Tag Archives: World Health Organization

Ghana/Senegal: research project on safe wastewater reuse for urban poor concludes

The WHO/IDRC/FAO research project on non-treatment options for safe wastewater use in poor urban communities was concluded on 30 April 2010. The report of the final workshop in Amman, Jordan (7-10 March 2010) has now been published.

The objective of the project was to test the applicability of the third edition of the WHO Guidelines for the Safe Use of Wastewater, Excreta and Greywater in Agriculture and Aquaculture (WHO, 2006). For this purpose the following four field studies were conducted:

  • Ghana Kumasi: Evaluation of non-treatment options for maximizing public health benefits of WHO guidelines governing the use of wastewater in urban vegetable production in Ghana.
  • Ghana/Tamale: Minimizing health risks from using excreta and grey water by poor urban and peri-urban farmers in the Tamale municipality, Ghana.
  • Jordan: Safe use of greywater for agriculture in Jerash Refugee Camp: focus on technical, institutional and managerial aspects of non-treatment options.
  • Senegal: Proposition d’étude en vue de l’intégration et de l’application des normes de la réutilization des eaux usées et excréta dans l’agriculture.

The research team is now working on the final product, a Guidance Document/Manual for Sanitation Safety Plans  to assist national and municipal authorities and other usersof the WHO guidelines in their application.

Project documents and the 2006 WHO guidelines are available on the WHO web page on Safe use of wastewater, excreta and greywater.

Zimbabwe: did the United Nations ignore the 2008 cholera outbreak to please Harare?

A U.N. official claims his warnings of a catastrophic cholera outbreak were stifled by a U.N. bureaucracy intent on keeping good relations with Zimbabwe’s dictator, Robert Mugabe.

Georges Tadonki, the former head of the Zimbabwe branch of the U.N. Office for the Coordination of Humanitarian Affairs (OCHA), was fired at the height of the cholera crisis in early January 2009 — in part, he says, because of the warnings he raised. He has appealed his termination, and his case opened before a U.N. dispute tribunal in Nairobi, Kenya, on 23 February 2010. International lawyer Robert Amsterdam, famous for defending the Russian political prisoner Mikhail Khodorkovsky, is Mr. Tadonki’s pro-bono legal counsel.

Between August 2008 and July 2009, about 98,600 people contracted cholera and more than 4,000 died. In April 2008, months before the initial outbreak exploded into a full-blown epidemic, Tadonki says he warned his superiors of the severe risk. But U.N. country director Agostinho Zacarias stifled that warning, Tadonki claims.

Tadonki claims that Zacarias forced him to significantly lower the initial prediction of cholera cases from 30,000 to 2,000 in the UN funding appeal launched in November 2008. “Because the government did not accept that there was cholera, the United Nations was forced to align with that position.” Both a high-level official from the opposition Movement for Democratic Change (MDC) who worked on the humanitarian response and Ed Schenkenberg van Mierop of the International Council of Voluntary Agencies (ICVA), confirmed that Tadonki had warned of a catastrophic outbreak.

Although some facts are in dispute, Tadonki’s story highlights the perils of U.N. engagement in authoritarian states such as Zimbabwe.

In response to the claim that the figures in the November 2008 UN appeal document had been manipulated, OCHA’s Deputy Spokesman told Inner City Press that “the prediction of 2,000 was realistic when it was made”, comparing it to the previous cholera outbreak in 2002, when 3,125 people were infected and 192 died.

Some U.N. officials contested Tadonki’s allegations, including a former U.N. agency head who told Foreign Policy that “the actual size of the cholera outbreak was larger than anyone (including Tadonki) had forecasted.” And some claimed Tadonki’s clash with Zacarias was due to poor performance, which is cited in U.N. internal reports as the reason for his firing, not his efforts to sound the alarm.

There are also conflicting reports about the response of the World Health Organization (WHO), which lead the health response. WHO representative in Harare, Custodia Mandlhate, told Foreign Policy that she, Zacarias, and the country head of UNICEF had finally “decided to go and see the minister of health … and convinced him to declare cholera an emergency.”

Schenkenberg, however, said that WHO “didn’t have its first meeting [to begin coordinating operations] until the first week of December” — after the government had already declared the cholera emergency. Nor had Zacarias pushed the WHO to do so, according to Schenkenberg.

