VZCZCXRO3761
OO RUEHBZ RUEHDU RUEHJO RUEHMR RUEHRN
DE RUEHSB #0086/01 0361312
ZNR UUUUU ZZH
O 051312Z FEB 09
FM AMEMBASSY HARARE
TO RUEHC/SECSTATE WASHDC IMMEDIATE 3998
RUEHSA/AMEMBASSY PRETORIA IMMEDIATE 5635
INFO RUCNSAD/SOUTHERN AF DEVELOPMENT COMMUNITY COLLECTIVE
RUEHRO/AMEMBASSY ROME 2230
RUEHGV/USMISSION GENEVA 1893
RUCNDT/USMISSION USUN NEW YORK 1982
RUEHBS/USEU BRUSSELS
RHEHAAA/NSC WASHDC
RUEKJCS/SECDEF WASHDC
RHMFISS/JOINT STAFF WASHDC

UNCLAS SECTION 01 OF 03 HARARE 000086 
 
SIPDIS 
AIDAC 
 
AFR/SA FOR ELOKEN, LDOBBINS, BHIRSCH, JHARMON 
OFDA/W FOR PMORRIS, ACONVERY, LPOWERS, TDENYSENKO 
FFP/W FOR JBORNS, ASINK, LPETERSEN 
PRETORIA FOR HHALE, PDISKIN, SMCNIVEN 
GENEVA FOR NKYLOH 
ROME FOR USUN FODAG FOR RNEWBERG 
BRUSSELS FOR USAID PBROWN 
NEW YORK FOR DMERCADO 
NSC FOR CPRATT 
 
E.O.  12958: N/A 
TAGS: EAID TBIO EAGR PREL PHUM ZI
SUBJECT:  ZIMBABWE CHOLERA - USAID/DART WASH ASSESSMENT 
 
------- 
SUMMARY 
------- 
 
¶1. From January 23 to February 7, the USAID Disaster Assistance 
Response Team (USAID/DART) water, sanitation, and hygiene (WASH) 
specialist undertook an assessment of the WASH sector response to 
the present cholera epidemic in Zimbabwe.  The water and sewer 
systems serving urban centers in Zimbabwe are in abysmal condition 
as a result of financial neglect and the resulting lack of 
maintenance.  Few rural areas have access to clean drinking water or 
sanitation facilities.  The lack of clean water and poor sanitation 
conditions are major contributing factors in perpetuating the 
present cholera outbreak.  The WASH sector response has been 
severely hampered by the lack of government WASH partners, as well 
as logistics issues. 
 
¶2. Despite the obstacles faced by the WASH sector, non-governmental 
organization (NGO) partners are performing exceptionally well in 
implementing cholera control interventions that meet professional 
standards.  Unfortunately, the cluster has not fully evaluated the 
effectiveness of WASH interventions to date.  In light of the 
increasing number of cholera cases, it is critical that the WASH 
sector conduct a real-time evaluation of the effectiveness of the 
WASH interventions and make adjustments to the cluster strategy 
based on the findings of the evaluation.  END SUMMARY. 
 
------------------------------------- 
USID/DART WASH SPECIALIST ACTIVITIES 
------------------------------------- 
 
¶3. While in Zimbabwe, the USAID/DART WASH specialist met with the UN 
Children's Fund (UNICEF), Oxfam/Great Britain (GB), World Vision, 
the International Organization for Migration, Concern, Mercy Corps, 
Norwegian Church Aid and GOAL.  The WASH specialist also met with 
representatives from the European Community Humanitarian Aid Office 
and the UK Department for International Development (DFID), as well 
as USAID and U.S. Embassy staff.  The WASH specialist conducted 
assessment visits to the urban areas in Beitbridge, Bulawayo, and 
Kadoma districts, high-density suburbs including Chitungwiza in the 
Harare area, and rural areas in Mudzi District.  The WASH specialist 
participated in Joint Health and WASH cluster and stand-alone WASH 
cluster coordination meetings. 
 
 
-------------------------------------- 
WATER AND SEWER SYSTEMS IN URBAN AREAS 
-------------------------------------- 
 
¶4. Water and sewer systems serving urban centers in Zimbabwe are in 
very poor condition as a result of financial neglect and the 
resulting lack of maintenance.  Water systems are on the verge of 
collapse.  Water is produced and delivered irregularly in urban 
areas, while many high-density urban areas have no piped service. 
Urban water treatment facilities have no chemicals other than those 
supplied by international organizations, primarily UNICEF.  Water 
treatment chemicals are a critically needed item as many municipal 
water sources are heavily contaminated, such as the Lake Chivero 
reservoir serving Harare and the Limpopo River serving Beitbridge. 
Qreservoir serving Harare and the Limpopo River serving Beitbridge. 
 
¶5. Facility operators are knowledgeable and professionally operate 
the facilities when chemicals are available, shutting off water 
supplies when there are no water treatment supplies.  Shutting off 
water supplies disrupts service and allows contaminated ground water 
to enter empty water pipes.  During water disruptions urban 
residents obtain water from shallow open wells.  The wells are in 
disrepair and easily contaminated with surface water. 
 
¶6. The gravity sewers have overflowed in numerous locations.  The 
sewage runs down streets and pools in low areas creating large 
marshy areas filled with sewage.  Residents have created dirt dams 
along streets preventing the sewage from entering yards and 
surrounding homes.  During heavy rains the sewage mixes with waters 
 
HARARE 00000086  002 OF 003 
 
 
flooding the communities and flows into the unprotected open wells. 
NGO partners are working with sewer operators, providing tools and 
assistance to unclog sewers.  Unfortunately, without long-term 
financial and technical support for the utilities, the sewers will 
become blocked again and overflowing sewage will place community 
residents at risk of catching cholera and other fecal-borne 
illnesses. 
 
