Cholera outbreak stretches health service

Zimbabwe's two largest infectious diseases referral hospitals are being inundated by new cases of cholera, despite government claims that the situation is under control. A team of government and municipal health workers visited both the Wilkins and Beatrice Infectious Disease Hospitals in the capital, Harare, this week in a bid to ascertain the extent of the outbreak. Patients in three wards at Beatrice hospital have had to be evacuated to make room for those suffering from cholera. "Something has to be done now or we will be swamped by cholera patients in the next few days," a nurse told IRIN. "We are taking in new suspected cholera cases every day, despite reports that the situation is under control." Government statistics indicated that at least 14 people had succumbed to cholera in Zimbabwe, three of them in Harare, but health practitioners told IRIN this week that more than this number had died of the disease. The government said 180 cases of cholera, a severe intestinal infection caused by ingesting contaminated food or water, had been reported by health institutions, a figure disputed by independent analysts and commentators. Health officials at the two referral institutions said they had been told not to divulge any details regarding admissions and deaths related to cholera. "It was an instruction from the ministry that no hospital authority should release any information on cholera," said an official at Wilkins Hospital. Precious Shumba, a spokesperson for the Combined Harare Residents' Association (CHRA), said according to information they had compiled, 40 people had succumbed to cholera since the outbreak began three weeks ago. "According to our information, the cholera-related deaths are pegged at 40 - the authorities are just under-reporting the seriousness of the outbreak because they are partly to blame for the outbreak," Shumba alleged. He called for the dissolution of the Harare Commission, led by Sekesai Makwavarara, which was appointed by government to run Harare after sacking the popularly elected mayor, Elias Mudzuri, in early 2004. "Cholera will continue to claim more lives in Harare because people are exposed to unsafe drinking water, raw sewage, and live with garbage which has not been collected for months on end," Shumba told IRIN. The president of the Zimbabwe Medical Association (Zima), Dr Billy Rigava, said cholera could not be controlled as long as there were mountains of uncollected garbage in Harare and raw sewage continued to flow in residential areas. "It's not possible to eradicate cholera when people are still drinking contaminated water and flies are hovering around their food daily because of uncollected rubbish," said Rigava. He noted that the outbreak was a clear indication of the collapse of the country's public services, and urged the commission to provide clean running water and collect refuse. The Harare City Council has been battling to collect garbage and provide clean running water, and some Harare residents have resorted to digging wells or fetching water from unprotected and polluted streams, exposing themselves to waterborne diseases. Council officials have blamed shortages of fuel and foreign currency, and outdated equipment for the current situation. At present the city has 14 refuse collection trucks in operation instead of the required 90. According to Harare town clerk Nomutsa Chideya, "The problem is fuel - we used to receive 30,000 litres of diesel a week but now we are only getting 10,000 litres a week to service the entire capital." A recent council report said water being delivered to Harare homes did not meet the specifications of the World Health Organisation (WHO) and the Standards Association of Zimbabwe. However, Munacho Mutezo, the Minister for Water and Infrastructure Development, maintained that the water quality was of acceptable standard and water cuts were less frequent. "Things are changing for the better, because residents who used to go for weeks without water are now accessing water within two days," he commented to IRIN. "Water released from the treatment works consistently meets WHO guidelines." Deputy Minister of Health Edwin Muguti told IRIN that his ministry was distributing chlorine tablets to contain the disease outbreak. "Cholera is now under control because we are not receiving any new cases," he said.