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.
Use of group maturity index to measure growth, performance, and sustainability of community health clubs in urban water, sanitation and hygiene (WASH) program in Zimbabwe

 Zimbabwe experienced an unprecedented cholera outbreak in 2008 and 2009. Reduced access to water, sanitation and hygiene, delayed community health education, and limited knowledge on cholera prevention were the major risk factors of this outbreak which were addressed by urban WASH interventions. Health and hygiene promotion through community health clubs (CHCs) is a cost-effective strategy to reduce the risk of cholera. In 2013, UNICEF Zimbabwe launched the Small Towns WASH Program (STWP) and used the CHC approach for hygiene promotion. To monitor the growth, performance, and sustainability of CHCs, STWP employed the Group Maturity Index, which measures the status of CHCs in five domains: objectives, governance, resources, group systems, and impacts. This study described the maturity status of CHCs as measured by GMI as a new monitoring tool and assessed if CHCs’ performances in GMI's output domains are associated with the impact domain. The results suggested that over 75% of CHCs had reached the managed stage or the mature stage by 2018. Three of the GMI's output domains were independently associated with the overall impact domain after controlling for potential confounders. CHCs and club members may experience overall positive impacts by developing their governance, resource, and group system domains.
A technique for large-field, superficial electron therapy.
The application of electron beams to radiation therapy has received increased attention in recent years. This interest stems largely from the special characteristics of the electron depth-dose distribution; the fall-off in depth dose near the end of the range of the electrons is particularly rapid for electron beams having energies less than about 10 Mev. Such an electron beam is suitable for the treatment of widespread, superficial lesions, where it is desirable to minimize the dose to deep tissues. All the common sources of super-voltage x-rays, apart from radioactive substances, are inherently capable of producing an external beam of electrons, though with varying degrees of complexity. Electrons of about the energy suitable for superficial therapy (several Mev) may be used to produce an x-ray beam which is sufficiently penetrating for the treatment of even the deepest lesions. The Stanford medical linear accelerator was designed to provide both x-rays and electron beams. The accelerator and its applic...