No ebola in Zimbabwe but Health Minister forced to issue statement as rumours abound

There is no ebola in Zimbabwe. Rumours are being spread by social media due to the panic that happened at Parirenyatwa Hospital when a patient came in an ambulance, pulled out his drip and there was blood all over, Health Minister David Parirenyatwa told Parliament yesterday.

In a ministerial statement, Parirenyatwa said because the patient was very ill and had blood all over, the staff thought he was bleeding from everywhere, so it might be ebola.

“I want to dispel that rumour and just say that, we do not have a case of ebola at all in Zimbabwe for now,” the minister said.

He said the first case of the circulation of Ebola was a rumoured case of Ebola at the South Medical Hospital in Chitungwiza on 13 September 2014. It involved a 27-year-old man, who was admitted on 9 September and died on 12 September.

Blood samples were taken and sent to the National Institute of Communicable Diseases in South Africa, which is only one of the centres in Africa that tests for Ebola. The results came back on 17 September and were negative.

The second case occurred at Parirenyatwa Group of Hospitals. A Zimbabwean man aged 50, working in Mozambique, was admitted on 16 September and referred to Beatrice Road Infectious Disease Hospital where he died the following day.

He said this man was not tested for ebola because there was no link to the disease at all.

More than 2 600 people have died of Ebola, mostly in West Africa, so far.

Full statement and debate:

MINISTERIAL STATEMENT

ISSUE OF EBOLA CASES IN ZIMBABWE

THE MINISTER OF HEALTH AND CHILD CARE (DR. PARIRENYATWA): Mr. Speaker Sir, I would like to make a Ministerial Statement on the issue of Ebola. I would like to clarify the issue regarding the rumours that are circulating about Ebola in Zimbabwe. Mr. Speaker, the rumour emanated and pointed at Parirenyatwa Group of Hospitals but I would like to dispel that rumour and say that, Parirenyatwa Group of Hospitals wishes to dispel the Ebola virus disease rumours. We would want to assure you that the hospital did not at any time, detect any Ebola case. Patients are screened in line with set protocols of the Ministry of Health and Child Care regarding the Ebola virus disease. Tents have been availed to screen patients before they are attended to at accidents, in emergency department and outpatients department respectively.

If any suspected case is identified, it will be transferred to an isolation centre at Wilkins Infectious Diseases Hospital. The patient who has caused this alarm and the case was brought up – this patient was brought in an ambulance and was examined by two doctors with special training in Ebola case management and detection. The two doctors were satisfied that the patient was not an Ebola case. I will go into detail about the rumours that are circulating.

The first case of the circulation of Ebola was a rumoured case of Ebola at the South Medical Hospital in Chitungwiza on the 13th September 2014; the hospital is called South Med. The national rapid response team of laboratory medical team from the headquarters, Harare City Health and Chitungwiza City Health visited the site in order to get more information about the case and to collect samples. This is a case of a male patient aged 27 years, who was admitted on the 9th September, 2014 and died on the 12th September, 2014. When he was admitted, the diagnosis was of urinary tract infection and it was queried meningitis and renal failure. Before admission, the patient was said to have had diarrhoea and vomiting and had pain while swallowing for the previous two weeks. The body temperature was initially at 37o and was latter elevated until he died.

The patient was on treatment on Rosephane and Chloramphenicol antibiotics. The specialist physician who examined the case was informed that he had been to the Democratic Republic of Congo, despite the fact that relatives claim that he did not have a passport and never visited the Democratic Republic of Congo. During the dates of admission, the patient was also isolated in the high dependence unit. Mr. Speaker Sir, a specimen was collected of blood on this patient and was sent to the National Institute of Communicable Diseases in South Africa, which is only one of the centres in Africa that tests for Ebola.

We received the results back on the 17th September and were negative for Ebola.

So, we can conclusively conclude that the case of South Medical Hospital is not Ebola and there are rumours already circulating Mr. Speaker Sir, that we have identified a case at South Med. I would want to squash that rumour and there is a report of the negative results.

