Page last updated at 16:58 GMT, Wednesday, 3 December 2008

'Water crisis hinders cholera fight'

Medecins Sans Frontieres emergency co-ordinator in Harare, Marcus Bachmann explains the challenges he is facing trying to deal with the cholera outbreak in Zimbabwe's capital.

More than 500 people have died from cholera since August and its spread has been aided by the collapse of Zimbabwe's health and sanitation systems amid a prolonged economic and political crisis.

Zimbabwean children in search of water
The rainy season is the most dangerous time for cholera
The degradation of the water supply and sanitation systems are one of the root causes of the cholera outbreak.

There are not sufficient safe sources of drinking water. This has become an incredible breeding ground for cholera.

In fact, many high-density areas of Harare have been without water for several months already.

For example, in the Mabvuku and Tafara areas in the east of Harare, supplies started becoming erratic a year ago. Then it cut off completely in April and has not been back since.

In the city centre, water supplies became erratic about a month ago.

Then they cut on Sunday for 24 hours. That was the first time that has happened.

Colour scanning electron micrograph (SEM) of the Gram-negative bacteria, Vibrio cholerae, the cause of cholera in humans [SPL]
Cholera causes vomiting and diarrhoea leading to potentially fatal dehydration

Water supplies have now been restored where I live but only for an hour or so each day, which is a problem when I get home after dealing with cholera.

Proper hygiene is the best protection against cholera and you cannot do this without clean water.

Our emergency clinic is treating about 200 severe cases.

Each one needs about 60 litres of water a day.


We have enormous problems to get enough water to our clinic.

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

We get clean water from boreholes and then truck it over but there are not enough trucks or enough boreholes.

This is a major headache for our logistics officers.

We have had to cut our distribution to 30 litres of water a day.

This is the real minimum to treat cholera patients, who are dehydrated.

And we are struggling to maintain even this minimum.

Then, when we release patients, we give them oral rehydration salts, containing salt and sugar, which they must dilute with one litre of water.

But they cannot get clean water when they go back home.

The rainy season has just started in Harare, which will only make the situation worse.

Wherever we operate, the rainy season is the most dangerous time for cholera.

The rain water will wash the bacteria into the shallow wells which people have dug to get drinking water.

map showing areas affected by cholera

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