Community-based emergency management: a case study on a cholera outbreak in Zimbabwe

Emergency management has been influenced by top-down approaches that prioritise the need for technocratic expertise and resource base in addressing acute situations. However of key importance in the processes of emergency management is the participation of affected communities, especially poor communities as these are most likely to experience severe adverse effects. In cholera outbreaks, responses to managing outbreaks have tended to be reactive rather than proactive, with a limited role for community participation, that is, some involvement in health education programmes. However community participation goes beyond “involvement” in programmes and requires active leadership to empower people to participate in emergency planning. A qualitative research study was conducted in Gadzema, a cholera-affected area in Chinhoyi town, Zimbabwe. This study draws on the community’s and local emergency actors’ perceptions about Cholera and the outbreak management in 2008. Utilising focus groups and key informant interviews, perceptions were analysed in relation to the literature on emergency management and the ladder of community participation framework. Although the findings suggest that the community was involved in the response to the outbreak through community health education campaigns and being recruited as community health volunteers, there is still more scope to enhance community participation in planning for future outbreaks. Through developing strategic steps to encourage community participation, social determinants of health can be identified and used to inform policy development to redress the underlying health problems in Chinhoyi