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Thursday, December 11, 2008

Cholera Still Rages In Zimbabwe Despite Mugabe Denials

Cholera Is Raging, Despite Denial by Mugabe

The New York Times

A grave digger at Granaville Cemetery in Harare, Zimbabwe.

Published: December 11, 2008

HARARE, Zimbabwe — Cholera swept through the five youngest children in the Chigudu family with cruel and bewildering haste. On a recent Saturday, the children chased one another through streets that flow with raw sewage, and chattered happily as they bedded down for the night.

Related

Organizations providing humanitarian assistance to Zimbabwe's children include:

UnicefWorld Health OrganizationDoctors Without BordersCARESave the ChildrenCatholic Relief Services
Desmond Kwande/Agence France-Presse — Getty Images

President Robert Mugabe of Zimbabwe during the state funeral for a ruling party official on Thursday in Harare.

The onslaught of diarrhea and vomiting began around midnight. Relatives frantically prepared solutions of water, sugar and salt for the youngsters, aged 20 months to 12 years, to drink. But by morning, they were limp and hollow-eyed. The disease was draining their bodies of fluid.

“Then they started to die,” said their brother Lovegot, 18. “Prisca was first, second Sammy, then Shantel, Clopas and Aisha, the littlest one, last.”

A ferocious cholera epidemic, spread by water contaminated with human excrement, has stricken more than 16,000 people across Zimbabwe since August and killed more than 780. Health experts are warning that the number of cases could surpass 60,000, and that half the country’s population of 12 million is at risk.

The outbreak is yet more evidence that Zimbabwe’s most fundamental public services — including water and sanitation, public schools and hospitals — are shutting down, much like the organs of a severely dehydrated cholera victim.

Zimbabwe’s once promising economy, disastrously mismanaged by President Robert G. Mugabe’s government, has been spiraling downward for almost a decade, but residents here say the free fall has gained frightening velocity in recent weeks. Most of the nation’s schools, which were once the pride of Africa, producing a highly literate population, have virtually ceased to function as teachers, whose salaries no longer even cover the cost of the bus fare to work, quit showing up.

With millions enduring severe and worsening hunger, and cholera spilling into neighboring countries, there are rising international calls for Mr. Mugabe to step down after 28 years in power. But he seems only to be digging in and even declared Thursday that the nation’s cholera epidemic had ended, just a day after the World Health Organization warned that the outbreak was grave enough to carry “serious regional implications.”

Water cutoffs are common and prolonged here, but last week the taps went dry in virtually all of the capital’s densely packed suburbs, where people most need clean drinking water to wash their hands and food, essential steps to containing cholera. On rutted streets crowded with out-of-school children and jobless adults, piles of uncollected garbage mounted and thick brown sludge burbled up from burst sewer lines.

The capital’s two largest hospitals, sprawling facilities that once would have provided sophisticated care in just such a crisis, had largely shut down weeks earlier after doctors and nurses, their salaries rendered virtually worthless by the nation’s crippling hyperinflation, simply stopped coming to work.

Inflation officially hit 231 million percent in July, but John Robertson, an independent economist in Zimbabwe, estimates that it has now surged to an astounding eight quintillion percent — that’s an eight followed by 18 zeros.

The situation has deteriorated to such a degree that soldiers — Mr. Mugabe’s enduring muscle — rioted last week on the streets of the capital, breaking windows and looting stores, after waiting days in bank lines without being able to withdraw their meager salaries from cash-short tellers. A midlevel officer who participated in the mayhem, but spoke on condition of anonymity for fear of prosecution, said troops were enraged that they could no longer afford to buy food or send their children to school.

“As we talk, children of chefs are in private schools learning while ours are playing in dusty roads,” he said bitterly, using the local term for the people in power.

Rumors about this extraordinary unrest in the army’s ranks have circulated feverishly, with some speculating that the rioting was staged to justify imposing a state of emergency. Others hoped it finally signaled the beginning of the end for Mr. Mugabe.

Still, the Mugabe government’s ability to clamp down on dissent seems intact. The police quelled the riot. Sixteen soldiers now face a court-martial. Beyond that, about 20 opposition party activists and human rights workers have recently disappeared. Last week, armed men abducted a well-known human rights activist, Jestina Mukoko, at dawn while she was barefoot, still in her nightgown and bereft of her eyeglasses and as her teenage son looked on helplessly.

Analysts have long predicted that Mr. Mugabe’s hold on power — which he has refused to loosen since September, when he signed a power-sharing deal with his nemesis, opposition leader Morgan Tsvangirai — would be broken only once the economy completely imploded and daily life became intolerable.

But as the endgame of the octogenarian Mr. Mugabe’s rule plays out, the human tragedies mount.

In a country with the terrible distinction of having the second highest proportion of orphans in the world — one in four children has lost one or both parents — the closure of schools and hospitals is hitting these most vulnerable children mercilessly.

