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Page last updated at 16:48 GMT, Tuesday, 2 December 2008

Zimbabwe cholera deaths near 500

People wait to get water from an underground well in Harare after water there was cut, 1 December 2008
People collected water from wells in Harare after supplies were cut

A cholera outbreak in Zimbabwe has killed at least 484 people since August, according to the UN.

More than 11,700 cases of cholera have been recorded over the same period, an update from the UN office for humanitarian affairs said.

The cholera outbreak has affected most of Zimbabwe's regions.

Its spread has been aided by the collapse of Zimbabwe's health and sanitation systems amid a prolonged economic and political crisis.

Previously it had been reported that 425 people had died from cholera, which is spread by contaminated water.

State media has reported that much of the capital, Harare, has been left without water because of a shortage of purification chemicals.

The World Health Organization has warned that the outbreak "can spread quickly into areas without access to safe water and sanitation".

"Case fatality rates may rapidly escalate in populations without rapid access to simple treatments," it said.

Shaking hands

Cholera is endemic in Zimbabwe, and there have been outbreaks annually since 1998, according to the WHO.

Proper hygiene is the best protection against cholera and you can't do that without clean water
Marcus Bachmann
Medecins Sans Frontieres

Health Minister David Parirenyatwa has said people should stop shaking hands to prevent the disease spreading.

He said it was the worst ever cholera outbreak in Harare.

Cholera can be treated easily but hospitals lack medicines and staff.

The WHO said Zimbabwe's health facilities face a "massive gap" in required medicines due to a drop in local manufacturing capacity, weakened in turn by a shortage of foreign currency.

Marcus Bachmann from medical charity Medecins Sans Frontieres told the BBC that many poorer areas of the capital had been without water for several months and this was a major factor in the severity of the outbreak.

"Proper hygiene is the best protection against cholera and you can't do that without clean water," he said.

Cases of cholera have been reported either side of Zimbabwe's borders with South Africa, Botswana and Mozambique, showing the sub-regional threat of the outbreak, it said.

'Sub-regional threat'

The BBC's Peter Biles reports from the South African town of Musina, near the border with Zimbabwe, that cholera patients are being treated at an emergency centre on the lawn in front of the hospital.

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Emergency cholera centre in South African town of Musina

One cholera victim from Harare told him that on Zimbabwe's side of the border, toilets had not functioned for one month, and people were "defecating everywhere".

"We need the world to help us. The country is dying and people are dying."

South Africa's ministry of health has confirmed more than 160 cholera cases, including three deaths.

Zimbabwe's government has blamed its crisis on Western sanctions it says are aimed at trying to bring down President Robert Mugabe.

But the sanctions imposed after allegations of electoral fraud and political violence are aimed at Mr Mugabe and his close associates and consist of travel bans and a freeze on their foreign assets.

Zimbabwe is facing a severe economic crisis.

The latest estimated annual inflation rate was 231,000,000%, and just one adult in ten is thought to have a regular job.

map showing areas affected by cholera



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