Ebola: Zim ill-prepared for deadly disease

WHILE government has tried to convince the public that it is on high alert following the Ebola outbreak that has wreaked havoc in West Africa, the state of the country’s major health facilities tells a different story.

Wongai Zhangazha

Although the government might have the theoretical knowledge of how to manage the epidemic, there is little to suggest that in terms of infrastructure, financial and human resources the country is equipped to handle the Ebola outbreak should it occur in the country.

Since the worst outbreak of Ebola in West Africa in March, which has killed more than 1 000 people in countries such as Liberia, Sierra Leone and Guinea, triggering an international public health emergency, government has not been pro-active in terms of awareness campaigns on relatively simple issues like the symptoms of the disease, how the virus is spread and how people can protect themselves.

Such information should be on noticeboards at the country’s major hospitals and other public places, but it appears to be business as usual.

Lest we forget that the country is not immune to the spread of diseases from beyond its borders as in 2009 when the deadly H1N1 influenza that originated in Asia was detected in the country and government health institutions had to hurriedly launch the H1N1 vaccination programme.

According to statistics provided by the World Health Organisation (WHO), the country experienced 1 538 suspected cases of the influenza, 253 probable and 41 confirmed cases between July and August 2009. The majority of the cases were among students in boarding schools. WHO says more than 18 000 people died from the influenza in more than 214 countries.

The government’s failure, for example, to deal with the cholera outbreak of 2008, which led to the death of 4 000 people, has raised questions over the country’s preparedness and ability to handle Ebola should it spread to Zimbawe.

Ebola is a virus that is described by WHO as one of the world’s most virulent diseases with a case fatality rate of up to 90%.

First identified in Africa in 1976, Ebola spreads from person to person through contact with organs and bodily fluids such as blood, saliva, urine and other secretions of infected people. Symptoms include weakness, fever, aches, diarrhea, vomiting and stomach pain.

Additional experiences include rashes, red eyes, chest pain, throat soreness, difficulty breathing or swallowing, external and internal bleeding. It has no known cure.

A visit to one of the country’s major hospitals, Parirenyatwa, showed a sorry state of affairs. The wards are dirty with visible drops of blood on the floor, the blankets look like they are in need of washing and long-slow-moving queues are the order of the day at the casualty ward.

Despite marginal improvement during the inclusive government between 2009 and 2013, the health delivery system is still under tremendous strain as hospital equipment breaks down frequently due to age, lack of maintenance and inadequate funding.

Most of the hospitals are said to be using obsolete medical machinery, with Harare Central Hospital’s X-rays and ultrasound scan machines down most of the time.
Senior researcher at Human Rights Watch Dewa Mavhinga said government might have the “know-how, but not the infrastructure, nor financial or human resources” to handle an Ebola outbreak.

Mavhinga said: “I think if there is political will, resources can be marshalled from the international community through donor agencies to bolster Zimbabwe’s preparedness to deal with Ebola.

In the case of cholera, one major shortcoming was lack of political will to acknowledge the health crisis and to deal with it.”

Dewa said he was, however, impressed with Zimbabwe’s screening processes at the Harare International Airport on Tuesday, where Health minister David Parirenyatwa was supervising health and immigration officials screening every person arriving at the airport.

“They checked each passport for stamps reflecting recent visits to West Africa and asking if you had been to West Africa in the last 21 days.

The process was thorough and caused a bit of delay, but it was impressive. Health officials who screened me said those found to have visited West Africa would be quarantined immediately for further screening and medical tests,” he said. “All the officials wore some protective clothing to handle our passports, that is, latex gloves. Seems to me it was serious, hope they do it at all borders until things are back to normal.”

While at Beitbridge Border Post, one of the busiest and most porous port of entry with the South African border, sources said there were health officials monitoring persons entering the country by checking their passports by Wednesday, but they were still waiting for equipment used in the testing of the Ebola virus.

Sadc ministers of health held an extraordinary meeting in South Africa last week to discuss appropriate strategic actions to prevent the introduction or spread of Ebola in the region.

Parirenyatwa said: “We met in South Africa last week to chart the way forward. We agreed that the Sadc region must fight Ebola and we realised that since the region is still free from it, the biggest preparation is monitoring our ports of entry.”

However, according to media reports, Zambia has banned travellers from countries hit by Ebola.

“Most of the people coming from West Africa enter the country through our international airports and so we have put health officials at the Harare International Airport, Joshua Nqabuko Nkomo Airport in Bulawayo and the Victoria Falls International Airport. They are monitoring and screening those coming from West Africa, particularly those from Liberia, Guinea and Sierra Leone,” Parirenyatwa said.

He said health officials have also been deployed at the Beitbridge and Chirundu border posts.

“Our infectious hospitals are well-equipped and a special ward has been created at Wilkins Hospital. Even those screening at the airports are wearing protective clothing.”

Douglas Gwatidzo of the Zimbabwe Association of Doctors for Human Rights said screening starts at all ports of entry as soon as news breaks out of a contagious disease in a foreign country.

“At these various ports of entry there are health officers whose duty is to check origins of all visitors including our own citizens who would have passed through a country known to be having the disease. There are checks and balances that take place and if anyone is coming from such a country, the person is placed on surveillance,” said Gwatidzo.

“They are interviewed and followed up for 21 days. If there are no symptoms, they are probably left alone. But if the person shows symptoms of the disease, they have to be placed in one of our infectious hospitals. In Harare we have the Wilkins and Beatrice that deal with infectious diseases. The staff is well-trained in any infectious disease.”

He said district hospitals also had sections where patients with infectious diseases are quarantined, but smaller district towns had no capacity.

Officials from the Health ministry this week said they had started training health personnel, some from Harare City Council on handling an Ebola outbreak.