Direct Relief Medical Advisor Conducts Assessment in Zimbabwe

Aid proving invaluable amid cholera outbreak and health system crisis

February 26, 2009 

Dr. Mike Marks, Direct Relief’s Medical Advisor for Africa, recently visited Zimbabwe to assess response to the health system crisis and cholera outbreak that has now affected 80,000 people. Meeting with in-country partners, Dr. Marks found that Direct Relief’s emergency aid, including $2.2 million (wholesale) worth of antibiotics to treat cholera, have proven invaluable.

Donated by GlaxoSmithKline, the antibiotics have been used to treat cholera patients in and around Harare, the capital city. An emergency aid consignment of medical supplies and pharmaceuticals valued at more than $2.6 million (wholesale) has helped support patient care at Harare Central Hospital. The total aid sent to Zimbabwe since December tops $5.87 million, with Music For Relief generously contributing $28,000 to cover emergency airfreight costs of critically needed medicines for cholera patients.

With the health system faltering amid extreme inflation and an interrupted national supply chain to government-run facilities, donated pharmaceuticals, equipment, and supplies help keep facilities open. Relying on these donations, Harare Central Hospital has remained open on a limited basis during the health crisis. An ongoing-aid shipment to United Methodist Hospital will provide a range of needed supplies and materials, from wound-care and surgical supplies to wheelchairs and autoclaves.

Though almost 4,000 people have died during the epidemic, “cholera doesn’t have to be fatal,” explains Dr. Marks.

A bacterial infection, cholera causes severe vomiting and diarrhea and can lead to fatal dehydration. Cholera spreads through sewage-contaminated water and food, and in Zimbabwe, the outbreak followed the collapse of the public water, sanitation, and garbage collection systems. Seasonal rains, open drains, burst sewage pipes, and a shortage of purification chemicals such as chlorine contributed to the rapid spread of the disease. Even if aware of the threat of unsafe water, many households in Zimbabwe cannot boil their drinking water due to the high cost and limited supply of fuel.

Left untreated, cholera can be fatal, killing quickly following the onset of symptoms. That’s why immediate medical aid is crucial. “We react early and deliver what’s needed at the time,” says Dr. Marks, “which makes the world of difference.”

During his tour, Dr. Marks visited the Howard Hospital about an hour's drive to the north of Harare. The busy mission hospital run by the Salvation Army provides free health care to more than 140,000 patients a year. Because the hospital does not depend on the national supply chain, Dr. Marks found its pharmacy to be well stocked with donated medicines compared to government-run facilities, whose shelves were bare.

One of eight shipments Direct Relief has sent since December, a consignment of IV sets, pediatric nutritionals and oral rehydration solutions sent mid-January will be particularly valuable for treating young cholera patients, who are vulnerable to the infection.

Zimbabwe: GlaxoSmithKline Donates $2.2 Million in Medicines to Address Health Crisis
December 18, 2008 

In response to the deepening health crisis in Zimbabwe, GlaxoSmithKline (GSK) has allocated $2.2 million worth of specifically requested antibiotics to Direct Relief International’s efforts in the country.

The donation of six antibiotics will support Harare Central Hospital, one of the largest health facilities in the country’s capital. Supply shortages and staff issues in the face of skyrocketing inflation had forced the hospital to limit its services, which have come back on line.

Direct Relief has supported clinical efforts at the hospital for several years, including the provision of a surgical suite at the facility that, among other services, delivers 16,000 babies a year.

GSK’s donated antibiotics--including Augmentin, Ceftin, and Bactroban cream--will extend Harare Central Hospital’s capacity to treat patients for a variety of infections. Specifically requested by Mr. Julius B. Nderere, the hospital’s chief executive and pharmacist, these medicines have been identified as most critically needed in this emergency response.

Because inflation has rendered salaries too low to pay for transportation to work, Mr. Nderere hired seven buses to ferry nurses and staff to and from the hospital.

 “We are grateful to GSK for this generous donation, which will provide critical aid at a critical time in Zimbabwe,” said Thomas Tighe, Direct Relief’s president and CEO.  Since 1997, GlaxoSmithKline has provided more than $37 million in donated products to Direct Relief.

Conditions in Zimbabwe present massive challenges to the country’s health system, exacerbated by a cholera outbreak that has reportedly moved into the rural areas outside Harare.

In addition to previous emergency aid delivered to Zimbabwe, Direct Relief last week provided medical aid to treat 10,000 cholera patients, and provides ongoing support to hospices in the country.

