Zimbabwe is facing a worsening cholera outbreak that has spread to more than half of the country’s districts, killing hundreds of people and infecting thousands more.
According to the latest situation report from the Ministry of Health and Child Care, as of January 2, 2024, there were 14 885 suspected cholera cases, 67 laboratory confirmed deaths, 266 suspected cholera deaths and 1 676 laboratory confirmed cases.
The outbreak, which started in September 2023, has now affected 56 out of the 63 districts in Zimbabwe’s 10 provinces. The capital Harare remains the epicentre of the outbreak, accounting for more than 70% of the cases and deaths.
Water and Sanitation Woes
Health experts have attributed the outbreak to a combination of factors, including poor water and sanitation services, water shortages, aging infrastructure, illegal waste dumps, power cuts and overcrowding.
“It is expected because of reckless behaviour during the holiday season whereby we saw people crowded, not observing prevention measures,” Johannes Marisa, president of the Medical and Dental Private Practitioners of Zimbabwe Association, told Newsday Zimbabwe .
“There were no proper sanitation facilities at most public gatherings. The rains themselves worsened the situation as they polluted water bodies. There is no improvement in water infrastructure by relevant authorities as well as water shortages, all contributing to an increased cholera burden.”
Marisa also lamented the poor cholera case management, especially at government institutions, where understaffing, poor remuneration and demotivated staff hampered the treatment of patients.
Itai Rusike, executive director of the Community Working Group on Health (CWGH), a network of civil society organisations, said a large number of urban and rural households have limited access to safe water and safe sanitation in Zimbabwe.
“Interruption of water supplies, overcrowding of sanitation facilities and difficulties with urban waterborne sanitation during periods of water cuts means that urban households are vulnerable to unhealthy environments,” Rusike said.
Government Response
The government has declared the outbreak a national emergency and mobilised resources to contain it. It has also received support from various partners, including the World Health Organization, the United Nations Children’s Fund, the World Food Programme, the International Federation of Red Cross and Red Crescent Societies, and the African Union.
Some of the interventions include setting up cholera treatment centres, conducting oral cholera vaccination campaigns, distributing water purification tablets, repairing water and sewer systems, and raising awareness on hygiene and prevention practices.
The government has also announced a review of passport fees to enable people to travel to neighbouring countries for treatment, as well as a waiver of import duty on water treatment chemicals and equipment.
However, the government has also faced criticism for its handling of the outbreak, especially for its failure to address the root causes of the water and sanitation crisis, and for its heavy-handed response to protests over the issue.
In September 2023, the police banned public gatherings in Harare, citing the cholera outbreak, but many saw it as a move to stifle dissent.Â
In October 2023, the police clashed with vendors and commuters in Harare, as they tried to clear the streets of informal traders and illegal transport operators, whom they accused of spreading cholera. The crackdown sparked outrage and condemnation from human rights groups and civil society organisations.
Despite the challenges, some people hope that the government will contain the outbreak and take long-term measures to improve the water and sanitation situation in the country.
“We are hopeful that the outbreak will end soon, as we have seen a decline in the number of cases and deaths in the past few weeks,” said Tendai Chikwana, a resident of St Mary’s, a suburb in Chitungwiza town, which has reported the second highest number of cases and deaths after Harare.
Since 2000, cholera outbreaks have recurred in Zimbabwe, with the worst one happening in 2008-2009, which killed more than 4,000 people and infected over 100,000.