polio vaccine type 2 (nOPV2) starting 20 February 2024.
The risk of poliovirus spreading within the country and neighboring countries remains high.
Special considerations need to be made in the polio outbreak response for special populations who include vaccine hesitant religious groups who are densely populated in Manicaland (Buhera, Mutasa and Mutare districts), populations in refugee camps (Tongogara in Manicaland and Waterfalls transit camp in Harare), populations along borders, cross border traders, artisanal miners, and populations in emerging peri urban settlements in Harare.
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