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Zimbabwe cholera outbreak may threaten neighbours
Reuters | Wednesday, 11 February 2009

Zimbabwe's spreading cholera outbreak poses a threat to its neighbours South Africa, Zambia and Mozambique, United Nations and aid officials have said.

Some 70,643 Zimbabweans have caught the water-borne diarrhoeal disease since August, and 3467 have died as a result in Africa's deadliest outbreak in 15 years, according to United Nations statistics.

The International Federation of Red Cross and Red Crescent Societies (IFRC), the world's largest emergency relief network, said the incursion of cholera into Zimbabwe's remote rural areas made it increasingly hard to control and contain.

John Roche, the IFRC's head of operations for Africa, said aid workers were distributing hundreds of thousands of water purification sachets door-to-door to confront "effectively many outbreaks" of cholera across the economically stricken country.

"We have a battle on many fronts," he told journalists. "Zambia and Mozambique cases are also on the increase."

South Africa is also at risk from the expanding epidemic in Zimbabwe, where there are now "a multitude of small epidemics that are hard to reach," said Dominique Legros of the World Health Organisation (WHO).

"It is a possibility that the outbreak will further spread to South Africa," Legros said, noting that surveillance systems are in place at the border and that potable water and other materials have been made available in vulnerable areas.

The WHO has not recommended travel restrictions in the area.

Zimbabwe's health system has collapsed under an economic crisis that has left eight in 10 people out of work. More than half the country is surviving on food aid and the population is also struggling with the world's highest inflation rate of more than 231 million per cent as of July last year.

Legros, WHO coordinator for disease control in humanitarian emergencies, stressed that because Zimbabwe's neighbours have stronger and more functional health systems, they should be able to prevent and treat cholera much more effectively.

In Zimbabwe, many doctors and nurses pay more in bus fares to get to health clinics then they receive in wages, he said.

The last time South Africa had a large outbreak of cholera was in 2001 and 2002, when the country's southeastern region had 166,000 cases. The fatality rate of that outbreak was below 1 per cent, compared to the 4.9 per cent seen in Zimbabwe.