JOHANNESBURG, 29 December 2008 (IRIN) - "There is no food, we have malnutrition, there is cholera, now we are expecting a malaria outbreak," said an exasperated Amanda Weisbaum, the emergency manager for Save the Children, UK, in Zimbabwe.

As the cholera death toll climbed to 1,564, and its caseload to near the 30,000 mark, Save the Children has found that acute malnutrition in children aged six months to five years has doubled since 2007 in one of the two districts in which it has been working in Zimbabwe.

With the onset of rain, there are mounting concerns of a possible malaria outbreak ravaging immune systems weakened by cholera and malnutrition, "especially among those aged under five", said Weisbaum.

But reaching out to those who need help in a country where most of the infrastructure has collapsed, and the inflation rate is unofficially in the trillions of percent, is a huge challenge and "extremely frustrating", she said.

"In terms of access, Zimbabwe, comparatively, is one of the worst areas I have worked in," said Weisbaum, who has worked in some of the world's crisis hotspots - Darfur, Chad and Niger. "At least in Darfur, when we ran out of stock we could fly in supplies to the areas we worked in - here we cannot," she said.

Challenges

Weisbaum listed the challenges an aid agency such as Save the Children, which works in two districts in the Zambezi valley in northeastern Zimbabwe, faces:

1. Communications: "Our day begins with us [the head office in the capital, Harare] trying to get in touch with our offices in the two districts Binga and Nyaminyami. It can at times take us an entire day - the phone lines don't work. Radio communication is also relatively poor," said Weisbaum.

2. Foreign exchange: When the office in Harare does get through to district offices, raising foreign exchange to buy and deliver the supplies is a "huge" problem.

Since last month, aid agencies have been allowed to pay their national staff in foreign exchange. The economy unofficially runs on the US dollar. "But we don't know who decides the exchange rate - the banks don't function very well and accessing US dollars can be quite problematic," explained Weisbaum. Petrol costs about 75 US cents per litre, and diesel about $1.20 a litre. "It [the costs] is huge for us, especially when you calculate the distances in trying to reach out to rural communities."

The aid agency can also spend an entire day trying to find foreign exchange to buy fuel and pay the driver.

3. Food shortages: Feeding staff and beneficiaries in the Cholera Treatment Centres (CTC) set up across the country in response to the cholera outbreak remains a huge challenge. "We provide food packs to our staff going to the field because often they cannot access food."

The charity even had to raid its own stocks to send food for 22 new cholera admissions and care givers in a CTC over the past few days in Nyaminyami District. "It is the World Food Programme's job to provide food for those admitted in the centre, but they don't have food either," explained Weisbaum. WFP is already rationing food aid in Zimbabwe.

4. Writing reports to raise money, which might not come: "And I think we seem to spend many days just writing reports, attending meetings, trying to compile data to raise money from donors, when we should actually be out there trying to help beneficiaries," said a frustrated Weisbaum.

The level of donor confidence in Zimbabwe is very low partly because of the uncertain political situation, so funds do not always follow reports and appeals. But the response to the cholera outbreak has been good, according to Weisbaum, so the aid agency hopes to raise money for its operations for the next few months on the back of the cholera outbreak.

All Zimbabwe needs is a bit of money, training "as doctors and teachers have all fled the country", and some political initiative, and the country would be back on its feet soon, added an optimistic Weisbaum.

jk/cb

© IRIN. All rights reserved. More humanitarian news and analysis: http://www.IRINnews.org

IRIN news