The IoS Christmas Appeal: First cholera. Now it's malaria and anthrax

Our special correspondent reports from Mashonaland West, where Zimbabwe's hard-pressed doctors are doing all they can to stop the spread of disease

The folding bed on which the cholera patient lay was the only piece of furniture in the room. The bag of 5 per cent dextrose fluid going into her arm had to be tied to the metal window frame, in which half the panes were broken, because the isolation camp had no drip stands. But 19-year-old Kitty was fortunate, in more ways than one.

The high-school student was the only cholera patient in the camp, set up in two derelict brick houses in a remote area of the Zambezi River valley, to have a bed. Other patients had to lie on the floor, with just a blanket between them and the bare concrete. Save the Children had donated two special cholera beds, which can easily be disinfected between patients, but a 60-year-old woman had died in the other one earlier in the day. Her body lay on the floor in another room, wrapped in blankets.

Cholera is extremely infectious – Kitty and her grandfather, also a patient in the camp, had both contracted the disease at the funeral of another victim – but easily treatable if caught in time. "I feel better already," said the young woman, just over 12 hours after she was admitted. Nobody had the heart, however, to tell her that her grandfather was not expected to last the day. Like many older patients, he had suffered kidney failure, caused by acute dehydration.

It is a measure of Zimbabwe's collapse under President Robert Mugabe that cholera has been allowed to get out of control. Last week his government finally stopped playing down the worst epidemic in decades, and declared a national emergency. More than 12,000 people have been infected, and nearly 600 have died, according to official figures, but health professionals believe the real totals are much higher. Food shortages and economic collapse have crippled the country's health services so badly that many unrecorded deaths are thought to have occurred in remote areas, beyond the reach of treatment.

Nor is that the only reason why the disease has taken hold. In several cases, starving rural people have failed to report suspected cases of cholera, because they know that the authorities will immediately ban public gatherings, and wrongly believe that this will extend to food distributions. Only when victims start dying does the news get out, and by then infection has spread far and wide.

Cholera is endemic in parts of Mashonaland West, and there are well-established procedures for dealing with the disease, which usually makes its appearance much later in the rainy season, in March or April. Isolation camps are immediately set up at the scene of an outbreak, and are not closed until 14 days after the last case is declared over. But one rural doctor said there was simply not enough food for the staff, let alone the patients, to set up the number of camps required in his area. "We are just firefighting," he said.

Steady rain was falling as we arrived at Kitty's isolation camp, set up next to a clinic that had never been completed, because desperate local people had stolen building materials to sell for food. Before entering, we had to retie our shoelaces to ensure they did not brush the floor, and afterwards our shoes were disinfected. Only a timely donation of maize meal from Save the Children had allowed this camp to stay open, but Kitty's luck did not end there.

Unlike one family, in which a woman lost her mother and three of her four children in two days, the 19-year-old had recognised her symptoms straight away, and when she arrived, the camp had enough intravenous fluids and antibiotics to treat her. The doctor said he knew of at least two cases of patients dying because supplies of fluid had run out, and after the first few cases, the local laboratory had exhausted its supply of the reagents needed to test patients for cholera. "I must be the most frustrated doctor in Zimbabwe," he said.

If anything, conditions are even worse in the urban areas. Roughly half the deaths have been in the capital, Harare, where sewage runs down the streets in many poor districts. The water supply has been cut off to much of the city, because the municipality cannot pay for the chemicals to treat it. With monthly salaries for medical staff barely covering the cost of a single day's bus fare to and from work, all Harare's hospitals have ceased functioning. Last week riot police broke up a demonstration by doctors and nurses demanding better pay and conditions.

Even if a massive infusion of international aid brings the cholera outbreak under control, however, doctors fear that an equally fatal epidemic of malaria will soon follow. In a tropical country such as Zimbabwe, some cases of malaria can be expected every year. But in the low-lying Zambezi Valley there used to be a network of modestly paid community health workers who would cut the grass in which mosquitoes breed, and spray each house ahead of the summer rains, helping to keep the disease under control. That system broke down a couple of years ago, and the number of cases shot up last summer. With this year's rains, the sitation is expected to be even worse.