Commenting on the Tadonki case, Wall Street Journal columnist Marian L. Tupy reminds us that “the crisis started when the Mugabe government nationalized Zimbabwe’s water supply in 2005 but soon ran out of money to maintain the infrastructure and treat the water [...]. In 2008 the government shut down the water supply altogether, reducing the people in the urban areas to scavenge for water in ponds and sewers. Since the Zimbabwean health-care system collapsed along with the rest of the economy, the U.N. effectively became responsible for providing the necessary aid to tackle the emerging health crisis”.

Source: Elizabeth Dickinson, Foreign Policy, 22 Feb 2010 ; Matthew Russell Lee, Inner City Press, 25 Feb 2010 ; Marian L. Tupy, Wall Street Journal, 22 Feb 2010

Zimbabwe, Harare: WHO provides water treatment chemicals

Harare City Council [has] received water treatment chemicals worth US$450 000 from the World Health Organisation with the UN agency pledging to attend to Harare’s water and sewer infrastructure. The chemicals , [which] are enough to treat water for a month [...] were bought with funds provided by the African Development Bank. The AfDB has made available a grant of US$1 million for cholera mitigation programmes, [not only for chemicals, but also for] tents, medicines, protective clothes and training activities.

[WHO country representative Dr Custodia Mandlhate] said the threat of cholera was still there and there was need to remain prepared for any outbreaks through the purchase of treatment chemicals, drugs and equipment, as well as training in social mobilisation. Dr Mandlhate said provision of water treatment chemicals alone would not solve the problem, hence there was need to attend to the city’s water and sewer infrastructure.

Source: The Herald / allAfrica.com, 15 Jun 2009

Zimbabwe: Worst-case cholera scenario getting worse

Zimbabwe’s worst-case cholera scenario, as predicted by the World Health Organization (WHO), is likely to be surpassed within a few weeks and there are still about two months of the rainy season left.

In December 2008 the WHO said cholera cases could balloon to 60,000 before the rainy season ended in March 2009, but Gregory Härtl, spokesman for the organisation’s Epidemic and Pandemic Alert and Response office in Geneva, told IRIN that as of 25 January, 53,306 cholera cases and 2,872 deaths had been recorded since the outbreak began in August 2008 [by 28 January the death cholera death toll in Zimbabwe had climbed to 3,028] .

Cholera, an easily treatable waterborne disease, thrives in poor sanitary conditions and is expected to remain a feature until Zimbabwe’s rainy season subsides.

The Herald, a state-owned daily newspaper, trumpeted in its 26 January edition that cholera was on the “retreat” in the capital, Harare. [...] However, Härtl said the conditions causing Zimbabwe’s cholera outbreak remained in place. “The systemic underinvestment in water and sanitation infrastructure and the health system … These conditions will not change overnight.”

Source: IRIN, 26 Jan 2009

To make matters worse, a report by SW Radio Africa stated that the International Red Cross has warned it could be forced to suspend its cholera-relief activities in the coming weeks, because of a critical lack of funding.

The US-based International medical rights organisation, Physicians for Human Rights (PHR), have labelled Zimbabwe’s health crisis a ‘crime’ that should be the subject of an investigation by the International Criminal Court. In a report titled ‘Health in Ruins – a man made disaster in Zimbabwe’ – PHR details the spread of the cholera epidemic and outlines the implications the collapse of the healthcare system has on victims of human rights violations. The report’s preface, which is signed by South African Archbishop Desmond Tutu, former UN High Commissioner for Human Rights Mary Robinson and Richard Goldstone, a former chief prosecutor at the International Criminal Tribunal for Rwanda, reads: “These findings add to the growing evidence that Robert Mugabe and his regime may well be guilty of crimes against humanity.”

One overlooked effect of the cholera epidemic, mentioned by Dr Douglas Gwatidzo, chairman of the Zimbabwe Association of Doctors for Human Rights, earlier in December 2008, was that it was diverting attention away from Zimbabwe’s HIV/AIDS crisis which claims the lives of more than 400 adults every day. People living with HIV are also particularly vulnerable to cholera because their immune systems are weakened and they have more difficulty recovering.

Regular updates and background information on the cholera epidemic can be found on the UN OCHA Zimababwe web page.


