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Full Extent of Cholera Epidemic in Zimbabwe Not Known

U.N. aid agencies say Zimbabwe is grappling with a cholera crisis of unprecedented proportions. They say the social and health breakdown in the country is making it difficult to gauge the full extent of the epidemic.

The United Nations reports the total number of suspected cholera cases in Zimbabwe is approaching 14,000, with nearly 600 deaths. But a World Health Organization spokeswoman, Fadela Chaib, says these figures have to be taken with some caution.

She says most of the reported cases and deaths from cholera come from the capital, Harare and two other major cities.

"We are giving these numbers based on the best knowledge we have on the situation on the ground," said Chaib. "But, the reporting and surveillance systems are weak in most of the districts in the country. So, we will not be surprised if when we get into these remote areas or when we have a better tracking system that the numbers of cases and deaths will be more important than what we are reporting presently."

In a crisis situation, such as that unfolding in Zimbabwe, Chaib says the World Health Organization sets up an early warning system to monitor the disease. She says the World Health Organization depends upon volunteers and health personnel to go to hospitals and clinics to record all the illnesses and deaths.

But in this case, she says the World Health Organization is unable to get the people it needs to maintain an effective surveillance system. She attributes this to the breakdown of the country's social and economic infrastructures.

"The health infrastructure in the country is very weak and it is very difficult to find medical supplies or equipment," said Chaib. "And, also health workers are not well paid and they leave their work, in fact, because the economic and social conditions are deteriorating in the country on a continuous scale. There are also a lot of strikes by the health workers because they are not paid. Or if they are paid, it is very late and their conditions of work are not good.

The U.N. aid agencies report the outbreak is worsening amidst growing criminality in the country. They say security is bad and looting is on the increase, as are attacks and robberies of humanitarian aid workers.

Cholera is having a devastating impact, as 43 out of Zimbabwe's 62 districts are reporting cases. In addition, the United Nations reports cholera is spreading to South Africa, Botswana and Mozambique.