Medical experts have forecast that a worst-case scenario in Zimbabwe's rampaging cholera epidemic could see earlier predictions double to 123 000 cases and go beyond May this year.
Just over a week ago, according to the Zimbabwean Association of Doctors for Human Rights (ZADHR), the epidemic passed Africa's worst, in Angola in 2007, when over 82 000 people were infected with the highly infectious water-borne disease and 3,204 died.
Late last year the World Health Organisation estimated that the worst-case figure could reach 60 000 cases, a level passed already in January. By Friday last week the WHO had recorded 84 027 cases, with 3 894 deaths recorded in Zimbabwe. The rate of fatalities had reached 4.6%, nearly five times what the WHO regards as "acceptable."
Drastic improvements needed
The Cholera Command and Control Centre, comprising officials from the WHO, the Zimbabwe health ministry and aid agencies involved in combating the epidemic, early last month forecast up to 92 000 infections. But, according to ZADHR, the continuing rapid increase in cases and still-collapsed state of the health, water and sanitation systems meant "the worst-case scenario of 122 945 seems likely to occur if drastic improvements ... are not made immediately."
Fighting the epidemic has become one of the most urgent tasks of the 18-day-old coalition government between President Robert Mugabe's Zanu-PF party and new prime minister Morgan Tsvangirai's Movement for Democratic Change.
The outbreak of the disease in August was triggered by the simultaneous breakdown of water supply, sanitation and refuse collection services in crowded townships. "Warnings ... of an impending major cholera outbreak went unheeded," the doctors association found. It took Mugabe's government four months to declare the disease a national emergency.
In recent weeks, aid agencies have significantly reduced the number of cases in urban areas but the outbreak is continuing to make inroads into rural areas and into the country's river system. The number of people dying at home, with no access to healthcare and little money for basic rehydration products such as sugar and salt, is now at 60%.
Last week, top WHO official Daniel Acuna said that a massive effort by aid agencies might bring the epidemic "to a reasonable pattern of control" within three weeks. "This is a big if," he warned. "If we don't make that push, we may continue to seeing this for many more weeks, and have an absolutely avoidable toll of people who could be living healthy lives."
(Sapa, March 2009)
Zim ripe for new epidemics