The second case that has occurred was at Parirenyatwa Group of Hospitals. This was a male Zimbabwean aged 50 years, working in Mozambique and he stays in Mozambique. He had come from Mozambique and presented at Parirenyatwa Casualty on an ambulance on Tuesday, 16th, with the following symptoms: he was confused, had a temperature of 38o – which is high. The normal temperature is about 37o. He was generally very ill and he required resuscitation. The alarm therefore, was caused by the fact that his wife is a Congolese who had visited the DRC more than 29 days ago. In other words, this particular woman had come from the DRC on the 18th of August. Our incubation period is 21 days and she had well passed it. She is well as I speak now and this woman has not been sick at all.

I want to develop this case and say that the patient works in Mozambique, came to Zimbabwe to meet with his wife but was then admitted at Parirenyatwa Hospital because he was unwell. We then called our Response Team from the Environmental Health National Microbiology Ward and the provision diagnosis was one of cerebral malaria or typhoid. It was never suspected of Ebola. There was no epidemiological link of the ill patient to any of the Ebola countries. He was working in Mozambique; never visited DRC or any Ebola area and as I have said, the wife had visited DRC well over 21 days ago. Adequate history was taken by health workers. He was attended by physicians at Parirenyatwa and had a working diagnosis of cerebral malaria was made. There was no need at all to test for ebola. This was excluded by the absence of any link. What is important is, there must be a link; you must have come into contact with a person who is infected or a dead body that died because of ebola. The patient was referred to Beatrice Road Infectious Disease Hospital as query typhoid and cerebral malaria. The patient died on the 17th of September at Beatrice Road Infectious Disease Hospital.

The rumours are spread by social media due to the panic that happened at Parirenyatwa Hospital, particularly with health workers. When this patient came in an ambulance, he was on a drip. In his confusion, he pulled out the drip and then there was blood all over. So, because the patient was very ill and had blood all over, the staff thought he was bleeding from everywhere, so it might be ebola. So, I want to dispel that rumour and just say that, we do not have a case of ebola at all in Zimbabwe for now. I want to emphasize, for now and I would like to say, we hope that we will not have a case of ebola in this country. We will continue to strengthen our surveillance and screening at the borders and again, we hope we will not have a case of ebola in the country in future. I thank you Mr. Speaker Sir.

*MR. NDUNA: Thank you Mr. Speaker. I want to pose my question in Shona. Between Chegutu /Kadoma and Chegutu/Norton, there are about five detours where cross border truckers usually stop especially those from Zambia. There are people from nearby places even in Chegutu who sell drinks, sweets and other accessories to the truck drivers. I want to know what precautionary measures you are taking for people coming from Zambia, Tanzania or those who come in contact with these truck drivers from other countries. What measures are taken to control the spread of ebola in Chegutu?

*MR. MADZIMURE: Thank you Mr. Speaker. Hon. Minister I know that as a country we screen visitors from affected countries. What precautions do we have in the event that we might have ebola cases in the country, are we able to treat them? Secondly, it is said that West African countries are receiving aid from the US. Do we have enough funds or resources set aside in case we might have Ebola outbreaks in the country so that we will be able to deal with the issue? Do we have resources set aside?

MR. HOLDER: Thank you Mr. Speaker. I just want the Hon. Minister to clarify on the situation where the countries affected have continued to use Ethiopian airlines. Ethiopian airlines have now opened up, coming from these affected areas into Zimbabwe. What mechanisms have you put in place and also, if you could also, clarify how ebola is spread. Can the exchange of money spread Ebola or not? I thank you Mr. Speaker.

MS. MANGAMI: Thank you very much Mr. Speaker. I want clarity from the Minister as regards to second hand clothes. People are sending messages on our social media that ebola can be transmitted from second hand clothes. What is the actual position?

*MS. NYAMUPINGA: Thank you Mr. Speaker. I want clarification on women who are involved in cross border trading. What awareness programme has our country given to these women so that they will not contract ebola? We are hearing that other countries are educating their citizens on ebola. I am worried that as women, we might contract ebola and then we go back to our rural areas, get sick and die because of ignorance. I want the Minister to clarify on the issue of public awareness against this deadly disease.

