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Zimbabwe’s Cholera Crisis Spurs New Calls for Mugabe to Step Down

December 9, 2008 at 6:45 PM EDT
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In the wake of Zimbabwe's cholera outbreak, worsening food shortages and political unrest, some international leaders are urging embattled President Robert Mugabe to step down. An analyst provides an update on the situation.
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JIM LEHRER: And finally tonight, cholera, chaos, and politics in the southern African nation of Zimbabwe. We begin with a report from Jonathan Miller of Independent Television News.

Be forewarned: This report contains some disturbing images.

JONATHAN MILLER: You really know a country is in trouble when a $10 million bank note gets dumped in the rubbish and then gets ignored by those scavenging for scraps of food in the stinking refuse.

You really know a country is in trouble when you see children filling water bottles in a street-side sewer, even when everyone knows about the cholera epidemic.

And most heartbreakingly, you really know a country is in trouble when you see pictures like this: a 2-year-old baby boy suffering organ malfunction and extreme symptoms of severe malnutrition.

President Robert Mugabe, defiant, unmoved, now accused of condemning his people to death, death by torture, death by hunger, and death by disease.

The rhetoric ratcheting up now, a growing clamor of voices, albeit from mostly Western leaders, saying enough, Mugabe must go.

As the crisis in Zimbabwe continues to deepen, the most outspoken from an African leader has come from the Kenyan prime minister, who’s called for military intervention.

The former U.N. Secretary-General, Kofi Annan, said today that Zimbabwe was rapidly becoming a full-blown failed state.

Total chaos is how the U.N. described the cholera crisis today. Officially, it’s put the number of cases at close to 14,000, nearly 600 dead, but we’ve been told again and again that these numbers are grossly conservative.

Now the projections cited by Channel 4 news 10 days ago that infections could hit 60,000 with a kill rate of 1 in 10 now being cited by U.N. agencies, too.

The disease, which is treatable and preventable, continues to spread and to kill in neighboring South Africa. The hospital in the border town of Musina, which when we visited last week was overwhelmed, was visited today by South Africa’s health minister, who recognizes the gravity of the situation.

BARBARA HOGAN, South African health minister: We’ve got to accept that there is a major health crisis in Zimbabwe. And I am very encouraged by the way the people of Musina have stood together under very difficult circumstances and are helping the people of Zimbabwe.

JONATHAN MILLER: Pretoria, those still unwilling to put pressure on Robert Mugabe to step down to forestall his country’s return to year zero.

AYANDA NTSALUBA, Department of Foreign Affairs, South Africa: If there’s any pressure on President Robert Mugabe and the ZANU-PF is the pressure for them to move with greater speed to make sure that there’s a successful implementation of the agreement which was signed on September 15th so that an inclusive government can be established.

JONATHAN MILLER: But for Zimbabweans, that agreement is dead in the infected water. Zimbabweans live in limbo between life and death. In the countryside, they now survive on wild berries, and their government continues to blame everyone but themselves for this crisis.

JIM LEHRER: And to Margaret Warner.

Cholera epidemic spreading rapidly

MARGARET WARNER: For more on Zimbabwe's cholera and governance crisis, we're joined by Stephen Morrison, who directs the Global Health Policy Center at the Center for Strategic and International Studies in Washington. He's also senior adviser to the CSIS Africa program.

Mr. Morrison, thanks for being here.

STEPHEN MORRISON, Global Health Policy Center: Thank you.

MARGARET WARNER: First of all, this dreadful cholera epidemic and outbreak, put it in context for us. How unusual is this in its scale, let's say, compared to elsewhere in the developing world?

STEPHEN MORRISON: Well, it's moved very, very rapidly. It started in August, and it's accelerated to nine of 10 provinces in Zimbabwe, so it's moved to a national scale very rapidly.

The earlier outbreaks that we had, for instance, in Lima in '91 were confined to very poor, overpopulated parts of the city. In this case, it's spread into the major urban areas and into the major rural areas, and it's having, as we heard in the report, very high mortality rates.

Normally you would have about a 1 percent mortality. The report cited a one in 10. Some communities, isolated rural communities, are suffering 30 percent to 40 percent mortality.

MARGARET WARNER: Now, why are we seeing this outbreak now in Zimbabwe, which has been a developing essentially basket case nutritionally, in terms of sanitation, for a number of years?

STEPHEN MORRISON: What we're seeing is the convergence of several failures. We're seeing a political failure, in terms of the inability for the power-sharing arrangement signed in September, in mid-September, to move forward at all, so there's a stalemate.

MARGARET WARNER: That's between Mugabe and his opposition, which we'll get to in a minute.

Health care system devastated

MARGARET WARNER: That's between Mugabe and his opposition, which we'll get to in a minute.

