Q and A with Kate Sheahan, Merlin’s Emergency Response Program Manager
Kate Sheahan, Merlin’s Emergency Response Program Manager, is currently based in Harare, Zimbabwe, where Merlin is responding to a widespread cholera outbreak. Merlin has partnered with the German NGO, Welthungerhilfe (GAA) and has been scaling up to address Zimbabwe’s public health crisis since November 2008. Currently, Merlin is reaching up to 500,000 people with a network of oral rehydration points, or ORPs, in both rural and urban areas.
A native of Chicago, Kate completed her Masters in Public Health at Tulane University in May of 2003. She has worked with Merlin since 2004, stepping into a number of different roles and taking on a range of responsibilities in countries throughout Asia and Africa.
Starting as an Operations Officer at Merlin headquarters in London, Kate helped coordinate tsunami relief projects in Sri Lanka, Myanmar and Indonesia, and health programs in Afghanistan. She was deployed as a part of the initial emergency response team following the earthquake in Pakistan and visited Nepal several times to secure Merlin program funding and registration with the government. She then went on to work in the field, spending five months in Darfur, Sudan, which remains one of the most challenging and inextricable humanitarian crises in the world. She then worked for a year in Liberia as a Project Coordinator in Maryland County.
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Q: You’ve been working in Zimbabwe since December 2008. According to the World Health Organization, or WHO, this cholera outbreak is one of the largest ever recorded. Yet it’s difficult to get a sense of conditions on the ground. What are your impressions of the situation?
A: There is a relatively good infrastructure—in Harare and the areas around Harare—so one must actually look beneath the surface. This is where you see that the country is crumbling, literally and figuratively. People are really struggling and schools have not been functioning properly because teachers are on strike. The national currency is losing its value; one can often see piles of money torn to pieces, or just left in piles on the ground. One of the most striking images I’ve seen is a truck driving down the road with Zimbabwe dollars blowing out of the back. There were literally thousands of bills blowing away, but the driver didn’t care because the money had lost its value. It was like snow, it was snowing money!
Q: If the economy is increasingly becoming more reliant on foreign currency how does this impact health care?
A: Health care services are now priced in US dollars and most people have no access at all to foreign currency. Prenatal appointments can cost up to USD $50, but your average security guard makes about $150 a month. A routine C-section can cost up to USD $800, so that presents a significant barrier to basic and emergency obstetric care.
Q: How do you address the severity of this cholera outbreak and the challenges that go with it?
A: Historically, Zimbabwe has had annual bouts with cholera. Therefore we first need to address the underlying problems in order to prevent cholera outbreaks in the future. Merlin programs are doing this by ensuring that people have early access to treatment. We are also teaching people how to prevent cholera and building the capacity of the Ministry of Health to prevent and respond to outbreaks.
Q: What are the challenges?
A: We are working in extremely remote areas, particularly the districts of Gokwe North and Gokwe South. It’s hard to get to these areas to provide supervision, supplies and referrals. But we are doing it! It’s also difficult for the government to retain staff in an environment where they do not get paid. We are paying incentives to our staff working at the treatment centers. But this is a major area where the government will need to deliver in order to properly support heath services here. There simply isn’t as much funding for cholera as one might think, and the need in Zimbabwe goes far beyond cholera.
Q: What are the additional needs in Zimbabwe and how do you see the population experiencing the crisis?
A: HIV/AIDS is a major issue here-—the prevalence is amongst the highest in the world and may play into why we see such high case fatality rates here. Graffiti is a really interesting way to see the priorities of the people. One that sticks out in my mind read: “No healthcare, no jobs, no water.” There is a sense of cautious optimism in the air—a result of the recent change in government—and that could mean huge changes in people's lives. But at the same time, people think that cholera has been sent to “punish” Zimbabwe.
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