Bureaucracy prevents importation of cholera drugs

By Tichaona Sibanda
6 November 2008

Doctors Without Borders, an international medical humanitarian organization, has deployed its staff into Zimbabwe to help fight the cholera epidemic, an MDC MP disclosed on Thursday.
Willas Madzimure, MDC MP for Kambuzuma in Harare, said the organization has brought in badly needed facilities, such as special beds for cholera victims and gloves for medical personnel. But the organization is still waiting to get the green light from government to import oral rehydration salts and drugs to deal with the disease.
The doctors provide aid in nearly 60 countries, to people whose survival is threatened by violence, neglect, or catastrophe, because of armed conflict, epidemics, malnutrition, exclusion from health care, or natural disasters.
The Zimbabwe Drugs Control Council, which regulates the importation and registration of all drugs into the country, has up to now, almost a month after the outbreak of the disease, still to make a decision on the request by Doctors Without Borders to fly in drugs to treat cholera.
‘We need the government to declare this a health disaster so that international aid organizations can bring in medicines without much hassle. As it is Doctors Without Borders have been waiting since their arrival to try and get the medicines into the country,’ Madzimure said.

The legislator said years of bad governance have taken a serious toll on the country’s social services and outbreaks of the waterborne disease are just one of the consequences of underinvestment in everything from roads, to health clinics, to clean water.

MDC MPs, led by Madzimure, went on tour of health facilities handling cholera cases in the capital. He said all the parliamentarians were shocked by the gravity of the situation, and blamed the regime for underestimating the figures. Over 100 people are now believed to have died countrywide since last month.
‘All the facilities we visited in the city were full with children, women and men suffering from cholera. We are deeply disturbed by the government’s failure to react swiftly to the outbreak of the disease,’ he said.
In a late, and partial response to the crisis, the central bank announced on Wednesday that it had provided R8,7 million, plus Z$374 quadrillion and vehicles and fuel for the Zimbabwe National Water Authority, to try to bring the cholera outbreak under control. The bank said the foreign currency had been paid over the past two weeks to import water treatment chemicals, while the local currency was released on Wednesday to repair and install pumps and other equipment that have affected water supply in recent months.
Oliver Mudyarabikwa, a medical health expert, said if not treated immediately cholera could become fatal. In the most severe cases, the quick loss of huge amounts of body fluids leads to death within two to three hours.

In less severe cases people can still die of shock and dehydration 18 to 48 hours after the first symptoms of cholera appear. Cholera is a bacterial infection, mostly transmitted through the consumption of contaminated water.

Outbreaks can occur in any part of the country where water supplies, sanitation, food safety and hygiene practices are inadequate. Overpopulated communities, usually in high density suburbs with poor sanitation and unsafe drinking water supplies, are most frequently affected.

Although cholera can be life-threatening, it’s easily prevented and treated. Successful treatment requires the replacement of fluids and salts lost through diarrhoea.
Mudyarabikwa said depending on the condition of the patient, a pre-packed mixture of sugar and salts can be mixed with water and drunk in large quantities.

If the patient is too weak to drink, fluids can be given intravenously. Although antibiotics may shorten the duration of the symptoms, they’re not as important as rehydration.

Meanwhile, twenty people from Mupandawana growth point in Gutu district, Masvingo have contracted rabies after being bitten by dogs infected by the deadly disease.

Masvingo provincial medical director Dr Robert Mudyiradima said they would investigate the origins of the disease and start working closely with the Department of Veterinary Services to put down all infected dogs.

No fatalities have been reported so far, but there are fears some of the
infected people might be in danger because of a shortage of anti-rabies
vaccines at nearby health centres and hospitals.

Reports say the outbreak has hit areas such as Gona, Mushayavanhu and Makuvaza on the outskirts of Mupandawana. Jackals prowling villages in search of food are believed to have infected dogs in the area.

The district’s health referral centre, Gutu Mission Hospital, and other health centres have run out of anti-rabies vaccines in their stocks.