CRUMBLING WATER INFRASTRUCTURE RAISES CHOLERA RISKS

C O N F I D E N T I A L SECTION 01 OF 03 HARARE 000919 AID SIPDIS AF/S FOR B. WALCH DRL FOR N. WILETT ADDIS ABABA FOR USAU ADDIS ABABA FOR ACSS STATE PASS TO USAID FOR E. LOKEN AND L. DOBBINS STATE PASS TO NSC FOR SENIOR AFRICA DIRECTOR B. PITTMAN E.O. 12958: DECL: 10/14/2018 TAGS: PGOV PREL ASEC PHUM SOCI ZI SUBJECT: CRUMBLING WATER INFRASTRUCTURE RAISES CHOLERA RISKS REF: HARARE 0009 Classified By: Charge d'Affaires, a.i. Katherine Dhanani for reason 1.4 (d) -------------- SUMMARY -------------- ¶1. (SBU) The supply and quality of water throughout Zimbabwe has continued to rapidly deteriorate since last November's assessment by the Water, Sanitation, and Hygiene (WASH) advisor from USAID's Office of U.S. Foreign Disaster Assistance (USAID/OFDA) (reftel). This is a result of a combination of factors including a lack of water treatment chemicals, reduced water flows due to the crumbling reticulation system, and a paucity of funds, accountability, and leadership at the parastatal water utility. It has led to a severe cholera outbreak in a town near Harare, as well as heightened cholera and diarrheal disease risks throughout the country. Most alarming is the lack of water at nearly all of the health clinics in Zimbabwe, which underscores the woeful inability of the GOZ to deal with the problem. END SUMMARY. -------------- Cholera Outbreak in Chitungwiza -------------- ¶2. (SBU) There is an ongoing outbreak of cholera in Chitungwiza, a high-density town about 10 kilometers south of Harare, which has claimed the lives of 15 Zimbabweans. WASH cluster coordinator and UNICEF representative Ben Henson told us on October 8 that the 15 fatalities were out of 138 documented cases in Chitungwiza, representing a fatality rate of aboQ 11 percent. As a comparison, the World Health Organization defines a one percent fatality rate as the trigger to classify a disease outbreak as an emergency. According to Henson, UNICEF targets an optimal response window of 72 hours following the identification of an outbreak. However, the Ministry of Health and Child Welfare did not inform UNICEF about the cholera outbreak for a full two weeks, resulting in needless additional deaths. Henson also suspected that the actual number of fatalities was higher that 15, as there were a handful of undocumented deaths in the area. Despite no recent diagnosed cholera fatalities, the crisis is not yet over as the number of cholera cases arriving at clinics in Chitungwiza rose from two or three the first week of October, to between three and six last week. The most immediate concern is that all of the clinics in Chitungwiza and most of the clinics throughout the country are without water. ¶3. (SBU) UNICEF, Oxfam, and MSF-Holland have been working with the City Health Department to coordinate a response to the Chitungwiza outbreak. USAID partner Population Services International (PSI) urgently stocked retail outlets, clinics, and treatment centers with Aquatab water treatment pills, while USAID-funded Oxfam worked on communication, advocacy and awareness with the local council. Also, six new boreholes are being drilled to supplement trucked water supplies. -------------- Other Emerging Hotspots -------------- ¶4. (SBU) Chitungwiza is not the only cholera risk site, as UNICEF just reported seven possible cases of cholera in the Kariba district. The German NGO Agro Action was directed to HARARE 00000919 002 OF 003 the region by the WASH cluster coordinator and is bringing in cholera treatment supplies. We were also told by UNICEF that they may have identified an additional cholera outbreak in the town of Chinhoyi, 100 kilometers to the west of Harare. Chinhoyi has been experiencing severe water shortages, and the local schools and the provincial hospital in Chinhoyi are dry. -------------- ZINWA Not Up to the Job -------------- ¶5. (SBU) Since the Zimbabwe National Water Authority (ZINWA) assumed control of municipal water services from town councils, the parastatal has largely proven itself incapable of providing potable water to the Zimbabwean population. Henson estimates that ZINWA is running at 40 percent of capacity, and because of leaks, only 60 percent of this makes it to faucets. Consequently, ZINWA is only delivering at 24 percent capacity. ¶6. (SBU) Harare has suffered considerably as ZINWA has stopped treating water at the Morton Jaffray Water Treatment Plant because of a lack of treatment chemicals. Currently, most parts of the capital--with the exception of