Another deadly disease, anthrax, has already made an appearance in north-western Zimbabwe, and has spread from animals to humans, because hungry villagers have eaten the meat of infected cattle. At least three people have died in the worst anthrax outbreak since the liberation war of the 1970s. More deaths are likely, because administrative disarray means the strict quarantine and slaughter system needed to defeat the disease is unlikely to be implemented. Inoculation of livestock against the disease all but stopped five years ago.

All these health disasters are on top of the ravages of HIV/Aids. Zimbabwe has one of the highest infection rates in the world, but progress was being made. Thanks to huge efforts by the Global Fund, anti-retroviral drugs have been widely distributed, but they are ineffective unless the person taking them is adequately fed.

In every case it is the children who are most vulnerable. David and Tambu's nine-year-old daughter Sarah showed symptoms of cholera at 4am, and by the same evening she was dead – probably, according to a doctor, because she was undernourished and had latent malaria as well. "She had been playing with children from a village where there was cholera," said David, who carried Sarah on his back for three hours to reach the nearest clinic. "We all went to church on Sunday, and on Monday she was dead. If the clinic here had still been running, perhaps she might have lived, but it closed a long time ago."

For Tambu, who was heavily pregnant with another child, the cruellest blow was that her daughter's body was returned to them encased in heavy plastic, to prevent infection. "If I had at least been able to see her one more time, it would have helped me grieve," she said. "I don't know how to tell the other children what has happened." Her fears for the family are growing, because they are dependent on food handouts. "We have traded our cooking pots for something to eat, and have nothing left to barter with," she said. "If no more food comes, we will die."

The doctor, who had been unable to save Sarah's life, said: "Cholera, malaria and deaths in childbirth are all easily preventable. Save the Children is a very strong pillar for us – compared with other districts, we lose far fewer people to these causes." Never, though, have the ordinary people of Zimbabwe been in greater need than now, and we are their only source of hope.

Some names have been changed

Anatomy of a killer

* Cholera, a bacterial infection, results from poor hygiene and contaminated water or food. It is common in crowded, insanitary environments, such as pre-20th-century London.

* One of the earliest breakthroughs in public health came when a cholera outbreak was traced to an infected well in Soho, London, in 1854.

* The disease causes massive diarrhoea and vomiting in its most virulent form, leading to dehydration and kidney failure. It can kill in as little as three hours if not treated.

* Cholera is easily treated by oral rehydration and antibiotics. But the disease will kill more than half those infected if left to run its course.

How you can help

Our Christmas Appeal has already raised over £10,000, but much more is still needed.

£5 will buy a mosquito net to protect a child from malaria.

£40 will buy a kit to treat a cholera patient with a drip, fluid and drugs.

£66 will build a safe toilet to prevent disease spreading.

£230 will fund a borehole and water pump so a village has clean water.

£660 will set up an isolation camp to treat cholera victims safely, and stop the disease from being spread.

You can also pledge at www.independent.co.uk/iosappeal

Voices
voicesGood for Lana Del Rey for helping kill that myth, writes Grace Dent
Sport
The Pipes and Drums of The Scottish Regiments perform during the Opening Ceremony for the Glasgow 2014 Commonwealth Games at Celtic Park on July 23, 2014 in Glasgow, Scotland.
Commonwealth GamesThe actor encouraged the one billion viewers of the event to donate to the children's charity
Sport
Karen Dunbar performs
Entertainers showcase local wit, talent and irrepressible spirit
Sport
Members of the Scotland deleagtion walk past during the opening ceremony of the 2014 Commonwealth Games at Celtic Park in Glasgow on July 23, 2014.
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebookA unique anthology of reporting and analysis of a crucial period of history
Arts and Entertainment
The Tour de France peloton rides over a bridge on the Grinton Moor, Yorkshire, earlier this month
film
Life and Style
fashion Designs are part of feminist art project by a British student
News
Very tasty: Vladimir Putin dining alone, perhaps sensibly
news
Life and Style
Listen here: Apple EarPods offer an alternative
techAre custom, 3D printed earbuds the solution?
Arts and Entertainment
Top guns: Cole advised the makers of Second World War film Fury, starring Brad Pitt
filmLt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a uniform
News
The University of California study monitored the reaction of 36 dogs
sciencePets' range of emotions revealed
News
Snoop Dogg pictured at The Hollywood Reporter Nominees' Night in February, 2013
people... says Snoop Dogg
Arts and Entertainment
A scene from Shakespeare in Love at the Noel Coward Theatre
theatreReview: Shakespeare in Love has moments of sheer stage poetry mixed with effervescent fun
News
Joining forces: young British men feature in an Isis video in which they urge Islamists in the West to join them in Iraq and Syria
newsWill the young Britons fighting in Syria be allowed to return home and resume their lives?
Arts and Entertainment
The nomination of 'The Wake' by Paul Kingsnorth has caused a stir
books
News
i100
Life and Style
food + drinkZebra meat is exotic and lean - but does it taste good?
Independent
Travel Shop
the manor
Up to 70% off luxury travel
on city breaks Find out more
santorini
Up to 70% off luxury travel
on chic beach resorts Find out more
sardina foodie
Up to 70% off luxury travel
on country retreats Find out more
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

