December 12, 2008
Cholera Is Raging, Despite Denial by Mugabe
By CELIA W. DUGGER
HARARE, Zimbabwe - Cholera swept through the five youngest children
in the Chigudu family with cruel and bewildering haste.
On a recent Saturday, the children had chased one another through
streets that flow with raw sewage, and chattered happily as they
bedded down for the night. The 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. President Robert G. Mugabe said
Thursday that the epidemic had ended, but 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 Mr.
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 his announcement about the
epidemic's end came just a day after the World Health Organization
warned that the outbreak was grave enough to carry "serious regional
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
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 is 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.
Political 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 after 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 closing of schools and hospitals
is hitting these most vulnerable children mercilessly.
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
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
"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
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
Throughout the day, she complained of a terrible thirst and a
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.