 
¶7. Repair and renovation of urban water and sewer systems will be a 
massive financial undertaking, but a necessary one if the Government 
of Zimbabwe wishes to minimize future outbreaks of water-borne and 
sanitation-related diseases in urban areas.  Any U.S. Government 
long-range strategic planning for the WASH sector must consider 
support for repair and renovation of urban water and sewer systems. 
 
 
-------------------------------------- 
WATER AND SANITATION IN RURAL AREAS 
-------------------------------------- 
 
¶8. Rural communities use shallow wells or handpumps connected to 
boreholes for water needs, where available, otherwise resorting to 
sources such as rivers and streams.  Many handpumps are 
nonfunctional due to a lack of spare parts and technical support for 
rural communities.  Oxfam/GB reported refurbishing a handpump that 
had been broken for more than six years due to a worn out leather 
gasket.  The leather gasket is inexpensive, simple to replace, and 
typically wears out in six months. 
 
 
¶9. The USAID/DART WASH specialist inspected a number of shallow 
wells during field visits, finding that all such wells were in 
disrepair and open to contamination.  Latrine coverage in rural 
areas is minimal as many pit latrines are full and not functional. 
 
-------------------------- 
HUMANITARIAN COORDINATION 
-------------------------- 
 
¶10. In partnership with the NGO community, UNICEF is actively 
resolving coordination problems through the WASH cluster mechanism. 
The WASH cluster has formed a strategic advisory group that overseas 
technical issues and has outlined a cholera control strategy that 
appears to have been adopted by the NGO community.  Health and WASH 
partners implementing social mobilization interventions have formed 
a working group to guide hygiene promotion interventions and 
standardize associated printed materials.  NGO partners appear to be 
actively participating in cluster meetings and working groups. 
 
¶11. UNICEF has added a full time information management officer to 
support WASH cluster efforts to improve coordination.  The addition 
of information management support should dramatically improve WASH 
sector data collection and dissemination of compiled data. 
 
------------------ 
TECHNICAL CAPACITY 
------------------ 
 
¶12. UNICEF and NGO WASH staff appear to have the technical capacity 
to effectively implement cholera control interventions.  The 
emphasis on household water treatment, hygiene promotion and quick 
cost-effective repairs to sewers, water lines, and hand pumps, if 
implemented effectively, should mitigate the spread of cholera and 
Qimplemented effectively, should mitigate the spread of cholera and 
provide community members with the knowledge and tools to protect 
themselves during future cholera outbreaks. 
 
¶13. New borehole construction remains a concern.  The construction 
of new boreholes is a costly intervention that is not sustainable 
without long-term technical support.  Instead of new boreholes, the 
WASH sector should place greater emphasis on household water 
treatment and the construction and protection of open wells, as well 
as the construction of rainwater catchments particularly in rural 
 
HARARE 00000086  003 OF 003 
 
 
areas. 
 
------------------------- 
EVALUATON AND MONITORING 
------------------------- 
 
¶14. While the implementation of WASH interventions appears to be 
progressing well, there has been no credible evaluation of the 
effectiveness of the interventions.  The lack of a standard, 
ongoing, real-time evaluation of WASH interventions is a critical 
shortcoming.  The sector is evaluating success based on materials 
provided, infrastructure repairs, and cholera prevention 
instruction.  The WASH sector must evaluate the expected outcomes of 
interventions such as evaluating household water quality and 
measuring cholera prevention knowledge, attitudes and practices. 
 
--------------- 
RECOMMENDATIONS 
--------------- 
 
¶15. USAID's Office of U.S. Foreign Disaster Assistance (USAID/OFDA) 
should continue to focus on the present hygiene promotion and 
household water treatment interventions.  Considering the present 
situation in Zimbabwe, interventions that strengthen individual 
household coping mechanisms have the greatest chance of being 
sustainable in both rural and urban areas.  Such emergency 
interventions will help increase household-level preparedness in the 
event of a future cholera outbreak, complementing USAID/OFDA's 
longer-term complex emergency WASH programming. 
 
¶16. It is critical that urban water treatment plants have sufficient 
chemicals to treat and deliver safe drinking water to urban 
residents.  USAID/OFDA should closely coordinate with other donors 
to ensure than UNICEF supplies urban water treatment plants with an 
adequate quantity of water treatment chemicals. 
 
¶17. USAID/OFDA should avoid funding drilling of new boreholes.  The 
present situation in Zimbabwe makes new boreholes unsustainable, as 
even existing handpumps are often not being properly maintained. 
The large number of existing non-functioning handpumps provides 
evidence of the present inability of communities to conduct repairs 
and the lack of a spare parts supply chain.  Rehabilitation of 
existing handpumps should only be funded if the implementing agency 
agrees to provide both long-term technical and material support to 
the community with the rehabilitated handpump. 
 
¶18.  For water source development, USAID/OFDA should consider 
funding the construction and renovation of open wells and the 
construction of rainwater catchments.  Such interventions, in 
combination with the household water treatment and hygiene promotion 
interventions have the greatest chance of sustainability and 
contributing to future disaster risk reduction. 
 
¶19.  USAID/OFDA should strongly encourage UNICEF and the WASH sector 
to conduct a real-time evaluation of the effectiveness of the WASH 
interventions. 
 
MCGEE