Zimbabwe struggles to tame cholera outbreak in rains

Zimbabwe is struggling to bring under control the cholera outbreak that began late last year. Instead, the disease is spreading to eight districts and has affected over 300 people in the last three months.

The outbreak that began on November 4, 2024, in Kariba districts had on January 20 spread to five of the country’s 10 provinces.

Authorities say the disease is spreading faster because of heavy rains pounding the country since mid-December.

The country’s most affected regions had just suffered a lengthy drought that also saw the Kariba Dam, the main source of hydropower for Zambia and Zimbabwe drop to the lowest water levels ever. In that season, the country also suffered an outbreak of cholera, which was blamed on scarce, unclean water sources.

The Ministry of Health and Child Care said eight districts had recorded active cases since the outbreak began in Kariba district.

“As of 21 January 2025, Zimbabwe has recorded 302 suspected cholera cases, 30 confirmed cases, and 286 recoveries,” said in an update on Tuesday.

“There are four cumulative deaths, two deaths were confirmed and are institutional deaths whilst two are suspected deaths who died in the community.”

The new cholera cases resurfaced just four months after the government declared the end to an earlier outbreak that killed 700 people in 18 months between 2023 and last year.

Health and Child Care deputy minister Sleiman Kwidini attributed the latest outbreak to contamination of water sources and said the government was planning to provide “tablets, which are going to assist in killing the bacteria that is found in water sources.”

“Also, we are encouraging our community to boil water, even if it’s coming from a clear or protected water source so that we reduce chances of getting cholera,” Mr Kwidini said.

In August last year, the government declared the cholera outbreak officially over after the disease had spread to all the country’s 10 provinces and affected 62 districts.

The last case of cholera had been reported on June 30, 2024, when the country had recorded 34 549 suspected cases with 4 217 confirmed cases and 33 831 recoveries.

There were 718 cumulative deaths with 87 being laboratory-confirmed and 631 suspected deaths due to cholera during the outbreak.

Zimbabwe has been battling serious cholera outbreaks since the turn of the millennium due to the breakdown of water and sewer reticulation infrastructure in urban areas.

A perennial water shortage in towns and cities due to frequent droughts has exacerbated the problem.

The worst outbreak in living memory happened in 2008 when more than 4 000 deaths and 98 000 cholera cases were recorded.  

Zimbabwe, like most southern African countries, is reeling from serious water shortages in the wake of one of the worst droughts on record attributed to the El Nino weather phenomenon.

Itai Rusike, executive director of the Community Working Group on Health, said the frequent cholera outbreaks were linked to the failure of the government to invest in the health sector and infrastructure.

“Cholera remains a public health crisis as the disease continues to affect the predominantly poor communities where access to clean and safe water and sanitation remains a serious challenge,” Mr Rusike told The East African.

“The persisting and recurrent outbreaks of cholera give a poor reflection of the health and development status of the country. 

“This reflects weaknesses in water and sanitation infrastructure and services, high-risk hygiene and social practices, gaps in surveillance and healthcare systems.”

Zimbabwe’s now perennial cholera outbreaks have been blamed on the collapse of sewer infrastructure in many urban areas.

Most of the country’s major cities often face serious water shortages because of frequent droughts and lack of investment in new water sources, with the capital Harare, and the second city of Bulawayo being the worst affected.

Desperate residents are often forced to rely on shallow wells and boreholes for water, but experts say most of Harare’s underground water is now polluted due to sewage leakages.

“We need to tackle these outbreaks at the community level by dealing with the fundamental public health issues and causes surrounding the continuous outbreaks,” Mr Rusike said.

“Ensuring basic water, basic sanitation, basic hygiene practices, and solid waste management is vital for the successful prevention and elimination of cholera. 

“The cholera outbreak of 2008-2009 was a marker of the need for investment in water and sanitation infrastructure.”

Cholera is a bacterial disease that usually spreads through contaminated water and food, which causes severe diarrhoea and dehydration.

If left untreated, cholera can be fatal within hours. Most countries have eliminated diseases such as cholera by investing in modern sewage and water treatment.

According to the World Health Organization, other African countries that have battled cholera outbreaks recently are Burundi, Cameroon, Comoros, the Democratic Republic of Congo, Kenya, Malawi, Mozambique, Nigeria, South Africa, Tanzania, Uganda and Zambia.

Zimbabwe is constrained from dealing with public health emergencies such as cholera outbreaks by the collapse of the health delivery system due to years of underfunding.

The country has also lost most of its experienced health professionals to countries such as the United Kingdom.
In 2021, World Health put Zimbabwe on its red list alongside South Africa, Botswana, Lesotho, Eswatini, and Namibia, which means other countries are restricted from recruiting their health professionals.