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Cholera outbreaks raise concern in nine Southern African countries

© UNICEF/NYHQ2008-1488/Nesbitt
A girl rests beside an elderly woman on a bench as they wait to be treated for cholera, at a UNICEF-assisted clinic in Musengezi village, Zimbabwe.

By Elizabeth Kiem

NEW YORK, USA, 10 March 2009 – With the peak of the rainy season already months past, cholera remains a problem for the governments of nine Southern African countries.

Thousands of cases of the water-borne disease have been reported in recent months from Angola to Zambia, even as a particularly severe outbreak in Zimbabwe continues amidst ongoing political turmoil there.

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In Zimbabwe alone, as of 5 March 2009, a total of 87,995 suspected cases of cholera and 3,975 deaths had been reported to the World Health Organization by the Ministry of Health and Child Welfare's surveillance department.

Continuing rains cause concern

“We have cholera presenting itself on a more continual basis in a good number of countries,” said Bob McCarthy, UNICEF Regional Emergency Officer for Eastern and Southern Africa. “You have a combination of some transmission occurring along the border areas from Zimbabwe, but we also have a situation where cholera has emerged … in areas independent of what we’re seeing in Zimbabwe.”

© UNICEF/NYHQ2008-1304/Tanner
A year-old child is treated with intravenous fluids to help her recover from cholera, at the hospital in the town of Musina, located in South Africa’s Limpopo Province, near the border with Zimbabwe.

The countries affected are Angola, Botswana, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.

Though November and December are typically considered the rainy season in Southern Africa, regional forecasts indicate heavy rainfall continuing, raising concerns that the situation could deteriorate further.

Region-wide impact

Cholera is spread through contaminated water supplies and is highly communicable. Many of the areas with the highest rates of infection are in areas bordering Zimbabwe, where political unrest, economic collapse and a ravaged health-care system have combined to fuel the epidemic.

Even without the problem of spill over from Zimbabwe, the numbers of cases in neighbouring countries are a concern.

“Most of the countries are still in a situation where an unacceptably high number of deaths are occurring.” said Mr. McCarthy, who attended a regional workshop of UNICEF and other UN programme officers in Johannesburg last month to address the issue of cholera and government capacity to respond.

Mission to Zimbabwe

Meanwhile, a UN interagency mission to Zimbabwe, led by Deputy Emergency Relief Coordinator Catherine Bragg, met with the President, the Prime Minister and other high-level officials to discuss how to address the simultaneous concerns of cholera and food shortages.

“Everybody [among the government] reiterated the support to facilitate humanitarian aid, give us humanitarian access and improve the humanitarian space, said UNICEF’s Senior Health Advisor for Emergencies, Robin Nandy.

While the absolute numbers of cholera cases and deaths are declining in Zimbabwe, the case fatality rate remains stubbornly high – near 5 per cent. Until the country can recover from its current collapse of services and infrastructure, Mr. Nandy said, health epidemics will likely remain intractable.

Mr. McCarthy agreed that the current cholera outbreak in Zimbabwe and throughout the region is but a “manifestation” of substandard health, water and hygiene systems, noting that more than half of all childhood deaths in Africa are attributable to diarrhoeal disease.

“It affects children’s nutritional status, their physical growth and development,” he said. “It’s a huge killer of children.”




6 March 2009:
UNICEF Regional Emergency Officer Bob McCarthy and Senior Health Advisor for Emergencies Robin Nandy discuss the cholera outbreaks in Southern Africa.
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