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Andile Tshuma

Climate change is driving increasingly extreme and unpredictable weather. Bulawayo can be very cold today, and we could be experiencing a blistering heat wave tomorrow.  

As the world reels from the aftermath of a cyclone that cut across a number of countries in the Southern African region, killing hundreds and displacing thousands, with hundreds of people still not accounted for, spare a thought for the victims of Cyclone Idai. May the souls of the departed rest in peace and may the survivors find comfort and all the necessary support and assistance they need from their communities and government.

Tropical cyclones are among the most destructive natural phenomena. The impact from cyclones extends over a wide area, with strong winds and heavy rains. However, the greatest damage to life and property is not from the wind, but from secondary events such as storm surges, flooding and landslides. After this people are met with the reality of a once familiar environment now scattered and characterised by massive destruction. The displacement of large numbers of people and the flooding triggered by Cyclone Idai significantly increases the risk of malaria, typhoid and cholera.

In an emotional telephone interview yesterday, Director of Epidemiology and Disease Control Dr Portia Manangazira shared how the Ministry of Health and Child Care was working tirelessly to ensure that victims of Cyclone Idai on special medication get uninterrupted supply of their required drugs. “The situation on the ground is dire. We are working flat out to ensure that people get all the assistance they require. We have special groups of people who need uninterrupted special medication. People on anti retroviral treatment, diabetes, high blood pressure, sexual and reproductive health medication should get uninterrupted supply of their drugs. These places have been inaccessible but we have been finding ways of getting emergency supplies to the ground,” said Dr Manangazira.

She said government doctors, Médecins Sans Frontières (MSF/Reporters without Borders) were working to ensure availability of medical services. “We are working with a lot of our partners that are helping to ensure that the help gets done. The CPU is still rescuing people and a number of them come with injuries so we are tasked with treating those casualties.   Due to flooding there is no clean water available so UNICEF under the Water, Sanitation and Hygiene programme and ZINWA are bringing in clean water to the area. Temporary treatment centres have been put in place,” said Dr Manangazira.

During the week, the ministry toured NatPharm in Harare and in Mutare to establish the availability of drugs. Dr Manangazira said some supplies have since been procured and availed for use at ground zero.

She said there was a risk of water borne and vector borne diseases at the area although the ministry was still conducting a number of assessments. “Such natural disasters come with acute public health challenges. Medication has been sent down but we are carrying out intense surveillance for common diarrhoea, typhoid, dysentery, cholera and vector borne diseases such as malaria. With flooding and so much water around, there are high risks of such therefore we are on high alert,” she said.

Dr Manangazira said Government appreciated the assistance that is coming in from partners, particularly in the health sector.

“While we are mourning, we need to try by all means to save the living, the injured. There is so much trauma and due to adverse weather conditions, there is a high risk of pneumonia as for most people all clothes are wet and there is no source of warmth. Hypothermia (lower than normal body temperature) is also a high risk in this situation,” she said.

According to research, the increase in infectious disease transmission and outbreaks after  tropical cyclones could be associated with the prolonged after-effects, which include displaced people, environment changes, increasing vector breeding sites, high exposure, poor water and sanitation conditions, poor personal hygiene and limited access to healthcare service.

Tropical cyclones can lead to heavy precipitation and floods. The water distribution network and sanitation facilities in affected areas can be heavily damaged, leading to contaminated drinking water.

Poor sanitation conditions play an important role in the transmission of infectious diseases. In addition, in affected areas where the devastation of infrastructure was profound, medical services could be damaged beyond functionality, leading to limited capacity to identify and/or treat patients resulting in the spread of infectious diseases. A better understanding of what infectious diseases could be affected by cyclones may assist local health sector in responding to potential outbreaks and allocating health resources in public health emergencies.

Various health institutions must be commended for providing urgent assistance to meet the health needs of thousands of people impacted by flooding in Malawi, Mozambique and Zimbabwe. 

The United Nations Office for the Coordination of Humanitarian Affairs estimates that a total of 1.6 million people have been affected by Cyclone Idai. Given the disruption of health services, the World Health organisation (WHO) and its partners are supporting all three affected countries in ramping up the health response to the disaster.

Deployed over the weekend, an initial surge team of WHO experts is working with the three health ministries and other partners to target support where it is needed most. WHO has already dispatched medicines for injuries and primary health care (including malaria treatment) to the affected countries. The supplies cover the primary health care needs for 10 000 people for three months, including treatment for severely injured persons. With most of the affected populations now housed in temporary shelter centres, the emergency supplies are providing support to outreach clinics and to better manage potential outbreaks of waterborne diseases, among others in those centres.

Search and rescue missions are ongoing in Zimbabwe and affected neighbouring countries. In Malawi, 922 000 people have been affected, with 82 700 people displaced, 577 injuries and 56 deaths. The cyclone also stormed through Chimanimani District in Zimbabwe, causing over 100 deaths and displacing between 8 000 and 9 600 people.

Displaced women, among them pregnant women, have lost critical health supplies including ante-natal care records, iron supplements and ARVs, which have been washed away with their belongings in flooding across two provinces. Women and girls from more than 2 500 households in eight districts in Manicaland and Masvingo provinces are in need of humanitarian assistance and critical sexual reproductive health services.

The floods have destroyed infrastructure and property. Access to health facilities and schools remains difficult in eight districts. The hardest hit district of Chimanimani remains inaccessible due to heavy rains and strong winds causing damage to roads, while the main access bridges have been washed away. Limited access has been gained by Zimbabwe’s Defence Force and private helicopters, which are transferring critical patients to two hospitals within the province, as well as delivering food and essential medicines. A joint inter-sectoral rapid needs assessment is ongoing in Chimanimani, Chipinge, Mutare, Nyanga and Buhera to determine the level of damage and to map the appropriate humanitarian response for the affected communities.

Humanitarian partners have pre-positioned non-food and food items in at-risk provinces, which are ready to be dispatched. These include temporary shelters, water sanitation and health (WASH), non-food items, child protection-related supplies, family planning resource kits and food.

The love, support and unity shown by Zimbabweans at this time is commended. Donations from across the countries have been mobilised and these will go a long way in helping victims of the cyclone.