VZCZCXRO7429
OO RUEHBZ RUEHDU RUEHJO RUEHMR RUEHRN
DE RUEHSB #1125/01 3511246
ZNR UUUUU ZZH
O 161246Z DEC 08
FM AMEMBASSY HARARE
TO RUEHC/SECSTATE WASHDC IMMEDIATE 3827
INFO RUCNSAD/SOUTHERN AF DEVELOPMENT COMMUNITY COLLECTIVE

UNCLAS SECTION 01 OF 02 HARARE 001125 
 
SENSITIVE 
SIPDIS 
 
DS, D, P, M, CA, S/CT, INR, CA/OCS 
 
E.O. 12958: N/A 
TAGS: AMED AMGT ASEC PGOV PREL SOCI CASC TBIO ZI
SUBJECT: HARARE EAC REVIEWS TRIPWIRES AND CHOLERA OUTBREAK 
 
REF: A. HARARE 1066 AND PREVIOUS 
     ¶B. HARARE 1067 
     ¶C. 07 HARARE 214 
 
¶1. (U) SUMMARY:  Post's EAC met on December 15 to review trip 
wires in relation to the cholera epidemic in Zimbabwe and the 
collapse of medical services.  The EAC agreed that the 
situation falls within the "Growing Potential for Drawdown" 
category in which Post has generally operated since March 
¶2007.  The EAC reviewed existing precautions and recommended 
others.  Post requests funding to purchase an additional 
water truck and a reverse osmosis water purification unit. 
END SUMMARY. 
 
¶2. (U) In response to a request from Crisis Management 
Support, and following up on Embassy Harare's December 2 EAC 
(Ref A), Post's EAC met on December 15 to specifically review 
Post's tripwires in relation to the cholera epidemic in 
Zimbabwe and the collapse of medical services.  Management, 
medical and USAID Office of Foreign Disaster Assistance 
(OFDA) staff provided context for the discussion by 
describing the nature of the crisis and Post's response to 
date (Ref B).  The EAC used the meeting to review tripwires 
broadly in relation to the deteriorating political situation 
in Zimbabwe as well.  RSO noted that Embassy Harare has been 
in the "Growing Potential for Drawdown" category since the 
surge in political violence in March of 2007 (Ref C).  Since 
that time, the EAC has regularly reviewed and revised 
precautionary measures depending on the immediate threats 
facing Post personnel.  These reviews have focused on 
political, security and logistical issues, but have not in 
the past tested the adequacy of Post 
's medical tripwires. 
 
--------- 
Tripwires 
--------- 
 
¶3. (SBU) Post's tripwires for medical threats distinguish 
between the seriousness and the susceptibility to control of 
a medical epidemic.  The three tripwires for "Growing 
Potential," "Authorized Departure" and "Ordered Departure" 
are: 
 
--There is an outbreak of a medical epidemic that could pose 
a direct risk to post personnel and private American citizens. 
-- There is an outbreak of a medical epidemic that can be 
controlled but still poses a serious medical risk to post 
personnel and dependents and American citizens. 
--An outbreak of a medical epidemic that cannot be controlled 
and poses a serious medical risk to post personnel and 
dependents and American citizens occurs. 
 
-------------- 
Where We Stand 
-------------- 
 
¶4. (U) Post's medical officer and the USAID OFDA 
representative explained to the EAC that cholera is a 
preventable disease that spreads where hygiene is poor.  In 
Zimbabwe the breakdown in public services means that 
untreated sewage and garbage litter the streets of 
high-density neighborhoods while supplies of clean water have 
been cut off.  This creates optimal conditions for rapid 
spread among individuals who live in these areas and have no 
access to clean water, soap, or water treatment.  Cholera is 
also a readily treatable disease, but lack of health services 
has resulted in an unusually high mortality rate in Zimbabwe. 
 
