Zimbabwean Cholera Outbreak - Causes

Causes

The principal cause of the outbreak is lack of access to safe water in urban areas and communities. A unique feature of Zimbabwe is that its two main cities are located on watershed divides, which means that the water draining out of the city flows into the drinking water sources, all of which are physically located downstream of these return flows. This is exacerbated by the collapse of the urban water supply, sanitation and garbage collection systems, along with the onset of the rainy season leading to faeces with cholera bacteria being washed into water sources, in particular public drains, as well as providing readily available but contaminated water. Due to a shortage of purification chemicals, such as chlorine, the capital city of Harare stopped receiving piped water on 1 December 2008. By that date, many suburbs had not had any water supply for much longer. On 4 December 2008, the Zimbabwe deputy minister for water and infrastructural development stated that there were only sufficient treatment chemicals in stock nationally for twelve weeks supply. The collapse of these systems has frequently been blamed on the current economic crisis. Attempts have also been made to attribute the blame to colonial rule, although Zimbabwe had become a fully independent nation 28 years earlier, in 1980. Many households cannot even afford sufficient fuel to boil all of their water. According to Médecins Sans Frontières, the spread of cholera from urban to rural areas from December 2008 onwards was due to infected city-dwellers visiting their families' rural homes for Christmas and the burial of infected city-dwellers in rural areas. In an investigation in mid-December 2008, human rights organization Physicians For Human Rights assessed the complicated circumstances surrounding the collapse of Zimbabwe's public health system, which had once been a model for southern Africa.

The cholera epidemic in Zimbabwe has had an unusually high fatality rate. According to Oxfam, "this is due to the fact Zimbabweans are seriously weakened by hunger, HIV and AIDS".

A major contributing factor to the severity of the outbreak is the collapse of Zimbabwe's public health system, declared a national emergency on 4 December 2008. By the end of November 2008, three of Zimbabwe's four major hospitals had shut down, along with the Zimbabwe Medical School, and the fourth major hospital had two wards and no operating theatres working. Zimbabwean hospitals still open by December 2008 lacked medicines and staff. Due to hyperinflation, hospitals were not able to buy basic drugs and medicines, and the resources of even internationally-funded emergency clinics are stretched. The ongoing political and economic crisis also contributed to the emigration of the doctors and people with medical knowledge. Some victims were travelling to Botswana and other neighbouring countries for treatment.