Engineering in the time of cholera: overcoming institutional and political challenges to rebuild Zimbabwe's water and sanitation infrastructure in the aftermath of the 2008 cholera epidemic
A devastating cholera epidemic swept Zimbabwe in 2008, causing over 90,000 cases, and leaving more than 4,000 dead. The epidemic raged predominantly in urban areas, and the cause could be traced to the slow deterioration of Zimbabwe's water and sewerage utilities during the economic and political crisis that had gripped the country since the late 1990s. Rapid improvement was needed if the country was to avoid another cholera outbreak. In this context, donors, development agencies and government departments joined forces to work in a unique partnership, and to implement a programme of swift improvements that went beyond emergency humanitarian aid but did not require the time or massive investment associated with full-scale urban rehabilitation. The interventions ranged from supply of water treatment chemicals and sewer rods to advocacy and policy advice. The authors analyse the factors that made the programme effective and the challenges that partners faced. The case of Zimbabwe offers valuable lessons for other countries transitioning from emergency to development, and particularly those that need to take rapid action to upgrade failing urban systems. It illustrates that there is a ‘middle path’ between short-term humanitarian aid delivered in urban areas and large-scale urban rehabilitation, which can provide timely and highly effective results.
Lessons Learnt from financing WASH rehabilitation works in small towns in Zimbabwe
ABSTRACT This paper describes urban WASH interventions (hardware, hygiene promotion, and institutional support) implemented in the Small Towns WASH Programme (STWP) across 14 towns in Zimbabwe with the associated costing. Key lessons in terms of urban WASH rehabilitation include the need for flexible funding and programme approaches accommodate changes during implementation, and that strong programme governance, multi-stakeholder involvement, and integration of hardware and software are required to contribute to benefits beyond infrastructure rehabilitation alone. Critical recommendations for sustaining the rehabilitated infrastructure and institutional strengthening are presented.
Cholera - The Grim Reality of Under-development
Cholera is a severe diarrhoeal illness caused by certain strains of Vibrio cholerae, which can lead rapidly to dehydration and death. Communities dependent on water contaminated with human faeces and those with poor sanitation are very vulnerable to cholera epidemics. Although theVibrio cholerae Ol El Tor strain presently circulating in southern Africa is multi-drug resistant and currently available vaccines offer inadequate proteccion, cholera can be pre-vented by simple cost-effective measures, including chlorination or sustained boiling of drinking water. The key to cholera management is aggressive fluid replacement with the correct fluids. The latter strategy is so effective that a cholera death may be viewed as a health system failure deserving formal review. The only sustainable solution to the scourge of cholera is fundamental economic and social development with the provision of safe water and adequate sanitation 
for all communities.