Direct Relief Commits Aid to Treat 10,000 Cholera Patients in Zimbabwe

Latest provision supplements $1.3 million (wholesale) in medicines and supplies already deployed

As the cholera outbreak in Zimbabwe escalates, Direct Relief International has committed additional emergency aid to help treat the waterborne disease in 10,000 patients. The medicines and supplies supplement $1.3 million (wholesale) in medical aid already deployed in response to the health crisis.

Direct Relief is sending to Harare Central Hospital the antibiotic doxycycline; CeraLyte oral rehydration solution (ORS), and water purification tablets to treat 50,000 liters of water and 60 wells. Clean water is critical for cholera patients’ full rehydration and helps prevent the disease’s spread. The World Health Organization reports that 16,700 people in Zimbabwe are currently infected, and the disease has the potential to spread to 60,000. Cholera has killed 792 people in Zimbabwe since August.

Cholera causes extreme vomiting and diarrhea, which can lead to fatal dehydration. Antibiotics, ORS, and clean water are critical to patient treatment. Direct Relief is able to provide these critical materials to help fight the cholera outbreak in Zimbabwe thanks to generous donations by Abbott, BD, Cera Products Inc., and Johnson & Johnson.

Direct Relief has established a fund specifically for relief efforts in Zimbabwe. Donor support will first replenish resources tapped in November to provide aid as the crisis became apparent. Civil unrest, rampant inflation, and the cholera outbreak have put an extraordinary strain on Zimbabwe’s healthcare system.

Since November, Direct Relief has provided $1.3 million (wholesale) in medicines and supplies to support hospice partners caring for patients too weak to visit the hospital and to help Harare Central Hospital resume care in the wake of extreme resource shortages in Zimbabwe.

Cholera Outbreak Dire as Health System Crashes in Zimbabwe

Direct Relief sending $1.3 million in medical aid to trusted partners responding to crisis.

A devastating cholera outbreak has killed 589 people with 14,000 more in Zimbabwe infected as drastic shortages of medicines and supplies have closed hospitals in Harare, the capital. The World Health Organization is now estimating that cholera could affect 60,000 Zimbabweans. Direct Relief International has airlifted humanitarian medical aid and is following up with ocean shipments in response to this crisis.

Requested medicines and supplies valued at more than $1.3 million (wholesale) have been sent to trusted partners in Zimbabwe: Harare Central Hospital, Island Hospice, Seke Rural Hospice, and United Methodist Church Health Systems. Contents include antibiotics, IV fluids and drip sets, wound-care materials, and other critically needed medical supplies.

An airlift of almost $430,000 (wholesale) in supplies and medicines will provide Harare Central Hospital medical personnel with the materials they need to resume treating patients. The second wave of aid includes an ocean container carrying almost 31,680 IV sets and other medical supplies. Cholera causes life-threatening diarrhea and can be treated with antibiotics. A lack of clean water and broken sanitation systems exacerbates the spread of the disease, which thrives in contaminated water.

A donation of antibiotics valued at $256,663 (wholesale) has been airlifted directly to our Hospice partners in Zimbabwe from the United Kingdom donor’s facilities to expedite delivery, with a second valued at $418,568 sent from Direct Relief's inventory. Direct Relief has supported hospices in Zimbabwe since 2006. Island Hospice and Seke Rural Hospice care for terminally ill patients in and around Harare. Their programs include training for volunteers who provide home-based care to thousands of patients who are too sick or too poor to visit the hospital. United Methodist Church Health Systems, a member of our longtime affiliate the Foundation for Hospices in Sub-Saharan Africa, operates 15 health facilities in remote regions of Zimbabwe. Thanks to these trusted relationships, logistics of delivering medical aid can be carefully managed.

Medicines are out of reach of most people in Zimbabwe, which now has the world’s highest inflation at a whopping 231 million percent. Ongoing civil strife, broken sanitation systems, a drastic lack of clean water, and an economic collapse have combined to devastating effect.

Stocks of medicines and supplies are so depleted and salaries are so low that doctors, nurses, and hospital staff have gone on strike in protest. Hyperinflation is so high that nurses can’t afford transportation to work.
 
Once considered the breadbasket of Africa, Zimbabwe is now suffering a major food shortage, and 45 percent of its population is malnourished. Life expectancy is about 43 years; it has one of the world’s highest rates of HIV/AIDS infection. Direct Relief has provided critical antiretroviral therapy drugs for HIV/AIDS patients in Zimbabwe since 2007.

Direct Relief continues to monitor the health situation in Zimbabwe and is directing emergency response efforts based on partner needs and requests for specific medicines and materials.