BI Manager - £50,000

£49000 - £55000 per annum + competitive: Progressive Recruitment: My client is...

BI Project Manager - £48,000 - £54,000 - Midlands

£48000 - £54000 per annum + Benefits package: Progressive Recruitment: My clie...

VB.Net Developer

£35000 - £45000 per annum + competitive: Progressive Recruitment: If you're pa...

SAP Business Consultant (SD, MM and FICO), £55,000, Wakefield

£45000 - £55000 per annum + competitive: Progressive Recruitment: SAP Business...

Day In a Page

Screwing your way to the top? Good for Lana Del Rey for helping kill that myth

Screwing your way to the top?

Good for Lana Del Rey for helping kill that myth, says Grace Dent
Will the young Britons fighting in Syria be allowed to return home and resume their lives?

Will Britons fighting in Syria be able to resume their lives?

Tony Blair's Terrorism Act 2006 has made it an offence to take part in military action abroad with a "political, ideological, religious or racial motive"
Beyoncé poses as Rosie the Riveter, the wartime poster girl who became a feminist pin-up

Beyoncé poses as Rosie the Riveter

The wartime poster girl became the ultimate American symbol of female empowerment
The quest to find the perfect pair of earphones: Are custom, 3D printed earbuds the solution?

The quest to find the perfect pair of earphones

Earphones don't fit properly, offer mediocre audio quality and can even be painful. So the quest to design the perfect pair is music to Seth Stevenson's ears
US Army's shooting star: Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform

Meet the US Army's shooting star

Lt-Col Steven Cole is the man Hollywood calls when it wants to borrow a tank or check a military uniform
Climate change threatens to make the antarctic fur seal extinct

Take a good look while you can

How climate change could wipe out this seal
Should emergency hospital weddings be made easier for the terminally ill?

Farewell, my lovely

Should emergency hospital weddings be made easier?
Man Booker Prize 2014 longlist: Crowdfunded novel nominated for first time

Crowdfunded novel nominated for Booker Prize

Paul Kingsnorth's 'The Wake' is in contention for the prestigious award
Vladimir Putin employs a full-time food taster to ensure his meals aren't poisoned

Vladimir Putin employs a full-time food taster

John Walsh salutes those brave souls who have, throughout history, put their knives on the line
Tour de France effect brings Hollywood blockbusters to Yorkshire

Tour de France effect brings Hollywood blockbusters to Yorkshire

A $25m thriller starring Sam Worthington to be made in God's Own Country
Will The Minerva Project - the first 'elite' American university to be launched in a century - change the face of higher learning?

Will The Minerva Project change the face of higher learning?

The university has no lecture halls, no debating societies, no sports teams and no fraternities. Instead, the 33 students who have made the cut at Minerva, will travel the world and change the face of higher learning
The 10 best pedicure products

Feet treat: 10 best pedicure products

Bags packed and all prepped for holidays, but feet in a state? Get them flip-flop-ready with our pick of the items for a DIY treatment
Commonwealth Games 2014: Great Scots! Planes and pipers welcome in Glasgow's Games

Commonwealth Games 2014

Great Scots! Planes and pipers welcome in Glasgow's Games
Jack Pitt-Brooke: Manchester City and Patrick Vieira make the right stand on racism

Jack Pitt-Brooke

Manchester City and Patrick Vieira make the right stand on racism
How Terry Newton tragedy made iron men seek help to tackle their psychological demons

How Newton tragedy made iron men seek help to tackle their psychological demons

Over a hundred rugby league players have contacted clinic to deal with mental challenges of game