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Why cholera is on the rise in Zimbabwe – Zimbabwe

Hundreds of people have died from cholera this year in Zimbabwe, where a lack of adequate water and sanitation is fueling an uncontrolled outbreak.

In Zimbabwe, water supply problems, lack of access to sanitation and hygiene and prolonged dry seasons caused by climate change have exacerbated a cholera outbreak that has killed hundreds of people this year.

The latest outbreak began in the town of Chegutu, about 60 miles south of the capital Harare, where the first cholera patient was reported in February 2023. The number of cases increased throughout 2023, spreading to 10 provinces. of all country. Cholera cases continue to increase: 35,000 cases and 600 deaths were recorded in 2024 alone.

In addition to putting pressure on Zimbabwe’s health care systems, the outbreak has exposed vulnerabilities in water, sanitation and hygiene infrastructure in both rural and urban areas. This has increased the risk of transmission. The limited global supply of oral cholera vaccines has further complicated response efforts. Below, two experts from Médecins Sans Frontières (MSF) in Southern Africa explain why a new approach is needed.

Zimbabwe is grappling with the second largest cholera outbreak in its history, and cases are spreading rapidly across the country. It began on February 12, 2023 and to date more than 600 people have died from cholera and more than 35,000 have been infected. To save lives and prevent more people from getting sick, Zimbabwe needs to invest in its water hygiene and sanitation infrastructure.

Cholera is a life-threatening disease caused by bacteria that live in water. Access to clean water, adequate sanitation infrastructure and hygiene measures reduce the likelihood and severity of cholera outbreaks. Recurring outbreaks in Zimbabwe are a problem caused by aging and degraded water and sewage systems in urban areas. Certain cities, such as Harare, have endured months without running water, and sewage has become common in densely populated suburbs.

Rural communities are affected because they resort to drinking contaminated water from surrounding rivers. The lack of abundant and adequate rainfall has aggravated the situation in both urban and rural areas, with the depletion of the water table.

In the Buhera district of Zimbabwe, where MSF teams supported the Ministry of Health and Child Care in the fight against cholera for three months, villagers had to drink water from the river, which they shared with domestic and wild animals. The wells have burst, leaving them with no other options. As expected, cholera did not spare Buhera.

MSF also intervened in the Mbire district, about 190 kilometers north of Harare. In Mbire, our teams noted that there was 52 percent coverage of drinking water sources, while 48 percent came from the river and a measly 37 percent latrine coverage. When the people of Mbire work in their gardens and fields along the river, they consume water from the river, which is not safe. With no toilets in the fields, community members resorted to using toilets in the bushes along the river.

“We bathe and drink water from the stream. There is no other source of water and we are used to it. Recently, the miners started complaining of diarrhea.” — Lasten, Kamudonzvo miner in Shamva

Mining communities are also recording a high number of cholera cases. Miners access water from contaminated sources, such as abandoned mine shafts and nearby rivers, creating a breeding ground for cholera. This is the case in Shamva district, where MSF teams recently provided support. Open defecation and limited sanitation facilities further aggravate the situation.

The villagers had to drink water from the river, which they shared with domestic and wild animals. The wells have broken and they have no other option. As expected, cholera did not spare Buhera.

Another population that registers a high number of cases is a conservative religious community that opposes contemporary medication. They believe in using water for bathing, which sometimes contaminates water sources. Many cases are believed to have arisen from their meetings.

The common element among all these communities is the lack of access to drinking water and adequate sewage facilities. This issue needs to be urgently addressed to control cholera outbreaks.

In theory, cholera vaccines could also help control the disease. Unfortunately, today there is a global shortage of oral cholera vaccines and Zimbabwe does not have enough doses to cover a larger portion of the population. The situation is the same everywhere else: no country today has enough vaccines against cholera. This shortage will not be resolved soon, so countries should not count on vaccination to prevent or stop cholera outbreaks. This underlines the urgency of strengthening water and sanitation systems.

“We just go to the river with our containers and dig a shallow hole in the sand. Once we reach the water level, we simply wait a few minutes for the unwanted particles in the water to settle and then go fetch water. Then we destroy the shallow well by putting sand back on top of the water and leave. This way we feel that the water is safe and our elders have been doing it since time immemorial and none of them have complained of stomach pains.” — Delinah, Buhera

Longer-term solutions include replacing outdated water and sewage systems, implementing a sustainable waste disposal system, and providing pipes for drinking water. The provision of safe water, basic sanitation and hygiene practices is essential to prevent and control the transmission of cholera and other waterborne diseases.

Responding to cholera in Zimbabwe

In response to the 2023 cholera outbreak in Zimbabwe, the government and non-governmental organizations launched extensive efforts to combat the disease. These combined efforts appear to be working, but more efforts will be needed to reach zero cases. MSF continues to support the cholera response across the country.

Caring for patients and improving cholera prevention measures are critical elements in controlling outbreaks. But without significant action to ensure people’s access to clean water, cholera is likely to periodically re-emerge in the country.

GENERAL DESCRIPTION

What is cholera?

  • Cholera is a highly contagious disease that occurs in environments without clean water and adequate sanitation, from remote, resource-poor villages to overcrowded cities, refugee camps and conflict zones.
  • Millions of people are infected with cholera each year, although it can be easily prevented and treated. Without treatment, cholera can quickly lead to death from dehydration.
  • Climate change threatens to spur the spread of the disease, with frequent droughts and floods often leading to contaminated water supplies, damage to water and sanitation infrastructure, and mass displacement.
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