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ss nucleus - Easter 2009,  Cholera outbreak in Zimbabwe

Cholera outbreak in Zimbabwe

John Greenall writes an eyewitness account

I t's in the early hours of the morning in mid January. I'm standing in a cholera camp in the town of Kadoma, 140km south-west of Harare (the capital). As I look around, my eyes widen taking in the sights. People are everywhere: beds, benches, floor and wheelbarrows. Sunken eyes look up at me, as I gaze at the endless line of IV drips. The stench of chlorine lingers in my nose; vomit and diarrhoea stain the floor. The camp, with a capacity of 200, is overwhelmed by 700 people.

Walking amongst the hastily erected tents is a team of nurses, doctors and medical students. They are changing IV drips, giving oral rehydration solution, as well as cleaning up the vomit and diarrhoea. One student is praying for a particularly sick elderly man, and as I turn around a seven year old child is carried in. He looks about four, malnourished and barely breathing; a cannula is sited and we pray that he might live.

Those first five minutes in the cholera camp moved and challenged me in a way I could not imagine. Amidst the stench of death, a group of Christian doctors, nurses and medical students are risking their own health and giving their time, bringing life and hope, and seeing God do amazing things.

from England to Zimbabwe

Three weeks ago, I was considering what I'd just read on the CMF website while driving home from work. (1) Zimbabwe is in crisis: crippled by massive inflation and political infighting, (2) most hospitals and the medical school have been closed for the last four months. In the few clinics that remain open, there is a lack of even basic drugs. Nurses are earning US $0.10 a month in a country where transport costs are US $40 per month. Now cholera is sweeping the country. The outbreak started in August 2008, but accelerated in early December (start of the rainy season) due to a number of factors, including poor sanitation and a lack of safe drinking water. Almost 88,000 people have contracted the disease, with close to 4,000 deaths. (3) Every province has been affected and what remains of the health system has long been overwhelmed. The website appeal is straightforward - 'pray and act now, Zimbabwe is bleeding'. As I prayed, I wondered what I could do. I realised that God was telling me to go, to encourage the workers on the field, raise awareness of the problem, and report back on rumours of some incredible things that God has been doing. So after discussion with my clinical supervisor, rearranging my annual leave, hurried emails, and a cholera vaccination - I was on the plane.

joining Celebration Health

I visited the health wing of Harare church Celebration Ministries International, Celebration Health. (4) On seeing the devastating cholera outbreak, it acted swiftly to raise funds from partners including CMF UK and a number of international organisations. Its cholera response, 'Operation Outstretched Hand', has seen an incredible mobilisation of staff and medical students. Over 7,000 patients have been treated in just seven weeks, with a death rate under 1%, according to Dr Andrew Reid (of the Celebration Health leadership team).

The work is not confined to one location. Celebration Health performs regular reconnaissance missions to rural areas investigating possible outbreaks, sometimes leaving team members to coordinate a response. These rural areas are particularly difficult to manage, given the thin spread of the population over large distances; death rates due to cholera are therefore higher. Local churches have also been involved; church members help to build the camps and educate the community, while choirs sing in the camps.

Operation Outstretched Hand

Celebration Health has sent in a total of 19 teams. Each team usually comprises five doctors, twelve nurses, four pharmacists, two logisticians, a driver and a caterer (though the largest team consisted of 85 people). Eight teams were ready to be deployed at any time. Celebration Health is now one of the largest providers of cholera care in Zimbabwe due to this large pool of volunteers. They work in partnership with other organisations including Medecins Sans Frontieres, UNICEF, WHO, as well as the local health authority and the Ministry of Health.

students and junior doctors lead the way

The medical students (part of CMF Zimbabwe) have been praying together regularly over the last few years. They have also led health education programmes in schools and hospitals in Harare. For example, a fourth year medical student (who leads the health education team) teaches the local community how to prevent the spread of cholera. They estimate that over 10,000 people have been reached by her team's community programmes.