Related

Organizations providing humanitarian assistance to Zimbabwe's children include:

UnicefWorld Health OrganizationDoctors Without BordersCARESave the ChildrenCatholic Relief Services

Aisha Makombo, 15, has been raising her 11-year-old sister Khadija since their mother died of AIDS last year. An expressive girl with a soft, round face, Aisha, who is H.I.V. negative, has been struggling to get drug treatment for Khadija, who is now sick with AIDS.

She took her little sister, so stunted she appears half her actual age, to Parirenyatwa Hospital, the nation’s largest referral hospital, last year, but crucial test results needed to qualify Khadija for life-saving medications were inexplicably misplaced.

On a later visit, Aisha was told the machine that performed the tests was broken. Now the hospital is virtually closed. Aisha said she was referred to private doctors who demanded payment in South African rand or American dollars, but the girls had no money.

Aisha’s eyes filled with tears as she explained that she had been able to obtain only cotrimoxazole, an antibiotic used to treat opportunistic infections, for her little sister.

Aisha used to escape the sadness of her life by going to school, but two months ago the teachers at her high school stopped showing up.

“She didn’t bid us farewell, she just left,” Aisha said of her math teacher, the one she misses most of all. “At first, we thought she would come back, but then we gave up hope.”

Aisha now scrambles to barter her labor for food, while her little sister, too weak to work, attends a small school run by a nonprofit group. Last week, Aisha started a four-day job, bent over in a field, readying it for planting. In exchange, she was to get two pounds of flour and a bottle of cooking oil, as well as a shirt and blouse for Khadija.

The girls pray together each night before going to sleep in the tiny, grubby, windowless room they share. The small house belongs to their grandfather, but he admitted it was Aisha who provided the food for him and her 45-year-old uncle who sometimes steals the cornmeal she earns, as well as the girls’ clothes to sell secondhand.

Yet the girls say they cling to their dreams. Aisha’s is to be a doctor, Khadija’s a bank teller, each hungering for what the sisters do not have — health and money for medicine and food.

Zimbabwe has one of the world’s highest rates of H.I.V. infection, and now a raging cholera crisis. But with the economic collapse decimating revenues needed to run the country’s public health systems, mortality rates among cholera victims here are five times higher than in other countries, public health experts said.

Mr. Mugabe’s government — in its pursuit of power and money — has also contributed to both catastrophes, analysts say.

Earlier this year, the government jeopardized $188 million in aid from the Global Fund to Fight AIDS, Tuberculosis and Malaria by taking $7.3 million the organization had donated and spending it on other, unrelated expenses. Only at the 11th hour, under threat that the money would be withheld, did the government reimburse the Global Fund for the missing funds.

And two years ago, the government took control of Harare’s water and sewer systems from the opposition-controlled city council, depriving the local government of a crucial source of revenue to keep services functioning.

“The real motive was to dilute the influence of the opposition Movement for Democratic Change and cripple them financially,” said Justice Mavezenge, an officer with the Combined Harare Residents Association, a civic group.

Last week, even Mr. Mugabe’s mouthpiece, the newspaper The Herald, castigated the state-run water authority for running out of chemicals to purify Harare’s water supply — chemicals it said could have been trucked in from South Africa in less than 24 hours.

The United Nation’s Children’s Fund and international donors have stepped into the void. They have begun trucking 50 tankers of fresh water into the most densely settled suburbs and will be providing water treatment chemicals for the city over the next four months, said Unicef’s acting country director, Roeland Monasch.

But some aid officials fear that the epidemic will be impossible to contain because of the failing water and sanitation systems in places like Budiriro, the Harare suburb where the Chigudu children died and where half the country’s cases have occurred.

“We’re not going to be able to control it,” said one aid agency adviser, speaking anonymously for fear of retribution. “The likely scenario is that people who get sick in places like Budiriro will go home for the festive season and you’ll get flash points all over the rural areas.”

Cholera stole the five Chigudu children in just two days, on Nov. 17 and 18, and the grandmother and aunt who helped care for them died just days later. Their father, who returned home just hours after the last of his children died, got his first inkling of unspeakable calamity when his youngest ones weren’t there to clamber all over him as he walked in the door.

“I will never get my children back,” he said.

The death toll mounts each day. Chipo and Tecla Murape rushed their orphaned 5-year-old niece, Moisha, to the clinic in Chitungwiza, a city just south of Harare, last week. Nurses told the family the veins in the girl’s arms had collapsed because she had lost so much fluid. No doctor ever saw her, her relatives said, and the nurses never hit a vein. Moisha, a shy, but friendly girl, instead drank rehydration fluids.

Throughout the day, she complained of a terrible thirst and a painful stomachache. On the advice of clinic workers, her aunts did not even hold her hand as she lay dying, fearing infection. After night fell, the nurses said there was nothing more they could do and suggested that Moisha’s relatives take her to the city’s hospital, some two and a half miles away.

But there was no ambulance. Tecla Murape, 42, swaddled Moisha to her back and set off hurriedly for the hourlong walk, her heart pounding with worry. Under a dark, moonless sky, she took a shortcut through a maize field, leaping across yet another putrid sewage spill. By the time they arrived, Mrs. Murape’s clothes were soaked with Moisha’s watery diarrhea. Hours later, Moisha died.

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