By Henoch Derbew
16 October 2009 [MEDIAGLOBAL]: As a result of severe shortages of vital services, Zimbabwe has become prone to the accelerated spread of diseases.
Last year, the scarcity of proper sanitation and safe water led to a cholera outbreak which, according to the World Health Organization (WHO), resulted in over 4,200 deaths from almost 100,000 suspected cases in all ten provinces.
In this environment, the emerging H1N1 pandemic, commonly known as swine flu, poses further serious risks both for Zimbabwe and its neighbors. Globally, there have been 375,000 confirmed cases of H1N1 and 4,500 deaths, including 8,000 confirmed cases and 46 deaths in Africa. In Zimbabwe alone, there have already been twelve confirmed cases and over 600 suspected which, WHO explained, may only be the “tip of the H1N1 pandemic iceberg” because these are the reported cases.
To take a proactive stance against a potentially large-scale H1N1 outbreak, WHO recently partnered with the Zimbabwean government and several other relief organizations to launch the Call to Action initiative. Through effective coordination, the initiative calls for a “key set of public health measures” to effectively combat the spread of disease. In this way, it hopes to effectively reach out to populations at increased risk, treat illnesses, and deliver vital services to reduce the spread of disease.
The Zimbabwean Ministry of Health and Child Welfare has been active in looking for cost-effective ways to guard against another outbreak like the one in 2008 and has been supportive of the initiative. This led to the 30 September signing of the Harare Declaration where Zimbabwe pledged to incorporate policy measures from the Call to Action into its national H1N1 plan, such as building capacity, strengthening partnerships, and taking effective, preventative measures.
Paul Garwood of WHO told MediaGlobal that ministries, as well as provincial medical directors and district public health specialists, are now coming together in “strong, cooperative, and effective” ways to more effectively combat H1N1. The initiative has thus proven to be an initial success, as health experts and leaders are taking the lessons learned from Call to Action meetings throughout Zimbabwe.
Garwood explained to MediaGlobal that through this and future initiatives, WHO hopes to target “countries where health systems are challenged or where humanitarian emergencies exist.” He added that though “H1N1 has reached pandemic proportions…the measures advocated in Call to Action can also be applied to many communicable disease and public health threats, not just H1N1 alone.”
As the danger from the virus crossing national borders is a regional issue, neighboring developing countries are encouraged to support the process in Zimbabwe and implement similar domestic initiatives.
The Call to Action initiative will serve as an example to similarly resource- and capacity-constrained developing countries hoping to strengthen their public health systems.
Zimbabwe’s fragile public health system is still recovering from the cholera outbreak and remains under intense economic hardships, including hyperinflation. In addition to budgetary concerns, political uncertainty presents difficulties for the government to receive aid, which will add problems to acquiring the US $12 million that WHO estimates Zimbabwe will need to effectively battle H1N1.
Call to Action plans to stop the transmission of the H1N1 into rural areas where services and health education are limited. To address the lack of education on the disease in the countryside, the national plan has therefore called for a public health awareness campaign, which is being conducted through various partners. The partners include grass-roots organizations that are teaching citizens how to correctly identify the disease and avoid misdiagnoses that can lead to even larger problems.
Although constructing viable public health systems in developing countries like Zimbabwe is a long-term goal, progress is already being made through Call to Action. As of now, 265,000 doses of the H1N1 vaccine are expected by December.
Garwood told MediaGlobal, “Although considered developmental and therefore largely ignored by the humanitarian response, this support makes initiatives more sustainable, creates ownership, and encourages the health system to use its own structures to manage public health challenges.”
