Rainy Season Brings Return of Cholera; Disease Rages Next Door In Zimbabwe

By Timothy Kasonde Kasolo

LUSAKA, Zambia – The rainy season has begun here in southern Africa and once again cholera has broken out.

Officials here in Zambia, one of the poorest countries in the world, said that 176 cases of cholera and at least four deaths had been reported in the capital city of Lusaka by mid-December. But they said the outbreak was under control and that emergency treatment centers in the northern and southern provinces had been shut down. The World Health Organization said that by Dec. 10 it had received reports of 16 cases of the disease and one death in a province south of the capital.

But the news from neighboring Zimbabwe has been terrifying. And Zambia and other countries that share borders with Zimbabwe are monitoring people arriving from Zimbabwe.  More than 20,000 people in Zimbabwe have been stricken with cholera and more than 1,1000 have died, according to the World Health Organization.

The government of Zimbabwe says the reports are exaggerated and that the outbreak is under control. But the World Health Organization said deaths continue to rise in one of the world’s worst outbreaks of cholera in recent years.

New cases of cholera, a bacterial disease that spreads through
water contaminated by human excrement, have also been reported in Botswana and Mozambique, which, like Zambia, border on Zimbabwe. Cholera has also hit South Africa, Uganda and Tanzania.

The World Health Organization has warned that the epidemic in Zimbabwe could have “serious regional implications.”

South Africa closed its border with Zimbabwe and the authorities in Zambia started screening people crossing into Zambia from Zimbabwe. “We are not leaving anything to chance,” a spokesman for Zambia’s health ministry, Canicius Banda, told IRIN, the news agency of the United Nations Office for the Coordination of Humanitarian Affairs, in late November.

The most severe outbreak – after the one in Zimbabwe – has been in South Africa..  More than 660 people have been treated for cholera and at least eight have died, the Associated Press reported. 

Cholera, which is rarely seen in developed countries,  causes diarrhea and vomiting and victims die of dehydration, often within less than a day. 

Health officials in Zambia say poor sanitary conditions here lead to at least some cases of the disease every rainy season.  Many households in Zambia do not have toilets. Public toilets are often filthy and latrines consisting of shallow holes in the ground are often dug near wells.  When the annual rains come, pools of water accumulate in the streets, in parking lots and backyards. The water mixes with waste that spills out of latrines and aged sewer lines and the noxious stew seeps into the drinking water.

Residents of Zambia have been encouraged to boil drinking water,  wash vegetables in boiled water and to thoroughly cook the vegetables. The authorities have been disinfecting public toilet and latrines with lime and dumping chlorine into wells.

According to a recent report in the American Journal of Tropical Medicine, 6,542 cases of cholera and 187 deaths were recorded in Zambia in seven months between late 2003 and early June of 2004 in one of the country’s worst encounters with the disease. The Royal Society of Tropical Medicine also published a report this year on cholera in Lusaka.

Zambia also struggles with high rates of malaria, HIV/ADS and tuberculosis. It’s economy has suffered as worldwide prices for its most important export, copper, have fallen and meteorologists are predicting widespread http://www.reliefweb.int/rw/rwb.nsf/db900SID/PANA-7MEDS4?OpenDocument” title=“flooding”>flooding in southern Zambia in the coming months.

The outbreak of cholera in Zimbabwe has come as the country’s economy, under the direction of President Robert G. Mugabe, has all but collapsed.  Many schools and hospitals have shut down or are barely operating. Teachers, doctors and nurses have walked away from their jobs as inflation has destroyed the value of their government paychecks, according to The New York Times.

In Harare, the capital, and in the dense suburbs, The Times reported, the supply of tap water, for drinking and washing hands, is frequently interrupted.  Garbage piles up and broken sewer lines spew thick brown sludge into the streets. The World Health Organization said the outbreak is “closely linked to the lack of safe drinking water, poor sanitation, declining health infrastructure and reduced health care staff.” The United Nation’s Children’s Fund and other international agencies are trucking water and chemicals for treating water into Zimbabwe.

Worry about cholera spreading has been nationwide in Zambia, a country the size of Texas with a population of about 12 million. Shortly after the first cases of cholera were reported in Zambia, health officials 180 miles north of Lusaka, in Kitwe, the country’s third largest city, went on the alert. Dr. Chakafuna Banda, the director of a district health unit, said “three townships have been identified as having the worst sanitary facilities such that we may have cholera cases. We are monitoring the situation and conducting weekly water sampling.”

In early December, the state-owned Zambia http://idga.org/News.aspx?id=124071323&IQ=healthcare ” title=“Daily Mail”>Daily Mail quoted Mwendoi Akakandelwa, the deputy minister of health in Zambia, on its website as saying that there had been 1,129 cases of cholera and eight deaths in Zambia since September. The Xinhua News Agency of China picked up the story and the Xinhua story was distributed on the website of the UN Organization for the Coordination of Humanitarian Affairs, ReliefWeb.  But a lengthy search of the Internet produced no other references to 1,129 cases of cholera in Zambia this year.

In an editorial earlier this year, The Times of Zambia, expressed despair that cholera, which has been eliminated in most developed countries, continues to trouble Zambia.  “The situation in most of our towns and cities is frightening especially when one looks at the state of drainage and sewer systems as well as the inability by local authorities to collect garbage,” the Times editorial said.  “With this scenario, it is not surprising that cholera breaks out almost every rainy season and year in and year out lives are lost and it appears no lessons are learnt.”