*MR. MUTSEYAMI: I visited Mutare border post and the airport. When you reach there, the officials look at your passport and ask you whether you have visited West Africa for the last 30 days a simple question just like that. When you answer no, they will allow you to proceed. They do not use any other way to detect a person’s health like use of thermometers for temperature checks or anything. I want to know whether there is no other better way that will help the country, looking at technology than asking each other as if we are story telling. We have people who are travelling to Tanzania to get cars. In Tanzania, they are likely to come across people from the Ebola affected areas. These Zimbabweans come back to Zimbabwe using different means of transport and there is incubation period of 21 days. Is it not possible to stop people from coming back for a certain period? After that, then we ask countries to meet like what Sierra Leone did that as from today, there is now a 72 hours curfew, you are not allowed to go out of your house, not your yard. Thank you Mr. Speaker.

MS. ANASTANCIA NDHLOVU: I want start by thanking the Minister for the efforts that they have made at our entry points such as the airports. Let me emphasise on what the hon. member said that we need to be very strict. I passed by the Harare International Airport two days ago and they just asked me if I had been to West Africa and I said no, and no one opened my passport to check. So, we need to be more thorough with our system. Also to say in terms of awareness, I am not referring to cross-border people only, I want to find out what efforts the Ministry has put in place or what efforts they are making to bring awareness. I remember that when this country was struck by the cholera epidemic, everyone was taught on the dangers, prevention et cetera. So, I want to find out on the level of awareness regarding the general populace of the country, not just cross-borders, but everybody from children who are in schools and everyone in the country.

MR. S. MADZORE: Thank you Mr. Speaker Sir. My question pertains to the levels of preparedness as a Ministry regarding training of personnel specifically on the causes and how to properly handle the treatment of ebola. I want to know the level of responsiveness regarding the health professionals. I am referring to the nurses and doctors. What have you done as a Ministry to ensure that a focused training is imparted to our health professionals?

MS. CHIMENE: I want to thank the honourable Minister for the statement. My worry is on the people who work at the border posts because they receive passports with bare hands. Are these people very safe? The other question is that advertisements are not being done as expected because this disease is deadly. We thought instead of having cigarettes and beer advertisements between news, we can have Ebola awareness advertisements. People should be told not to shake hands, hugging each other and so on.

MR. GABBUZA: Thank you Mr. Speaker. The pre-screening of Ebola is normally done at official border posts but the Hon. Minister is aware that there are several unofficial crossing points particularly between Mlivizi and Binga and people are getting shoes from the DRC and many other areas. Is the Ministry considering, maybe setting up an initiative like ZAM-ZIM Anti Malaria Programme to try and avert this spread of Ebola because that is a very potential transmission area.

*MR. NYANHONGO: Thank you Mr. Speaker. I have just received information from my Constituency that three wards have been affected by typhoid. What measures are you taking to respond to these to check whether there is no relationship between this problem and ebola? I was of the view that there should be an urgent response to this to check whether it is typhoid or something else.

MR. MANDIPAKA: My questions is that, in Liberia, we understand Mr. Speaker Sir that it has been ravaged and we had our police officers conducting United Nations Peace Keeping Missions there. I would want to know from the Minister whether they are still safe or they have already been withdrawn?

*THE MINISTER OF HEALTH AND CHILD CARE (DR. PARIRENYATWA): Thank you Mr. Speaker Sir. There are several pertinent questions and I really appreciate hon. members asking these questions because it does show their concern but it also illustrates that we need to educate each other much more. In other words the issue of awareness is a big issue. I am glad that I have brought in here the representative of the World Health Organisation in Zimbabwe, he is sitting right there, Dr Okello, perhaps he will be giving me written coaching on some of the technical issues. Mr. Speaker Sir, clearly we need to start educating our own legislators here so that they can spread the word to others.

