The toll from Zimbabwe's cholera epidemic will almost double in the next few months as up to 55,000 more people contract the disease, according to private predictions by the World Health Organisation.Last weekend the number of infections swept past 60,000, the worst case
predicted by the United Nations in early December. The Times has now
obtained a WHO memorandum expecting between 32,000 and 55,000 more
cases.
The epidemic has already claimed 3,300 lives – greater than the toll
for the whole of Africa in most years – and is one of the worst
recorded. Last week there were 8,578 new cases and 324 deaths.
We are at our wits' end, one senior aid worker confided. We are not
yet winning the battle, admitted Custodia Mandlhate, the WHO
representative in Zimbabwe.
Another Western health official said that the epidemic would not end
until May, when the rains cease and it can run its natural course.
Cholera has increasingly moved from urban to rural areas, and the
small, isolated village of Numasi, with its thatched mud huts, dirt
paths and tiny vegetable plots, illustrates why a small army of aid
organisations has failed to tame it.
The disease arrived in Numasi on December 23, almost certainly imported
by a city-dweller returning to relatives for Christmas. A middle-aged
man, Iwell Phili, was the first to fall sick. Nobody knew what was
wrong with him. The local white farmer who might have helped was on
holiday. Within two days Mr Phili was dead, and a red flag flies from
the roof of his hut to warn of danger.
In early January an old man, Everson Ngozo, developed the same symptoms
– sweating, vomiting and chronic diarrhoea. The farmer sent him to the
town of Chegutu, 15 miles (25km) away along a pitted track, but Mr
Ngozo died on the way. The villagers were shocked. They didn't know
what was happening. At first they thought someone among them was a
witch and killing the others, said George Zulu, one of their number.
Margaret Phili, a woman in her sixties, developed the illness one
morning and was dead that night. The day of her funeral her husband,
Lapulan, developed cholera. It started in my stomach. I got diarrhoea,
then I passed out. I didn't know what was happening. I thought I was
going to die, he said. He, too, was taken to Chegutu, spent five days
in the cholera treatment centre there, and survived.
Four other villagers were stricken and lived, but not Yusof Katumba, 14, who succumbed in less than 24 hours last week.
Western aid organisations, working with Zimbabwe's skeletal health
service, have made herculean, if sometimes haphazard, efforts to
counter the epidemic. They have trained or retained medics and
volunteers, helped to open 235 cholera treatment centres, delivered
oceans of clean water, drilled scores of boreholes, unblocked sewers,
and distributed untold quantities of hygiene kits, buckets, water
purification tablets and leaflets.
In urban areas this has yielded results. The Chegutu cholera centre – a
canvas encampment on the edge of town – was receiving 145 cases a day
when it opened in early December but now receives a mere handful.
However, cholera is erupting instead in rural areas, where it is far
harder to control.
Infections soared after Zimbabweans returned to their villages en masse
for Christmas. The health service no longer has the vehicles, fuel or
staff to venture into the countryside to educate, spray and bury.
Villagers are so destitute that they have no means of reaching the
urban cholera centres, and in extreme cases – especially in a
population weakened by hunger – cholera can kill in four to six hours.
Most villages have no sanitation and rely on shallow wells for water,
and with the rainy season in full spate many of those have been
contaminated. Villagers are often unaware of the need to boil their
water or wash their hands – even if they had soap. They sometimes fail
to report cholera deaths, or to bury victims properly, and officials in
Chegutu spoke of instances where corpses were simply abandoned.
More than 70 per cent of Zimbabwe's victims are now dying in their
communities – meaning that they are unable to reach help at cholera
centres. Fatalities are running at 5 per cent, far higher than need be
the case for a disease easily treated with antibiotics and rehydration.
But the regime of Robert Mugabe appears unconcerned about the tragedy.
Cholera is under control, Gideon Gono, the Reserve Bank governor,
declared this week. Every year there is a cholera outbreak in southern
Africa. The epicentre of the disease just happened to be in Zimbabwe
this year.
Anatomy of an epidemic
1,828 cases diagnosed on Wednesda
27 deaths confirmed on Wednesday
90 per cent of districts affected
61 per cent of those districts reported new cases on Wednesday
3,323 have died since outbreak began in August
65,739 infections since last August
1 per cent of those infected with cholera die, under normal circumstances
5 per cent of those infected in Zimbabwe are dying because of lack of clean water
13 months since Harare's biggest township, of one million, had running water
34-year life expectancy for women in Zimbabwe, the world's lowest
Source: www.reliefweb.int; Times database
Blantyre Cholera has killed more than 50 and affected more than 1,800
people in Malawi. The Health Ministry said that 39 deaths occured in
two shanty towns in the capital, Lilongwe, because of water shortages
and poor sanitation. (AFP)
Post published in: Analysis