HARARE // Beatrice Chirumarara says 11 people living on her street in the densely populated Harare suburb of Glen View 3 have died of cholera in the past week. On the next street seven people, all members of the same family, perished after contracting the disease during the same period. Mrs Chirumarara, 37, is one of the few lucky ones to survive a cholera outbreak that has hit Harare and its environs. On Wednesday last week, the married mother of two complained of incessant vomiting and diarrhoea, both symptoms of cholera, and immediately consulted a doctor at High Glen private clinic. "At first I thought it was a minor problem, which would simply pass, but it would not go," she said. "I then suspected cholera and was rushed to clinic that same day. I spent the day there and Thursday under treatment and observation and was discharged late that day. I thought I was dying because I was feeling very weak and losing my voice. Thank God I am still alive." Mrs Chirumarara spent US$110 (Dh404) on medication, a princely sum in this poverty-stricken country. Cholera is a contagious water-borne disease that is caused by a bacteria called vibrio cholerae and is most prevalent in Zimbabwe during the wet season from October to February. Its symptoms are incessant watery diarrhoea and vomiting and it can kill an infected person in as little as three hours because of the excessive dehydration it causes. Official figures say by the end of October, 121 people had died of the disease after 4,500 people were infected over the past three months in Harare and its satellite suburbs, Chitungwiza and Ruwa. The epicentre of the disease has been the sprawling working class suburbs of Glen View, Glen Norah and Budiriro, south of Harare, where streams of raw sewage have become a permanent nuisance and cause of suffering and death. The suburbs, like others in the city, have not received tap water in almost six months. When it comes, residents say, it is greenish in colour and smells of human waste. For two days last week, the water crisis drifted into the city centre, causing authorities to suspend High Court sessions and parliament. The cholera epidemic is the latest crisis to hit Zimbabwe's wobbly health system, already under pressure from Aids and shortages of drugs, equipment and staff. Health experts said the failure by the Zimbabwe National Water Authority (Zinwa), a parastatal utility, to treat sewage for the capital's estimated three million people or provide them with enough safe water has triggered the cholera outbreak. The utility is also failing to collect refuse. Without running water, residents, like Never Nyandoro, have dug shallow wells in their yards from where they fetch water for household consumption. They are also using nearby bushes as toilets. "What can we do?" Mr Nyandoro said. "We have spent more than three months without water, absolutely no water. So our only sources of water are these wells." The government has designated two public health centres, Budiriro Polyclinic and Beatrice Infectious Diseases Hospital, to exclusively attend to cholera patients. Mrs Chirumarara said she was fortunate to seek medical attention at a privately owned clinic as the two designated public centres are short of staff and drugs. "I have realised that most cholera patients who go to Budiriro Clinic do not return alive," she said. Her neighbourhood is always engulfed in a pungent smell emanating from the pools of raw sewage that litter the streets. A stream of sewage flows undisturbed through her yard, with swarms of huge green flies droning around. At first, it disturbed her appetite, but she is used to it now. As a precautionary measure to contain the disease, the government does not allow relatives to visit cholera patients while in hospital, a decision that causes emotional anguish to both the patient and relatives. The state is encouraging residents to adopt more hygienic lifestyles through boiling drinking water and treating it before use. In the event that the patient dies of the disease, relatives are not allowed to view the body or to bury it as the government takes sole charge. People are also barred from cooking food or gathering in large numbers at funerals. David Parirenyatwa, the minister of health, recently discouraged residents from shaking hands "unnecessarily". Sasa Musiyazviriyo, another Budiriro resident, said the early victims of the disease were children aged between one and three, but is now killing people of all ages. "With the deaths we are witnessing in the area, I think the official death toll is an understatement." At Budiriro Polyclinic, which is overwhelmed by the crisis, patients are brought in wheelbarrows, push carts and cars. Some patients sleep on verandas overnight because all beds are taken up. Because of the rising deaths and the pain patients endure, Thandiwe Nyathi of Glen View 7 said she thinks Aids is a lesser evil than cholera. Her reasoning is that Aids, which kills 2,000 Zimbabweans weekly, progresses over years and allows the patient to seek treatment while cholera causes intense pain and kills in hours. The widening cholera outbreak has also alarmed human rights activists. "It is worrisome," said Douglas Gwatidzo, head of the Zimbabwe Association of Doctors for Human Rights. "This indicates the absence of capacity and ability of the government to manage public health." With the rainy season having started and already flooded the shallow wells in cholera-hit suburbs, Mr Nyandoro fears an escalation of the crisis. * The National
