According to doctors in Zimbabwe, the cholera epidemic in Harare is claiming many lives and the government is massively under reporting the death statistics from this easily preventable disease. Peta Thornycroft reports that broken water pipes and sewage systems are responsible for most of the cases in Harare at a time when almost all government health services have collapsed.
In Harare Tuesday, doctors from the state's largest hospital in Harare were prevented by riot police from demonstrating against the government's lack provision of medicines, equipment and living wages.
They have also demanded salaries in foreign currency. The Parirenyatwa Hospital where the doctors were demonstrating stopped admitting patients last month because specialist doctors refused to to work under the present conditions. Now the rest of the doctors have formally announced a work stoppage.
Zimbabwe University closed the country's only medical school Monday and sent all third fourth and fifth year students home because of what it describes as the prevailing conditions.
This unrest in the state medical fraternity comes against the background one of the worst cholera epidemic in Zimbabwe. Doctors Without Borders, which is trying to assist says 1.4 million people in Harare are now at risk of catching this preventable disease.
In the Budiriro suburb, to the west of Harare city center, many people have dug wells in their gardens to get water.
The city's water pumping works break down regularly as little maintenance has been carried out for several years. Some parts of Harare have had no water into houses, or sewage waste removal all year. Sewage flows down the streets of several high density suburbs.
The water from many of these wells is infected, doctors say, and account for much of the cholera.
At one clinic in Budiriro which is being used as an emergency treatment room and which is overflowing with new admissions, at least 60 people have died in the last two weeks according to an official who asked not to be named.
The government has admitted many more have died and nearly 500 people have been treated for cholera in Beit Bridge on the border with South Africa. Other urban areas in the country have also reported an outbreak of the disease.
Many people are at home with the disease which can and has killed people in Harare in 24 hours from first symptom.
Donors are providing drugs and equipment to the Infectious Diseases Hospital in Harare which is the only one left in the city able to treat people for cholera The only doctors available are some from the Zimbabwe National Army.
The Combined Harare residents association says it monitored the infectious diseases hospital for only and hour this week, and in that time five adults and one child died of cholera. It says there are no health centers open in most of the city and and that the government has stopped the staff from talking to the media.
Doctors say only those who can afford private health care can get medical treatment in Zimbabwe now. They say most of the state's health centers are closed around the country.
Zimbabwe had the best state medical care in Africa for at least 10 years after 1980 independence.
Many of those dying of dehydration from the ongoing epidemic are also suffering from HIV/AIDS, said one Harare doctor. He said so many people have damaged immune systems and do not get enough to eat and therefore have little resistance to recover from cholera.
The government has only disclosed partial statistics and some doctors believe several hundred people have died from cholera in the last month. The outbreak of cholera has come just as the annual summer rains are due to begin and doctors have warned that more than 1.4 million people could be in danger of contracting the disease unless urgent action is taken.