STEPHEN MORRISON: Because Mugabe and the opposition. Then we're seeing a collapse of the medical system, which at one time was among the best in Africa, so that you have hospitals closed, you have health workers who have -- 80 percent of your health workers have left the country. Those that remain are not being paid; they're not reporting to work; there are no inputs.

You're seeing a collapse of basic sanitation and water purification systems. The basic chemical inputs for the water purification system are not there. And so...

MARGARET WARNER: And that's the real cause of cholera? I mean, that's how it spreads?

STEPHEN MORRISON: Yes, it is transmitted by water. The bacteria is transmitted principally by water. It's ingested. It sets off a massive dehydration within two to three days, and it can be spread. It's highly contagious and can be spread among families, between those that are preparing foods and others.

MARGARET WARNER: Now, you said that a lot of the nurses and medical personnel have left. So who's running basic health and sanitation in the country? And are international aid workers getting in?

STEPHEN MORRISON: In the last week, the Ministry of Health and Child Welfare in Zimbabwe sounded the alarm, declared a national emergency, and began to move ahead in the discussions with the World Health Organization, with UNICEF, with a number of other U.N. operations, with some NGOs, like MSF France, World Vision, and others, in trying to put an emergency consortium effort together that would begin to change the knowledge and habits of people so that they were washing their hands, boiling their water, preventing the transmission, and that they had access, if they became infected, to the kind of emergency rehydration treatments that are needed to bring down the mortality levels.

MARGARET WARNER: But, I mean, why didn't people in Zimbabwe already know this?

STEPHEN MORRISON: Why did they not know that this would be necessary?

MARGARET WARNER: Well, you said -- yes, you mean, because they used to have a functioning clean water system.

STEPHEN MORRISON: This has been predicted for some time. This began in August. There was an earlier outbreak in 2002. There was one in '98.

People have been predicting that, with the collapse of water purification and the contamination of the drinking supplies, that an epidemic of this scale was going to happen. And we're not at the end.

Politics complicate crisis

MARGARET WARNER: And what is the connection between this and, as you said, there's this stalled -- they were supposed to have a unity government between Mugabe and the opposition figure that he ran against in the very contested elections early this year.

One, why is it stalled? Two, what difference does that really make?

STEPHEN MORRISON: The government of Robert Mugabe signed this agreement in September and has refused to implement its basic provisions in order to share the control of the ministries, normalize the status constitutionally of the new prime minister, relax the oppression, the abductions, the detentions, the torture that goes on across this country.

And so we are left in a country that has a climate of pervasive fear and intimidation. This is one in which you do not have any basis of common collaborative governance in this country that might permit a common approach of mobilizing people to deal with this urgent and rather astronomical medical emergency.

MARGARET WARNER: Now, as the tape pointed out, many leaders, particularly in the West, but also Bishop Desmond Tutu, Kofi Annan, have taken a step further and said, essentially, forget about the power-sharing, Mugabe ought to go.

What is the impact -- does that have any impact internally?

STEPHEN MORRISON: I think those that are suffering the most at the hand of this tyranny take a certain amount of comfort in the fact that people are still paying attention.

I think, when President Bush spoke up today, I spoke to people in Harare this afternoon, and I asked them, what was their reaction? Suddenly, this epidemic, this cholera epidemic has sparked this dramatic explosion of condemnations from multiple sources.

And the answer was: People here are in a very grievous and somber mood. Their children can't go to school. And yet they are drawing a certain hope, so there is a sustainment of hope at the street level.

The role of Mugabe, his supporters

MARGARET WARNER: But what about those that are sustaining Mugabe in power and Mugabe himself?

STEPHEN MORRISON: Well, I don't think there's any evidence yet that the hardliners who are keeping Mugabe in power, who are resisting any compliance with the terms of the power-sharing, are yet changing their position at all, but they have to be worried.

They have to be worried that this is going to get out of control, that it's going to carry back into the Security Council and get new momentum. There's plenty of prominent and respected African leaders who are stepping forward and saying very confrontational things about this crisis.

The whole notion that this is some Western plot against Africa is losing its credibility.

MARGARET WARNER: And yet, briefly, the African Union did today sort of reject that idea and say, "We've got to continue a dialogue."

STEPHEN MORRISON: Well, I think the African Union position is really about whether to abandon the power-sharing agreement and shift to another path which says, "OK, Mugabe must go."

That was the essence of the president's statement and President Sarkozy's statement. Let's go back to basics. Let's get him out of the way. Let's figure out some way to leverage these hardliners to move on, and then that may open the way for a settlement.

Those are the two opposing views right now.

MARGARET WARNER: All right, Stephen Morrison, thank you so much.

STEPHEN MORRISON: Thank you.