AFRICA - Cholera epidemic in Malawi and Zimbabwe seems unstoppable

Rome (Agenzia Fides) – The cholera epidemic that has been effecting Malawi's capital of Lilongwe since November 2008, is rapidly expanding. According to the organization “Doctors Without Borders” (in Italian, MSF), the epidemic has struck two of the most densely populated shantytowns in the capital where there is no running water and has now infected 30% of the country's districts, with the highest concentration being in Lilongwe and its surroundings.
“39 people have died from cholera with more than 1,000 cases recorded. It’s extremely worrying as the disease continues to spread and numbers mount,” says Dr. Moses Massaquoi, medical coordinator in Malawi for MSF.
“Every day the rain pounds down and people with no access to safe water resort to drinking untreated water from swamps or from unprotected wells in slums. As one of the poorest countries in the world, water and sanitation levels are extremely low. On top of this, the floods cause latrines to overflow and sewage then mixes with drinking water.”
MSF teams are helping set up special isolation units in the most affected areas in Lilongwe, as well as installing latrines and donating special cholera beds and plastic sheeting to help with the response.
“Authorities here are doing their utmost to try and contain the spread, but it is a real struggle. At the best of times, the country has an acute shortage of healthcare workers, so when cholera breaks out it puts an unbearable strain on an already creaking health system and overworked medical staff,” Dr. Massaquoi continued.
“People have forgotten about the disease so it spreads faster,” the doctor added. “Right now, there aren’t enough health staff in Malawi with the training or experience needed to respond to a serious cholera outbreak. Time is life in a cholera outbreak so it’s essential to act fast, but people are going to clinics too late. Cultural practices are also contributing to the worrying increase in cases as people continue to wash dead bodies before burial, look after and visit the sick, and eat together during funerals.”
In neighboring Zimbabwe, the situation is even worse, as the sanitary system is nearing collapse. According to the most recent report from the MSF, “the fact that the outbreak has become so large is an indication that the country's health system can't cope.” The report says that many health structures have closed, while others charge exorbitant prices in foreign currency. “Effectively, this makes it impossible for most Zimbabweans to access medical care.” “There has been a devastating implosion of Zimbabwe's once-lauded health system, which doesn't just affect cholera patients,” said Manuel Lopez, MSF Head of Mission in Zimbabwe. “We know that public hospitals are turning people away, health centers are running out of supplies and equipment, there is an acute lack of medical staff, patients can't afford to travel to pick up their HIV medication or to receive treatment and many of our own clinics are overflowing. From what we see each day it couldn't be clearer – this is a massive medical emergency, spiraling out of control.”
Zimbabwe's political crisis and resulting economic breakdown have led to abysmal access to public healthcare; a collapsed infrastructure; a crushing HIV epidemic; political violence; food shortages and malnutrition; internal displacement and displacement to neighbouring countries. An estimated three million Zimbabweans have sought refuge in South Africa, the most extraordinary exodus from a country not in open conflict.
The World Health Organization says that since the outbreak of the epidemic in August 2008, 3,688 have died and a total of 77,650 are infected with the disease. (LM) (Agenzia Fides 23/2/2009)