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Zimbabwe Health System Collapse Set Stage For Devastating Cholera Epidemic

As if the people of Zimbabwe did not already have their fill of suffering in late 2008, a year in which hoped-for electoral change was frustrated and millions felt the pangs of hunger, the country has been swept in recent months by a particularly deadly cholera epidemic.

Cholera first took hold in Harare’s high-density suburbs where effluent from burst sewage pipes seeped into streets where children played and boreholes dug by residents unable to rely on the Zimbabwe National Water Authority or ZINWA for clean drinking water.

The Budiriro township was one of the first such cholera hotspots. Sick residents flocked to the Budiriro Infectious Diseases Hospital only to find scant medical relief available – a pattern repeated in Chitungwiza, a Harare satellite town, and provincial towns like Chegutu, a town in Mashonaland West province that was also severely hit by the disease.

This week the death toll topped 2,000 as the water-borne bacteria that cause cholera spread through public and informal water supplies and victims had to seek assistance from thinly deployed relief workers instead of the country's formerly robust health care system.

The cholera epidemic came as no surprise to local health activists who had long warned of the danger when the rainy season arrived and human waste left by Harare residents without water to flush indoor toilets washed into the informal local water supplies.

High fatality rates averaging over 5% nationwide but much higher in places like Chitungwiza at 17% were ensured by the near-total collapse of the national hospital system even as the cholera epidemic took serious hold in the Harare metropolitan province.

It was a perfect storm in public health terms.

The progressive deterioration of the national water supply infrastructure, taken over by the central government in recent years in an apparent bid to capture a principal source of revenue for local governments, combined with the closure of hospitals in late 2008 due to chronic underfunding resulting in walkouts by most staff, has had tragic consequences.

Harare correspondent Sylvia Manika of VOA's Studio 7 for Zimbabwe filed a special report on the failure of the country's public health system at a critical point in time.

For another perspective on the collapse of Zimbabwe's state health system, once the envy of African neighbors, reporter Patience Rusere spoke with Executive Director Itayi Rusike of the Community Working Group on Health, who said the decline started years ago.

More reports from VOA's Studio 7 for Zimbabwe...