Zim.Cholera timeline

JOHANNESBURG , 5 December 2008 (IRIN) - The UN is calling it an "unprecedented cholera outbreak", with more than 500 lives claimed in Zimbabwe since August 2008. This is a timeline of cholera in the country in recent years and how it reached epidemic proportions.

1993 – The World Health Organisation (WHO) reports 5,385 cases and 332 deaths from the waterborne disease.

1998 – For nearly five years there are no reports of cholera, but 335 cases and 12 fatalities are recorded in 1998.

1999 – 700 cases and 88 deaths, attributed to unsafe water, poor
sanitation facilities and the lack of information on how the disease
spreads.

2002 – 3,125 cases and 192 deaths recorded.

2004 – Interruptions in reticulated water supplies, burst sewage pipes
and contaminated reservoirs are blamed for an outbreak that kills 40
people and infects 900 others.

2005 – About 14 recorded deaths and a further 203 infected during the
low-risk months from May to June. Shortages of medicines hamper
treatment.

2006 – Civic organisations in the capital, Harare, warn of a "cholera
time-bomb" after an outbreak in March kills 27 people; refuse
collection is poor and burst sewage pipes remain unrepaired. Government
dismisses the concerns of civil society.

2007 – February – Erratic reticulated water supplies are blamed for an
outbreak in Harare that kills three people and infects another 19.

2007 – August – Reports that the Zimbabwe National Water Authority
(ZINWA) has dumped raw sewage into Lake Chivero, Harare’s main water
supply source.

Public clinics report they are treating about 900 cases of diarrhoea daily.

Burst sewage pipes remain unrepaired.

2007 – September – Severe water shortages in Zimbabwe’s second city,
Bulawayo, with about 400 people treated for cholera and dysentery.
About 40 cases reported in Harare. Residents dig shallow wells as
erratic water supplies continue. Hygiene and sanitation become
increasingly compromised.

2007 – November – Severe water shortages lead to over 3,000 cases of
diarrhoea in Bulawayo. WHO and UNICEF, the UN children’s agency, and
other humanitarian agencies assist the health ministry in containing
the outbreak.

2008 – January – Hundreds of cases of stomach ailments reported and at
least 10 people die from dysentery and diarrhoea; sporadic reports of
cholera in Harare’s working-class suburbs. Health services become
increasingly stretched as doctors and nurses embark on strike action
for higher wages because of the country’s hyperinflation.

2008 – February – Bulawayo municipality says it is bankrupt and cannot
deliver services or purify water. Water rationing imposed. Cholera
outbreak in the rural areas of Mashonaland East and Central provinces
claims at least

11 lives. Hundreds of cases of diarrhoea reported in Harare’s poor suburbs of Mabvuku, Tafara, Hatcliffe and Chitungwiza.

2008 – March – Service delivery collapsing. Refuse uncollected, and
more than 500 reported unrepaired burst sewage pipes in Harare. At
least 14 cases of cholera reported and four fatalities.

2008 – August – Rising discontent over ZINWA’s failure to provide
uninterrupted water supplies and government’s inability to collect
refuse after another diarrhoea outbreak in Harare; 19 cases of cholera
reported in the townships of Mbare, Kuwadzana, Highfields, Chikurubi
and Mbvuku.

2008 – September – Sewage flowing in the streets and interrupted water
supplies result in at least 11 fatalities from cholera. A political
power-sharing deal is signed between the parties, but fails to break
Zimbabwe’s post-election logjam.

2008 – October – About 120 cholera deaths reported since February, and
the recognition that cholera is becoming more difficult to contain as
it spreads from urban to rural areas.

The UN says it is battling the disease in three areas: Chitungwiza, a
dormitory town on the outskirts of Harare, where 144 cases and 15
deaths are reported as of 13 October; Mola, in Mashonaland West
Province, where 22 cases are reported and one fatality recorded as of 7
October; and Chinhoyi, also in Mashonaland West, where 15 cases and six
deaths are reported by 13 October. The political deadlock is said to be
hampering the fight against cholera.

2008 – November – The Civil Protection Unit (CPU), which is usually
deployed in times of disaster, assists in water provision, establishes
cholera clinics and conducts educational programmes. The government
says the CPU’s deployment was not in response to a disaster. UNICEF
assists in water provision and ZINWA acknowledges that they have been
pumping raw sewage into Lake Chivero, Harare’s main water source.

Cholera crosses international borders and 14 cases and two fatalities
in four days are reported in the South African border town of Musina.
In Beitbridge, a Zimbabwean town on the border with South Africa, 445
cholera cases are reported and South Africa’s Red Cross Society
evacuates hundreds of patients from Zimbabwe for treatment in South
Africa, where medical resources are more readily available.

In Zimbabwe, humanitarian organisations report 2,893 cases and at least
115 deaths from cholera since August. Health organisations warn that
the onset of the rainy season will exacerbate an already precarious
situation.

Médecins Sans Frontières warns that 1.4 million people are at risk from cholera in Harare alone.

Reliefweb, the website of the UN Organisation for the Coordination of
Humanitarian Affairs, reports 9,463 cases and 389 dead as of 27
November.

WHO procures supplies to establish 30 treatment centres.

2008 – December – The Limpopo River, which delineates the border
between South Africa and Zimbabwe before flowing through Mozambique to
the Indian Ocean, tests positive for cholera. The UN says there have
been 12,546 cases and 565 deaths since August, although civil society
says cholera deaths could be in excess of 1,000. UNICEF provides
Harare’s water authority with a month’s supply of water treatment
chemicals.

On 4 December the Zimbabwean government declares the cholera outbreak a
national emergency and calls for international assistance. Britain, the
country’s former colonial power, pledges about US$11 million. The
government says it required US$4 for water treatment and delivery alone.

Hundreds of asylum seekers from Zimbabwe have been streaming into South
Africa daily; the number of illegal immigrants is unknown. Authorities
fear the migration could result in cholera establishing a foothold in
South Africa.

WHO says the death rate among infected Zimbabweans is 4.5 percent, and
as much as 20 percent to 30 percent in remote areas. The normal
fatality rate, where clean water and medication are available, is below
one percent.

Post published in: Analysis

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