Let me start with the question asked by Hon. Nduna on the detours and on how prepared we are and also touch on resources whether we liaise with other SADC countries. Your question Hon. Nduna is very good. When you get the transmission of ebola, if you understand transmission, everything else becomes easy. Ebola is transmitted through contact with someone affected or a dead body of a person who was affected with ebola, but in that contact there should be fluids that will have been exchanged between the two bodies probably through tears, blood, urine, sweat, feaces and semen.

Such fluids transmit ebola. Ebola cannot be transmitted through coughing like flu, it is not airborne. It is transmitted through body fluids or a contaminated object and we should understand that. People should stop shaking hands like we used to do during the cholera outbreak, to greet each other using clenched fists. We should continue to do that so that we do not end up having that contact which spread the fluids.

Mr. Speaker Sir, the issue that has been raised of clothing, on whether ebola can be transmitted through clothing, it is possible to transmit it when it is still fresh. The virus has a very short life span. After four hours, it is dead. There is no danger in those clothes. Fresh bodily fluids are dangerous. You should be very careful; do not shake hands.

I am the Chairman of the SADC Health Ministers, we have met twice on this matter. Most of the things we are doing in Zimbabwe are being done in neighbouring countries. This is a new disease. The problem with our country is awareness, conscientising the people like we did on the issue of HIV/AIDS. What we have done here is, we have taken the job and have given it to the National Aids Council. The National Aids Council did a lot on the issue of HIV/AIDS. It has Provincial Aids Council, DAC, WAC and FAC for families. That is the process we are going into so that they look into this and use radios, televisions and other media.

The matter where you said advertisements should be placed at intervals in between programmes, my plea is that advertisements are placed regularly on television, radios, et cetera. I can see that you want us to conscientise each other here. Probably our people are even worse off. Therefore, we should quickly pass on the word to the chiefs, village heads, religious leaders, traditional healers and all that we used to do long back. The word should go into schools so that it reaches the people. How it is transmitted and how we can do advocacy, we have already covered that.

Hon. Holder asked about what is being done to European countries who have removed travel bans. He asked whether we are not in danger because of that. Travel bans have been banned, so the world has agreed that there should not be any travel bans, either on international airports, shipping ports or on road but screening on entry points should be strengthened. It has been discovered in West Africa that travel bans are not serving much purpose. The situation actually becomes worse because it is like imposing sanctions on the people. The people no longer receive food, there is no trade and the economy is collapsing; it is like a country on sanctions. It is counter-productive, so the idea is no more travel bans but strengthen your screening processes and strengthen awareness to the people. That I think is the major target that we are looking at.

There is an hon. member who asked whether Ebola is spread through money. If the money is contaminated, we have to be very careful of course. However, we should not panic too much. If we look at it, yes big populations have been affected but really to date, it is about 4 500 people who have been infected and of those, half have died, of all those countries. Let us measure it and we should not panic too much but we should always be very cautious. Hon. Mangami asked about second hand clothing and symptoms of the disease and I have already explained. Hon. Nyamupinga asked about training and the issue of cross border trading. I think that is the major issue, people should be well informed.

It is not every country that people are suffering from Ebola. There is Guinea Conakry but Guinea Bissau and Equatorial Guinea are not affected. In fact, we have 120 students who came from Equatorial Guinea. We have Guinea Conakry, Sierra Leone, Liberia as the most affected countries. Senegal, Nigeria and DRC are also affected. DRC is the only country in the SADC region affected by ebola. However, we are grateful that DRC has managed to contain the spread of the virus; it is only one corner that has Ebola, on the north-eastern part of the country. One of the best ways of containing ebola is to crowd it at base, to keep it there and bar it from spreading and that is what they have managed to do. DRC has done a good job, they have really crowded it that side, so let us not panic too much about it but we need to continue to teach our people, especially those who are cross bordering.

