2009: Zimbabwe Case Study : Cholera Prevention in Mutare
Most countries in Africa will fall short of meeting the MDG targets for the provision of water and sanitation due to lack of financial and institutional capacity (WSP-Africa, 2006). Although safe sanitation has been found to be the most effective single intervention in reducing diarrhoea (Esrey, et al.1991), this does not necessarily mean the building of latrines, as these can become a fly breeding ground if they are not sealed properly, and further compound the spread of diarrhoea. The faecal-oral route can be broken much more easily and a lot more cost-effectively through faecal burial and hand washing with soap (Curtis & Cairncross, 2003). After more than a decade of pilot projects in many countries in Africa the Community Health Club (CHC) Approach can reasonably predict behaviour change, and ensure zero open defecation and handwashing with soap. By creating a strong demand for safe sanitation and a ‘Culture of Health’ that insures good hygiene (Waterkeyn & Cairncross, 2005) Community Health Clubs can become a potent mobilisation strategy in emergencies not only in rural areas but, as this case study shows, in urban areas as well. During the cholera outbreak that affected 12,700 people and claimed 420 lives in Zimbabwe, the a high density suburb of Sakubva, in Mutare, only had 4 cases and no deaths. This has been attributed to an environmental clean-up and improved the hygiene behaviour due to the efforts of 5,400 members in 36 Community Health Clubs.