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Cholera One Part of Zimbabwe’s Growing Health Concerns

More than 2,000 people have died from cholera, and suspected cases of the illness have topped 40,000, the World Health Organization reported Wednesday.

Cholera, a diarrheal illness caused by a bacterial infection of the intestine that is spread through contaminated food or water, can cause rapid dehydration and a drop in blood pressure that leads to death in days or even hours, according to the Centers for Disease Control and Prevention. Although it is life-threatening, it is easily prevented and treated.

In Zimbabwe, the WHO has reported a fatality rate for new cases of 12.6 percent, much higher than the 1 percent level normally attributed to large-scale outbreaks, according to the Associated Press.

The outbreak, which began in August, is symptomatic of the country’s overall health challenges.

Physicians for Human Rights, a health and human rights advocacy group based in Cambridge, Mass., sent a team to Zimbabwe for a week in December to investigate the cholera outbreak but found many larger scale problems.

“The 2008 cholera epidemic that continues in 2009 is an outcome of the health systems collapse, and of the failure of the state to maintain safe water and sanitation,” the group said in a report released Tuesday.

The group blames President Robert Mugabe, saying he should be investigated by the International Criminal Court for possible crimes against humanity.

Mugabe has been in power since minority white rule ended in the African nation in 1980. He says the problems in his country are the result of Western sanctions.

Reacting to the report, Zimbabwe government spokesman George Charamba told the AP he would not comment on charges from a “stupid, Western-created organization.”

Patrick McCormick of the United Nations’ children’s organization, UNICEF, said he agreed that government irresponsibility caused the massive spread of disease.

“There’s a chronic breakdown of the social structure needed to run a health care system,” he said. “There’s a total lack of medical staffed hospitals. The country’s in a state of collapse.”

Laurie Garrett, global health fellow at the Council on Foreign Relations, said Mugabe, who retained power after controversial elections last year, cut off electricity to districts that voted against him. Without reliable electrical supplies, pumping and water supplies have been compromised, forcing many urban and suburban hospitals to shut down, she said.

Mugabe has claimed the cholera epidemic is being exaggerated by Western media as an excuse to remove him from power.

“Because of cholera, Mr. (Gordon) Brown, Mr. (Nicolas) Sarkozy and Mr. (George) Bush want military intervention,” he said in a televised speech in December.

While cholera has been highlighted as a major problem in Zimbabwe, HIV/AIDS and malnutrition, particularly among children, are also concerns.

“Every three days, you have more people die in Zimbabwe from HIV/AIDS than the total number of people who have died from cholera since the cholera epidemic started,” said Jonathan Hutson, a spokesman for the group.

Aid agencies are providing hundreds of thousands of liters of water a day, along with food, water-purification tablets and medicine to try to address the residents’ immediate health needs.

In addition, the country’s hyperinflation has made treatment unaffordable. Many of the hospitals are private institutions which charge high fees, often in U.S. dollars, which are more stable than Zimbabwe dollars.

But the requirement that patients pay upfront in U.S. dollars means only a small segment of society can afford care. Not only the procedures, but the cost of traveling to the medical sites can be prohibitively expensive, said Frank Donaghue, CEO of Physicians for Human Rights.

“We’ve hit a situation where the only way out of this mess is for the African leadership to step up to the plate and say, ‘Mugabe, we want you out,'” Garrett said.

But that scenario seems unlikely. The United States and United Nations have urged the African Union to take action, but some African leaders have expressed reluctance to succumb to pressures from the West and allow outside forces to interfere in their democracies.

Meanwhile, aid agencies continue to work against time to control illnesses during Zimbabwe’s rainy season, which can last until April and accelerate the spread of water-borne disease.

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