WHO Says Better Monitoring of Cholera Needed in Zimbabwe

By Lisa Schlein
Geneva
20 December 2008


The World Health Organization says it hopes to have a surveillance system in place soon that can accurately track cholera cases as they occur in Zimbabwe. WHO says it is difficult to know which parts of the country most need help in treating and containing the epidemic without accurate monitoring. 

The United Nations reports cholera in Zimbabwe has claimed more than 1,100 lives and more than 20,000, people have become infected with this deadly disease.

But, the World Health Organization warns cholera cases could soar to 60,000 if urgent action to contain the disease is not taken. In fact, WHO says it is likely there already are more cases than the official figures indicate.

Coordinator of WHO's Disease Control in Emergencies, Dr. Dominique Legros, has just returned from Zimbabwe.   He was there to help set up the United Nations Command and Control Center for the Control of the Cholera outbreak.

He says the UN hopes to have a surveillance system in place in a few days. He says this is absolutely crucial in monitoring the course of the epidemic.

"We are setting up with implementing partners, a system of daily reporting of cases," said Dr. Legros. "We got clearance from the government to get these figures from the periphery to the central level through contact persons in the CTC's [Central Treatment Centers] and CTU's [Central Treatment Units] in the main cities and the main towns so that we have immediate, if you wish, updates and alerts for new outbreaks occurring in different places."  

Dr. Legros calls this absolutely critical. Until now, he says, the surveillance system has been too slow for health workers to respond to emergencies.  

While in Zimbabwe, Dr. Legros was part of a WHO delegation that visited two cholera treatment centers in the capital, Harare-the Budiriro Cholera Treatment Center and the Beatrice Road Infectious Diseases Clinic.

Approximately half of the cases have been recorded in Budiriro, a heavily populated suburb on the western outskirts of Harare. Other major concentrations of cholera cases have been reported along the borders with South Africa and Mozambique.

Dr. Legros says the quality of health care has to improve if lives are to be saved. Unfortunately, he says the health facilities are in terrible shape.

"The staff was basically not going to work because of the lack of salary or too small salary with regard to the expenses," said Dr. Legros. "I have seen hospitals, which were basically empty, like sort of ghost hospitals because no material, no staff, etc. But, some staff resumed working for the cholera outbreak and I have staff from the government working in the CTC's and CTU's, cholera treatment units, cholera treatment centers."  

Dr. Legros says efforts must be made to quickly fix the discrepancy in salaries between government workers, who are badly paid and staff working for non-government organizations, who command higher salaries. He says this would act as an incentive to get health care workers back on the job.