Cholera in Zimbabwe

Lack of clean drinking water has unleashed a cholera epidemic in Zimbabwe


Zimbabwe is currently in the midst of a major epidemic of cholera, a disease that all but disappears even in Sub-Saharan Africa when there is a basic public health system in place and those affected have access to basic medical treatment. The World Health Organization estimates that as of March 1st 2009, 85,000 cases were reported, and 4000 deaths, and the epidemic is beginning to spread to neighboring countries. Doctors without Borders, who are actively working in the area, say that the epidemic is “a massive medical emergency rapidly spiraling out of control.” One new case is appearing in their clinics every minute. This epidemic represents a tragedy on many levels. It is a tragedy when so many lives are lost needlessly for want of basic interventions with oral re-hydration solution and a few days of inexpensive antibiotic. With any kind of treatment the mortality of cholera is 1% or less. In Zimbabwe the mortality is 5%, an indication that their health system infrastructure, once a model for Africa, is now dysfunctional and without resources. At another level it is a tragedy because the epidemic has resulted from a breakdown in water supply and basic sanitation. It is also a tragedy because this epidemic is occurring in a country that was once the Bread Basket of Southern Africa, a land of prosperous farms and a healthy populace. Cholera has always been a barometer of inadequate access to safe drinking water and basic sanitation. A cholera epidemic signals that the water supply is severely contaminated with human feces. Reports from Zimbabwe describe water pipes that contain no water, sewer pipes that are clogged, and garbage is piled high on the streets
Eric Mintz (1) points out that the current epidemic represents a fundamental failure of governance. He also states that “the failure of the global community to mobilize the resources needed to prevent and to treat cholera among the less fortunate reflects our lack of commitment to equity and social justice”.
The current epidemic of cholera is just one symptom of a terrible social and political disease that has taken over this beautiful country. We can mobilize an effort to treat the symptom of cholera, but can we do anything to stop the greater political disease that is destroying Zimbabwe?
Ref: Mintz, Eric, Guerrant, Richard. Global Health: A Lion in Our Village—The Unconscionable Tragedy of Cholera in Africa. NEJM 2009;360:1060-1063.
Submitted by Roger Boe MD, Medical Consultant