the central business district and certain wealthy suburbs--do not have water. As a result, even prominent institutions such as the University of Zimbabwe have been forced to close their doors. According to an unusually candid article in the government-run daily newspaper, the Herald, trucking company Border Transport and Unifreight halted chemical shipments to ZINWA because the parastatal collectively owed the companies for prior shipments. Additionally, ZINWA's leadership is in disarray as the parastatal's advisory board was dissolved just prior to the March elections, according to the Combined Harare Residents Association. ¶7. (SBU) Drought-prone Bulawayo, which traditionally fares worse than Harare, is performing marginally better than the capital this year. Heavy rainfall in the 2007/2008 season left reservoir levels with a higher than usual 20 month supply. Despite plenty of water, the Bulawayo City Council is rationing water because of insufficient quantities of treatment chemicals, according to Henson. Additionally, USAID estimates that there is close to a 50 percent loss of pumped water in Bulawayo due to broken pipes. -------------- -- Hyperinflation, Politics, and No Accountability -------------- -- ¶8. (SBU) Rampant hyperinflation has eliminated ZINWA's ability to generate sufficient income to repair Zimbabwe's crumbling water reticulation systems. All of ZINWA's water revenues are billed in local currency and are quickly rendered worthless by inflation rates unofficially estimated to be in the billions of percent annually. Consequently, ZINWA cannot afford to buy water treatment chemicals, nor repair leaking pipes. Additionally, the government has not allowed ZINWA to raise water prices out of concern this might lead to greater public dissatisfaction. ¶9. (C) The politically-motivated move to give the national government control over water also backfired as ZINWA's delivery failures have made it--along with the electric utility and reserve bank--one of the most loathed Zimbabwean government institutions. Despite ZINWA's poor performance and widespread knowledge of the broken water infrastructure, the government strictly bans NGOs from drawing attention to the problem. Krishna Jafa, the deputy country director for HARARE 00000919 003 OF 003 PSI told poloff that they have been specifically warned about publicizing burst pipes and can only refer generally to water shortages. Jafa also mentioned that with ZINWA in control there exists an "us versus them" attitude regarding delivering water to regions of the country that did not support ZANU-PF in the March elections. In Chitungwiza, PSI was even charged with profiteering by the police and threatened with arrest when they gave water treatment tabs to retail outlets to sell at the ludicrously low and practically worthless price of 20 Zimbabwean cents per tab. ¶10. (SBU) Meanwhile, Henson suggested that the lack of local accountability has contributed to Zimbabwe's water plight. Henson cited Bulawayo's better performance versus Harare as an example of the benefit of local accountability. (NOTE: Through negotiations, Bulawayo was able to maintain shared water authority between ZINWA and the local councils that had traditionally managed Bulawayo's water distribution. END NOTE.) -------------- Rural Areas Struggling as Well -------------- ¶11. (SBU) WASH cluster assistance has traditionally focused on high-density population centers such as Harare and Bulawayo because the higher human traffic led to greater risks of disease outbreak. However, rural areas are now facing water scarcity issues caused by the breakdown or depletion of boreholes. The collapsed Zimbabwean economy and hyperinflation has made repairing boreholes unaffordable for local communities. Henson estimates between a third and half of all rural people do not have access to potable water and are resorting to drinking untreated water from shallow wells, standing pools, or local rivers and streams. ¶12. (SBU) COMMENT: The lack of potable water in Zimbabwe is a critical problem that the GOZ shows little urgency in tackling. In fact, the GOZ has restricted the NGO community's ability to help, by limiting their activities to treatment and short-term relief operations. Most alarming, though, is the absence of water in clinics and hospitals, which will drive up the fatality rate as cholera outbreaks continue to occur. The approach of the rainy season will exacerbate the situation by flooding clogged sewers and further increasing the risk of disease. END COMMENT. DHANANI