boilingspot: Cholera moves to rural Zimbabwe

BBC News, 22 January 2009

The collapse of the health system has fuelled the cholera outbreak

The main impact of Zimbabwe's cholera epidemic has shifted from urban areas to rural areas, making its containment much harder, a medical charity says.

Medecins Sans Frontieres told the BBC that the disease was spreading to remote areas, while cases in some urban areas, like Harare, were decreasing.

The UN says at least 2,755 people have now died - a 20% rise in a week.

The rainy season could lead to even more infections, as water sources become contaminated, aid workers warn.

MSF Zimbabwe representative Manuel Lopez said that small villages off the main roads were now being affected following the Christmas holidays, when urban residents went home.

"Everybody touches the body and everybody cries on the body and they get infected as well." - Manuel Lopez, MSF

Funerals of cholera victims had also seen the infection spread out of the cities.

"Traditionally in Zimbabwe whenever someone dies they usually bring the body to the village of origin for funeral and burial and many times, unfortunately, bodies are not disinfected," he told the BBC News website.

"Everybody touches the body and everybody cries on the body and they get infected as well."

He added that the lack of awareness and the difficulty of getting to clinics meant that those dying of such an easily treatable disease was growing.

"Many times they don't have the transport means to the clinics because transport is one of the biggest challenges in the country.

"They don't have vehicles as well as they did some years ago and on top of that it has become very very expensive for people."

In many urban areas, like Harare, cases are actually decreasing, he said.

Doctors' strike

President Robert Mugabe has faced increasing criticism over his country's dire economic and humanitarian plight.

The cholera outbreak has been fuelled by the collapse of Zimbabwe's health, water and sanitation systems.

Opposition leader Morgan Tsvangirai visiting a cholera treatment centre in Harare

Zimbabwean journalist Brian Hungwe says that many nurses and doctors are refusing to work, unless they get paid in hard currency.

The Zimbabwe dollar is virtually worthless, because of hyperinflation. Last week, a new Z$100 trillion note was launched - worth about US$30 (£20).

Mr Mugabe's allies have accused Western countries of trying to use the cholera outbreak as an excuse to topple him.

Cholera cases have been reported in all 10 of Zimbabwe's provinces and nearly 50,000 people have been infected with the preventable disease, the WHO says.

A week ago, it said 2,200 people had died from cholera in Zimbabwe since August 2008.

The disease has also spread to neighbouring South Africa.

African pressure?

The latest WHO figures were released as campaign group Human Rights Watch called on African leaders to put pressure on Mr Mugabe to end Zimbabwe's suffering during an African Union summit in Ethiopia next week.

HEALTH CRISIS

Cholera: 2,755 died since August

Anthrax: Eight deaths since November

HIV/Aids: Estimated 400 deaths a day

Maternal mortality: Risen from 168 per 100,000 in 1990 to 1,100 in 2005

The organisation accuses Zimbabwe's government of leaving five million people dependent on food aid and most of the population without access to health care.

South Africa says it will host a regional summit next week - the latest attempt to broker a power-sharing agreement between Mr Mugabe and opposition leader Morgan Tsvangirai.

The pair met on Monday but failed to make any progress on implementing a deal they agreed in September. They remain divided on the key question of who should control key ministries.

The opposition leader won the first round of last year's presidential election but withdrew from a run-off in June citing state-sponsored violence.

Mr Mugabe's supporters blame Zimbabwe's problems on Western sanctions.