Hon. Mutseyami asked on the screening of people at border posts. As a ministry, we keep on improving the system. It is a very new system, we are keeping on improving and we have trained our people. There are trainings that are going on. WHO last week and this week has been training, particularly health professionals because in Sierra Leone and Liberia, a third of the people who died were health professionals. This is because doctors and nurses are front line people, so they need to be specially trained. We need to give them protective clothing at airports and ports of entry and we have already given them all. We have capacitated them and given them gloves to protect themselves. We have protective gear at border posts just in case something happens. Also, there are forms which are going to be instituted. Everybody is going to fill in a form and we screen from that form. The form contains information of where you are coming from, where you are going, contact details, so that we are able to be more actively screening. We should not make people look like prisoners.

They are not prisoners; we should be able to balance and protect their human rights and protect them from diseases. We are screening but we do not isolate them. Let us not even stigmatize those countries where Ebola is coming from. We are trying our best together with WHO and other partners to use this stance to balance that equation.

The issue that you have raised on borders, I agree with you but we are not doing an effective job at entry points. We have ordered thermometers that we put on your forehead and we measure your temperature. You can come into the country without the virus but when you pass through the entry point; your temperature has been checked and it showed that you are well – 11 days down the line you begin to show symptoms. It is not a matter of isolation, the most important thing is where have you been? Who have you been in contact with? Not everybody with a high temperature has ebola.

You asked me about symptoms and I will repeat; these are high temperature, sore throat, diarrhoea or vomiting and body weakness. It does not mean if you have these right now you have ebola. No. These are symptoms that you also get with malaria, common flue and typhoid. These are generic symptoms but what is important is: have you been in contact with someone who has ebola or a dead body of an infected being? If you have not been in contact with such, do not conclude that you have ebola.

If the symptoms persist, you begin to bleed everywhere; on eyes, nose, mouth, ears, anus, vagina and so on. Usually, you do not survive. Those are the symptoms.

In this region, only South Africa has the laboratory called level 4 laboratory; it is a special type of laboratory where they test for ebola. When we get samples like the ones we got from South Med, we had to send them to South Africa. They sent back the results and they said it was negative. We have not reached that level 4 and we need to do it properly.

Someone asked why we did not respond yesterday when there were messages that the ebola was now in Zimbabwe; I said we first of all verify. We have verified and there is no ebola in the country yet and we hope it stays like that.

Hon. Mutseyami indicated that in Tanzania they mix with our people. There is no Ebola in Tanzania. We should not suspect that there is Ebola like what is happening in Europe. They suspect that anyone from Africa has Ebola even if you come from Chegutu. Let us be careful with what we also do to others, it will be done to us. Let us be careful about how we relate to this issue.

In Sierra Leone, people have been put in ‘keeps’; there is no need to do that internationally. There is absolutely no need to isolate ourselves. It is not possible. In fact this Sierra Leone trial is not giving us better results, it is a study, we will see what comes out from there.

Hon. Ndlovu said that we should be stricter and there should be more training for nurses. I agree with you entirely, we need to continue training and on awareness, we can do what we did for cholera but more instructively what we did with HIV. I think that is the way we will do it.

Hon. Madzore also spoke about training of health professionals, I agree with you. There is specific training for them because they are front liners and a lot of them have died in West Africa.

Hon. Chimene, I said they should wear gloves. Wherever I go, I am always checking on that. I have been to Victoria Falls and Beitbridge to see how they are doing it. It is important to keep on prompting our people to be more vigilant.

Hon. Gabbuza mentioned that there are several entry points; it is very difficult for us honestly that Ministry of Health and Child Welfare looks for illegal borders. We ask the Ministry of Home Affairs to intervene on this one.

Hon. Nyanhongo said his people have typhoid and you are wondering if it is related to Ebola. They are two different entities and I suspect that our Provincial Medical Director, the issue will be dealt with if they have not already dealt with it. Every typhoid cases are reported, we must have it and reactions must be happening already on that side.

Since you have mentioned it, I will follow it up but typhoid and Ebola are not epidemiologically related.

Hon. Mandipaka, I think I also covered the issue that you raised.
Mr. Speaker, I have tried to answer but I think that in general our thrust is more awareness, screening at the borders, removing stigma from our people. Let us all recognise, no more travel bans but stricter screening procedures. I thank you Sir.

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