Diarrhoea: We all have a role to play

Thursday, 09 February 2012 00:00

Paidamoyo Chipunza Health Reporter It is half curled with a runny and grainy mustard texture protruding from the sides of the soiled diaper which was ravished by stray dogs. Huge green flies usually associated with human excreta fly from one pamper to another and sometimes cross sand lines to dine with humans. Yes, they know no etiquette, the uninvited guests popularly referred to as "green bombers" cross over boundaries, finding themselves at the dinner table well before everyone. Still ahead of us, the "green bombers" stir their taste buds with a bit of every dish prepared for the banquet in the process contaminating our food with bacteria they have picked up on the roadside. "Mothers should also play their part by washing off baby poo from diapers before disposing them into bins or bury them in their backyards," said 38-year old Mrs Marvelous Munemo of Glen View. "It is just not right to see soiled diapers thrown everywhere. We should also play our part by creating environmental conditions that we are conducive to live in." Mrs Munemo said with diarrhoeal diseases raging, issues of public health should must take centre stage and everyone should play their part in mitigating these now recurrent outbreaks. According to statistics from the Ministry of Health and Child Welfare, an average of about 2 000 cases of diarrhoeal diseases including typhoid, cholera and dysentery were recorded per week in November 2009, and the cases shoot up to 8 000 cases per week around the same period in 2011. "The likelihood that people ingest faecally infected food or water, or both is very high," public health expert Dr Portia Manangazira said. Dr Manangazira, who is also the director of epidemiological and disease control in the Ministry of Health, said the situation was compounded by poor hygienic practices that are found in areas where water is scarce. "In most of our urban locations, the coverage of safe water and sanitation on average ranges from zero to only 50 percent and these conditions prevail today, and this has resulted in massive outbreaks of diseases that were rare in the past. "During my five years of training in medicine, I only saw one case of typhoid, and managed none during my 10 years of clinical work spanning central, provincial and district hospital levels," she said. Dr Manangazira said buzzwords "reduce" and "recycle" should be embraced at all levels in refuse disposal. Citing the example of Bulawayo City Council, where residents had mini-dumps to keep refuse till refuse trucks could pick it to the proper dumpsite, Dr Manangazira added that this was not being done in Harare. Because of inadequate water supplies people are also resorting to the bush system to relieve themselves. "In the absence of flushing toilets we now have flying toilets' in the suburbs whereby newspapers or plastics containing faecal material has been found at some garbage heaps," she said. According to the Harare City Council, the majority of boreholes and wells in the city were sunk without expert advice on citing and some have since been found to be unsafe for human consumption. Community Working Group on Health (CWGH) executive director Mr Itai Rusike said

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Diarrhoea: We all have a role to play

Thursday, 09 February 2012 00:00

environmental conditions underline many of the common health problems in Zimbabwe. "Local government earmarked revenue for waste collection should not be reallocated to other spending. Routine waste collection, water treatment services and more reliable provisioning need to be improved as a public health priority," Mr Rusike said. There was need to develop and implement an effective and appropriate approach to Primary Health Care (PHC) where key health messages are disseminated and tackled at community level. "Urban communities are more mixed and less cohesive, urban health knowledge is often lower than rural on key aspects of health, and practices such as waste disposal or food storage. This needs to be effectively addressed at individual and community level," said Mr Rusike. Village health workers and environmental technicians have a big role to play in enhancing health literacy programmes especially on endemic diseases. "Health Centre Committees (HCCs) identify the priority health problems in communities, plan how to raise their own resources, organise and manage community contributions, and tap available resources for community health activities. "The HCC is the mechanism by which people can become involved in health service planning at local level," he said. Health and Child Welfare Minister Dr Henry Madzorera called for concerted efforts in mobilising resources to refurbish the water, sanitation and sewerage infrastructure as a matter of urgency to put a stop on the outbreaks. He said: "There remains a critical need to deal with the underlying causes of these recurrent outbreaks of water- borne diseases." Dr Madzorera said while his ministry collaborated with responsible authorities to come up with lasting solutions, people should also take it upon themselves to practise hygiene at all times. He said the ministry is in the process of constituting the National Emergency Operations Centre (NEOC) to better co-ordinate the response to future outbreaks. He said the NEOC would be housed at Kaguvi Building. World Health Organisation representative Dr Custodia Mandlhate said her organisation recommended that Government adopted the Cholera Command and Control Centre (C4), which was instituted in 2008 at the height of the cholera outbreak. "The C4 is still very effective and is competent in the management of all disease outbreaks. It has worked very well for us during the cholera outbreak (between 2008 and 2009), with HIN1 (also known as swine flu). The same approach has also worked very well for other countries like Haiti," Dr Mandlhate said. According to a report jointly done by the United Nations Children's Fund and WHO, an estimated 2,5 billion people lack improved sanitation facilities and nearly one billion people do not have access to safe drinking water the world over. The report, titled "Diarrhoea, why children are still dying and what can be done", says children are at greater risk of life threatening dehydration because water constitutes a greater proportion of children's body weight. "Young children use more water over the course of a day given their higher metabolic rates and their kidneys are less able to conserve water compared to older children and adults," reads part of the report. The report notes that improving unsanitary environments alone is not enough unless children's nutritional status has also been improved. Apart from water, sanitation and hygiene, the report recommends adequate nutrition, exclusive

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Thursday, 09 February 2012 00:00

breastfeeding for the first six months, micronutrient supplementation and adhering to immunisation schedules as prevention strategies.

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