Deadly cholera outbreak: Zimbabwe's latest affliction (News Feature)

By Jan Raath Nov 3, 2008, 18:23 GMT

Harare/Johannesburg - Most of the patients lay limp as corpses, on the ground in the open, some of them with their drip bags of saline solution suspended from tree branches. All 28 of them had been brought in during the day.

Flies hovered over a nearby overflowing garbage bin and there was a pool of vomit, almost certainly brimming with the cholera pathogen, near the entrance to the cholera isolation area.

Since the current outbreak of cholera, the worst in Zimbabwe's history, began two weeks ago, nine people have died in Harare's Beatrice Road infectious diseases hospital, a scruffy, run down municipal institution in a crowded township with a perennial stench of raw sewerage and permanent embankments of uncollected garbage.

How many more have died without entering the hospital is unknown.

'The situation is 500 per cent better than on Saturday,' said an aid agency doctor who asked not to be named. 'It was like a war zone in the Congo. Sputum, vomit, faeces on the floor, patients unattended, lying with empty drip bags. The kitchen was in an appalling state and the hospital toilet wasn't working.'

At the weekend, Western aid agencies moved in, delivering drugs, disinfectant, water sterilizers, mops, buckets, and water tanks to the critically under-funded and under-staffed hospital. The local Red Cross sent auxiliary nurses as cleaners to free the hospital staff for medical work.

'Twenty is probably an underestimate for those who have died in the community, either without or after treatment,' the doctor said. 'We don't know if the incidence of cases will spike in a sudden surge of hundreds of cases. It is the potential start of an epidemic that could spiral and turn out very, very bad.'

Most of the cases Monday and the deaths were from the sprawling township of Budiriro that has 115,000 residents, but cases from other townships were also registered, indicating a wide spread of infection.

A total of about 130 people have died in cholera outbreaks around Zimbabwe this year as the country's economy crashes and infrastructure irrevocably closes down under the weight of multi- billion per cent inflation.

Death by cholera is the latest affliction to be visited on care- and disease-worn Zimbabweans. Famine all over the country is reported anecdotally to be claiming the lives of hundreds of infants.

Zimbabwe has one of the highest rates of HIV-AIDS infection in the world - about 16 per cent of the adult population. 'People are already nutritionally compromised and immune-compromised and a bout of diarrhoea is a death sentence,' said the doctor.

On Monday, state radio reported fresh cause for alarm - an outbreak of rabies, the virus transmitted by dog bite that ends in death if untreated, in the southern town of Masvingo. There were no vaccinations in the country to treat patients, and doctors were 'having to refer patients to go back home and treat wounds with salt and water,' it said.

And there is no doubt in the minds of most people that the sole cause of it all is Zimbabwe's 84-year-old President Robert Mugabe who refuses to relinquish his hold on power, despite losing elections in March this year.

Harold Mawere looked anxiously across at his brother, lying still on a bed in the open. 'He's been lying there for an hour, and blood has started to flow back into the drip bottle, and no-one is doing anything,' he said. 'He came to visit us in Budiriro yesterday and in the middle of the night he was suddenly attacked by cholera. We brought him here this morning, and I don't know if my wife and kids are ok.

'These people are innocent,' he said. 'This government has made all this, they don't care about people. There has to be a political solution. Mugabe has to go, and then we can begin our lives again.'

The collapse of the sewerage system and the breakdown of water supplies that has lasted for an unbroken year in some parts of the city, date from Mugabe's enforced decision in 2004 to create a government water utility that took over Harare's water supply from the municipal authorities, says Budiriro councillor Penganayi Charumbira of pro-democracy leader Morgan Tsvangirai's Movement for Democratic Change who beat Mugabe in the March elections.

'Harare and most other urban councils are run by the MDC, but Mugabe wanted to strip them of power, so he took away the water and gave it to ZINWA (Zimbabwe National Water Authority). It's a disaster, they didn't know what they are doing and now we have no water in the townships and sewerage is running in the streets, and flowing into people's wells.

'This is why there are these dire consequences now. It is all caused by politics, and we have to get rid of him.'