Zimbabwe

Cholera: Govt or council to blame?

PEOPLE have been asking how it is even feasible that one can still die of a so-called medieval disease like cholera in the 21st Century in a supposedly modern city like Harare. The same Harare that is trying to vainly rebrand and position itself into a world-class city status by the year 2030. Harare has lofty ambitions to be spoken about in the same bracket as Vienna, Montreal, Sydney, London, Beijing, New York and other world class cities in a mere 12 years from now. Evidently, some slogans and mantras should be taken with a pinch of salt because they are just feel-good PC jingles which are not backed up by any serious intent. It’s obviously just another meaningless campaign to give the PR department something to do.

guest column: MIRIAM T MAJOME

Cholera is rightly called a medieval disease because it was prevalent in Europe and the Americas in the 19th Century. The advent of the industrial revolution led to the unprecedented population explosion in urban settlements. There was massive uncontrolled rural to urban migration, which resulted in more people living in towns and cities, something that had not been planned or designed to cope with the sudden influx of people. Like never before massive human populations began living together in very close proximity and sharing very limited rudimentary sanitary facilities.
Running water had not yet been invented or sewerage systems properly designed for urban settlements or proper sanitation and hygienic systems established. The overcrowded and cramped human settlements encouraged unhygienic conditions which provided fertile breeding ground for germs and germ carriers like rats and flies. The working class continued to flood towns and cities regardless of the lurking dangers to look for work and economic opportunities. Scant regard was paid to health, living conditions or sanitation so soon enough diseases like cholera, typhoid and other plagues developed and spread rapidly, killing rich and poor people indiscriminately. Germs could not and still cannot be confined to less affluent areas because flies and rats are equal opportunity vectors. Vermin does not care about social status and other such frivolous human vanities.

This is the only reason there is always such a high-level fuss when deadly infectious diseases strike within close human settlements. It is the only time you see kings and queens, high-ranking ministers, mayors and other very important people running around and working round the clock because they do not want to catch poor peoples’ bugs and die. Rich people never all of a sudden start caring for poor people without a selfish motive. The well-to-do are educated and know better than anyone else that flies and rats do not respect the invisible borders that separate the northern suburbs where they live and the southern suburbs where the rest of the population lives and is where poor peoples’ diseases like cholera and typhoid start. They know too well that when underground water is contaminated with fecal matter in Glen View it is only a matter of time before that poor water blends with their rich water in Umwinsidale. It was reported that the broken sewer pipes which had troubled Glen View residents for weeks on end were repaired within hours of the cholera scourge hitting the headlines. It took only an invisible microscopic germ called vibrio cholerae to get the attention of the important people in government and snap them into immediate action because they did not want their children catching a poor man’s disease. Even mounds of months of uncollected garbage around the city are disappearing like magic. As somebody correctly tweeted, cholera, indeed, is the best ever health services manager.

Politicians have been tripping over each other, dressed to the kilt in raincoats to visit cholera patients and grab photoshoots in order to score points of who the most compassionate and responsive is of them. One of the first public acts the newly appointed Minister of Health Obadiah Moyo did was to tour Glen View and Budiriro suburbs, which have been officially pinpointed as the areas of origin of the cholera bug. He minced no words when he laid the blame squarely on the City of Harare. He blamed Harare Municipality for having allowed the disease to develop by not attending to the broken sewer pipes and the raw sewage flowing freely in the streets. The newly-appointed Harare mayor councillor Herbert Gomba quickly returned the blame back to the sender. He blamed the central government, accusing it of refusing to provide the council with adequate finances to run the city’s affairs. Meanwhile, as the big fish fight among themselves as usual and shirk responsibility, the residents continue to die like fleas — victims of inept politicians who do not do their jobs as they should. But who has not been doing their job between the council and the minister? The cholera epidemic needs to be considered in its legal context and see what protection and remedies the law provides. Is there any legal recourse available when the authorities entrusted with ensuring public health are so remiss in their responsibilities and fail the public so irredeemably?

According to Part II Section 3 of the Public Health Act, Chapter 15;09, the Ministry of Health is the responsible authority for public health in the entire country. The Ministry of Health is charged with preventing and guarding against the introduction of disease from outside the country and the promotion of public health and the prevention, limitation or suppression of infectious and contagious diseases within Zimbabwe. It is the Ministry of Health that is squarely in charge of all public health matters. It is, therefore, correct to say that the Ministry of Health did not do its job and is to blame for the more than 4 000 people who died of cholera in 2008 and the 25 people who have died so far this year.

The Ministry may delegate its responsibility through the various structures of government and local government, but the buck stops with it so the minister has no leg to stand on to blame the councils. The Harare City’s failings are ultimately the Ministry of Health’s failings. It is not as if the council’s health department has its own health policy, which is independent and separate from the central government’s, if at all the government has any public health policy.

The ministry’s stated responsibilities in the Act are to advise and assist local authorities in regard to matters affecting public health and promote and conduct research and investigations in connection with the prevention or treatment of human diseases. The ministry also has to publish reports and statistics or other information relative to the public health and to administer the provisions of the Public Health Act.

Notwithstanding the provisions of the Act, the power tussles and political manoeuvring between the Zanu PF-controlled central government and the MDC Alliance-controlled urban councils are well known. For years, MDC-T councils have fought for power and control of their local budgets and operations with then Zanu PF Local Government ministers Ignatius Chombo and later with Saviour Kasukuwere. The fights were never for the benefit of the residents as the culmination of their long years of fighting since the year 2000 now clearly show. The result of their fights is the parlous state of the public health system which is completely neglected, underfunded and a total shambles. The roots are judged best by their fruits. All the years of Chombo and Kasukuwere fighting MDC-T councils have culminated in this present problem, which first manifested in 2008 and now in 2018. While the fighting for control of urban councils was happening, the Ministry of Health was fiddling and snoozing in blissful indifference. It has only been wakened from its slumber now by a microscopic bacterium which has the potential to wipe out half of Harare’s population within weeks.

 Miriam Tose Majome is a lawyer and teacher. She writes in her personal capacity and can be contacted on enquiries@legalpractitioners.org

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