The Aftermath

“Vasvika, vasvika!” (Shona meaning, they have arrived), excitedly exclaimed the children of the homestead we were visiting. They had been waiting all day for us to arrive as promised but we were very late as the drive was filled with twists and turns – literally.

In 2019 tropical cyclone Idai devasted the Chimanimani and Chipinge districts of Zimbabwe. I was freshly deployed as a District Coordinator supporting the Chipinge District with a project focused on identification and treatment of tuberculosis (TB) in children. Our district had especially high rates of tuberculosis, with 98 cases per every 100 thousand people, and timely, quality care was paramount to this community’s overall health and well-being.

Nothing could have prepared me or my peers for the aftermath of the tropical cyclone. Thankfully, the district hospital where we were stationed was spared, but this was not the case for many of the smaller sites we supported, which are key touchpoints for healthcare in rural communities, leaving them without access to much-needed health services. The strength of the cyclone washed away roads, marooning many on their homesteads, and making travel to the spared district hospital perilous, or even impossible.

Together with district teams, we devised a plan to follow up on all of our patients, collect samples for TB testing and provide medicines as needed. Thankfully the organization has all purpose vehicles which enabled us to travel through the cyclone-damaged terrain. Journeys were now much longer, as navigating through the damage was extremely treacherous with loose boulders and trees obstructing what was left of the roads. On some occasions, even our capable vehicles just could not cope.

In this short clip, the vehicle was struggling to cross a river with many loose boulders from the cyclone. This 50 km journey, which ordinarily should take 30 minutes, took us 4 hours. For this river crossing my colleagues and I exited the car and walked carefully across the rushing water, allowing our colleague driving to manoeuvre the vehicle without the additional weight of the team. We were told by the family we were visiting that before the cyclone it was barely a small stream and they crossed easily. After the cyclone, the flow of the water increased and left them marooned on the other side.

The family was glad to see us as we had brought supplies of clothes and a few groceries for them and their 20-month-old baby, who we had tested and confirmed a TB positive. Their joy to receive much needed life-saving medication for their family is what carried us through this tough challenging period providing health services in the aftermath of tropical cyclone Idai. Idai disrupted the healthcare of thousands of people in Zimbabwe, but research suggests this is just the beginning, as the severity and frequency of such extreme weather is expected to grow over time due to climate change. That week it took us eight times longer to provide health services, and families could not get to health care in the case of medical emergency. Can these families survive another, stronger storm?

Without robust investment in climate-resilient infrastructure and healthcare planning, we will continue to be unprepared for these events, and I fear for the communities I’ve worked so hard to uplift and care for. I’ve joined a group of my colleagues at the Elizabeth Glaser Pediatric AIDS Foundation to look at how our organization can better prepare for the future, and I call on the broader public health community to look seriously at how we can be proactive in protecting essential healthcare in the face of climate threats.

Caroline Madiro-Zinyemba is a Senior Public Policy & Advocacy Officer with the PPA team based in Harare, Zimbabwe. In her role she provides strategic direction to EGPAF countries in Africa for improving public policy and advocacy implementation at national level. Caroline holds a Master of Science in Development Studies and has more than 17 years’ experience in regional and national public health programming.