 
¶5. (U) EAC members noted that Post's tripwires do not provide 
a clear dividing line between risk and serious risk.  Medical 
and OFDA staff stressed that the role of hygiene in the 
transmission of cholera means that, as long as employees and 
American citizens have access to water which they can treat, 
the risk to Americans from cholera is easily mitigated. 
Consular staff reported that they view the breakdown in 
health infrastructure as a threat to the safety of Americans 
in Harare, but their concern focuses on trauma, more than on 
cholera.  Both prevention and treatment protocols for cholera 
are simple and well understood by the community.  EAC members 
agreed that the risk posed by cholera is not currently 
"serious" for these reasons.  The EAC believed that, the risk 
would become serious, and would merit authorized departure, 
if members of the official community were not able to obtain 
water.  Without adequate water, Post would be unable to 
control the spread of cholera to the Mission community. 
 
¶6. (U) The EAC discussed Post's logistics tripwires and noted 
that, for the time being, the Embassy has been able to 
 
HARARE 00001125  002 OF 002 
 
 
ameliorate the impact of the collapse of Zimbabwe's 
infrastructure.  Although Post does not anticipate that the 
collapse will outstrip Post's ability to cope, the EAC 
considers this risk particularly pertinent to the 
sustainability of a large USG presence and has continued to 
seek possible measures to make Embassy coping mechanisms more 
robust.  (Lack of water, even without a cholera epidemic, 
would justify authorized departure, according to existing 
tripwires.)  The EAC also noted that, as we have been for 
some time, Post is in the "Growing Potential for Drawdown" 
category with respect to tripwires for Police and Security 
Forces, Political, and Media environment as well. 
 
--------- 
Responses 
--------- 
 
¶7. (U) The EAC reviewed responses to the threat already 
carried out, including: 
 
--Issuance of a Travel Warning. 
--Distribution of information on precautions against and 
treatment of cholera. 
--Scheduling of a Town Hall meeting for Embassy community at 
which the option of voluntary SMA authorization will be 
raised. 
--Consultation with Harare International School. 
--Ordering of hand sanitizer. 
--Closure to the public of Post's Public Affairs Section when 
water is unavailable. 
--Revision of EAP and F-77 lists. 
--Request for funding for additional well drilling surveys. 
--Request for provision of enhanced Post medical unit 
facilities. 
 
¶8. (U) Additional measures being initiated or endorsed by the 
EAC include: 
 
--Procurement of additional satellite phones and repetition 
of messages advising employees that these phones may be 
requested for in-country travel. 
--Drafting evacuation travel orders for all newly-arrived 
employees and ensuring all have valid visas for Zambia. 
--Review of additional options for emergency evacuation. 
--Procurement of water treatment supplies for LES employees. 
--Request for funding to procure an additional water truck 
and hire an additional driver.  (See Action Request para 10.) 
--Request for consideration of funding to procure a reverse 
osmosis water pumping unit.  (See Action Request para 11.) 
 
¶9. (U) The EAC considered but did not endorse the following 
measures at this time; they will be reviewed in subsequent 
EACs: 
 
--In-country travel restrictions or restrictions on TDY 
visitors. 
--An additional Town Hall meeting for American citizens. 
--Restrictions on public functions. 
 
--------------- 
Action Requests 
--------------- 
 
¶10. (U) Mission facilities and residences are kept supplied 
with water by two water trucks currently operating eight 
hours per day, seven days a week.  Embassy employees are 
advised to conserve water, but there is no rationing 
enforced.  If one of the trucks were to break down or if many 
more of our wells dried up, water use restrictions would have 
to be imposed, and authorized departure might be necessary. 
To reduce this risk, Post requests funds to obtain an 
additional water truck and hire an additional driver. 
 
¶11. (U) Embassy employees rely on distilled water for 
drinking.  Public utility and well water are used without 
treatment for all other purposes.  If water supplies 
deteriorated severely in both quantity and quality, Post 
might need to rely on lakes or other poor quality water 
sources.  This would likely trigger a request for ordered 
departure, depending on the severity of the situation. 
Procurement of a reverse osmosis water purification unit 
would enable Post to serve the needs of remaining staff. 
 
 
DHANANI