Malawi: rains expose poor sanitation

Malawi is [...] battling a cholera outbreak which has killed 19 people [in Lilongwe] since the onset of the rainy season, an unusually high death toll. Up to 485 cases of the epidemic have since been registered and treated. World Health Organisation records from the 2007/2008 rainy season indicate not even a single cholera case was registered in the country’s capital, Lilongwe, last year, although up to 20 deaths and 1,022 cases were documented in nine of Malawi’s 27 districts.

[...] The country’s health experts have attributed the [cholera] problem to lack of safe water combined with poor sanitation and poor hygiene. [...] “We encounter cholera outbreaks almost every rainy season when people who have little or no access to safe water resort to using untreated water from swamps,” [Malawi's principal secretary for health Chris] Kang’ombe told IPS.

[...] A task force comprising the Ministry of Health, United Nations Children’s Fund – (UNICEF), World Health Organization (WHO) and United Kingdom’s Department For International Development (DFID) is currently working to promote civic education on hygiene and chlorination of water sources in the country to control further cholera outbreaks.

Source: Pilirani Semu-Banda, IPS, 23 Jan 2009

Zimbabwe: Nigel’s Story – the tragedy of country’s cholera outbreak

[Nigel Chigudu lost] five siblings in five hours to the cholera epidemic that has been sweeping across Zimbabwe. “They started vomiting and had serious diarrhoea,” recalls Nigel, 15. “The youngest, Gamu, was 14 months old, and Lameck was 12 years old. It was in the middle of the night; I could not take them anywhere. I just watched them die. “Two days later, my grandmother also passed away,” he adds.

Nigel lives in Budiriro Township, Harare, the epicentre of Zimbabwe’s latest cholera outbreak. [B]urst sewage pipes have left puddles and a permanent stench while months of uncollected refuse litter the streets. Filthy conditions like these have prompted UNICEF to make an international appeal for help to control the epidemic, which is spread by contaminated water.

[...] UNICEF has provided hundreds of thousands of water treatment tablets with a capacity to treat and purify water in more than 3 million households. It has also distributed thousands of oral rehydration salts, IV fluids and drips to treat diarrhoeal dehydration, as well as washing soap and buckets. In addition, UNICEF is trucking safe drinking water and mounting community-based water tanks in cholera-affected communities. There is also a drive to intensify hygiene education and health promotion.

[...] UNICEF has embarked on a $17 million emergency programme for the next 120 days. This programme will fund medicines for 70 per cent of the population; scale up community-based therapeutic feeding; carry out outreach immunization services, and provide incentives for teachers and nurses to return to work.

Listen to a UNICEF podcast about Nigel Chigudu here.

Source: Tsitsi Singizi, UNICEF, 19 Dec 2008

On 18 December 2008, there were 1123 registered deaths and 20896 suspected cases of cholera in Zimbabwe (OCHA Daily Cholera Report, 2008-12-18). Medecins Sans Frontieres (MSF), predicts that the cholera epidemic in Zimbabwe will last well into 2009. Manuel Lopez, the head of MSF in the country, told the BBC the epidemic was still at a critical level and would not subside until the rains end in March. (BBC, 21 Dec 2008).

The outbreak could surpass 60,000 cases, according to an estimate by the Zimbabwe Health Cluster, which is a group coordinated by World Health Organization (WHO) and comprising health providers, nongovernmental organizations and the Ministry of Health and Child Welfare (MoHCW). The estimate is based on six million people, or half of Zimbabwe’s 12 million population, potentially being at risk of contracting cholera, with an estimated 1% of those at risk of actually suffering from cholera. (WHO, 10 Dec 2008)

Angola: third national de-worming campaign in schools launched

Over the next month, primary school children in all of Angola’s 18 provinces will receive de-worming tablets as part of a national campaign that is now in its third year. The campaign aims to ensure that the country’s children have better health for better learning.

Parasitic infections, or intestinal worms, can lead to malnutrition, anaemia and slow cognitive development.

In Angola, the school de-worming campaign is led by the Ministries of Health and Education, with support from UNICEF and the World Health Organization. It is part of a broader programme to promote health in Angolan schools; this effort includes the provision of water and latrines, the establishment of hygiene education and health and hygiene clubs, and a school feeding programme.

Read more: Lone Hvass, UNICEF, 24 Sep 2008