Celebration Health is sharing the gospel and seeing many come to Christ. In each area where they have worked, a church or cell group has started. Conversions even happen amongst team members; volunteer doctors and nurses come onto the field and God so touches them that they are born again and begin to undergo discipleship. The work is, however, tough and they are obviously tired. Yet one of the students said to me: 'God is not a God who stands back and watches...Jesus is in that cholera camp, amongst the vomit and the diarrhoea, full of compassion for these people. I asked myself where Jesus would be at Christmas and I knew he would be here, so I wanted to be here too.'

The scale of the problem can seem overwhelming. One area of a local town (home to 20,000 residents) has no clean water available and the sewage system is not functioning. During my visit, I saw that the public toilets were two feet deep in faeces, with a writhing mass of maggots - and still in use. Adults were getting drinking water from broken pipes that well up amongst sewage; children were playing ball in the sewage, as well as eating fruit with dirty hands. The community has lived like this for seven years. It has gotten so used to living in the sewage that the people do not seem sad. On the contrary, many smile and the children play happily.

As I walked alongside rivers of sewage, I was reminded that in heaven there are rivers of living water running through the streets. (5) The Celebration Health team have seen that God wants them to be agents of reformation in this town and throughout Zimbabwe; they long to see living water provided for these people now. This will involve rebuilding infrastructure and changing behaviour.

biblical truths come alive

In a country with so much need, biblical truths seem to come alive. One doctor said that they are ministering to Jesus himself when they help those stricken by the cholera crisis. Jesus will say to those who have lived in obedience to him:

'For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.' “Then the righteous will answer him, 'Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?' “The King will reply, 'I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.' (6) Most importantly, Celebration Health has always been underpinned by prayer. They are taking God at his word and seeing that God's answer to the situation comes through them. It really hit home to me that when the Bible speaks of our God being a God of compassion, (7) justice, (8) and concern for the weak (9) - that God acts in these ways through us. As part of God's kingdom on earth, we are the means by which his kingdom comes to those around us. God's love, compassion, justice and mercy are being demonstrated powerfully in Zimbabwe through this team of men and women. The students have stepped up to the challenge and they are leading something big. Their vision, maturity and leadership skills are developing rapidly. Their dream is big; their prayers are fervent, and these are beginning to be answered.

ask what you can do

It is tempting for us to feel 'I'm just a student, I couldn't be involved in anything as big as this', and yet these Zimbabwean students inspire us to get involved. So what can you do? You can pray both for the situation in Zimbabwe and also for the students over there with uncertain futures, that they would know God's leading in their lives. You can give financially - the CMF appeal has now closed, having reached the target of £30,000 (for IV fluids, giving sets, needles, soap and gloves amongst other things), but the Archbishops' Appeal is open. (10)

And, like the students in Zimbabwe, you can be open to God calling you to something far bigger than you ever imagined. Will you lift your eyes up, dream big, and ask God to help you believe that he may use you to achieve the impossible? After all, his Word says that we can do anything through him. (11) Who can you reach out to? What needs exist in your home country or town or street - homelessness, deprived populations, a lack of health education? As medical students and doctors we have a key role to play for 'the least of these'. (12)

The Celebration Health team would often sing one particular song. I pray that it will be your prayer as you recommit yourself to sacrificially serving our all-powerful God:

Lord I answer to your call To go where others dare not go To press on ahead and never look behind. Though the road may not be easy, It always hurts to sacrifice But I'm ready Lord to pay the final price. There's a new great horizon just waiting there for me, If I only trust in God and just believe. I won't give what cost me nothing; you're far too precious Lord for me. Thank you for your mercy, Thank you for your love, Thank you for choosing, using me.

John Greenall is a foundation year two doctor in Kent

References
  1. www.cmf.org.uk/appeal/zimbabwe
  2. www.tinyurl.com/bpqr6j
  3. www.tinyurl.com/cldaqw
  4. www.tinyurl.com/att9ra
  5. Revelation 22:1-2
  6. Matthew 25:35-40
  7. Psalm 103:8
  8. Zechariah 7:9-10
  9. Psalm 82:3
  10. www.tinyurl.com/agqmgo
  11. Mark 9:23
  12. Matthew 25:40
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