Two men struggle to push a rusty wheelchair over quarry stones into one of the tents at a clinic in Kuwadzana phase 4, one of Harare’s densely populated suburbs.
In the wheelchair is an elderly woman only identified as Mai Chimunda. She is unconscious.
Chimunda’s tenant Christopher Chibupwe, one of the men wheeling her into the clinic says his landlord’s case is a culmination of over 48 hours of sickness with symptoms of cholera.
“Two days ago, she stayed in her bedroom without coming out as she normally does.
“We then knocked on her door trying to inquire if she was alright and that was when we realised she was not feeling well,” the middle-aged man explained.
Like most people, Chimunda, a hypertension patient, thought her running stomach would get better with time, but her health deteriorated dramatically as time progressed.
“We woke up today (November 23) and she could hardly speak and looked very weak so we had to rush her here as we suspected it was cholera,” Chibupwe said.
Cholera is a severe intestinal infection caused by ingesting contaminated food or water. It causes severe diarrhoea, which can lead to dehydration and death if untreated.
It is most likely to occur and spread in places with inadequate clean water supply, poor sanitation, and inadequate hygiene, according to the World Health Organisation.
Harare has emerged as a hotspot, with the number of cases growing at an alarming rate, especially in some of the crowded and poor suburbs like Kuwadzana where the high number of confirmed cholera cases has resulted in the capital city declaring a state of emergency.
A deadly combination of poor waste management, unreliable clean water supply and burst sewage pipes among other public service delivery shortcomings in most suburbs such as Kuwadzana has made the capital a breeding ground for the deadly disease, which is now endemic.
The worst cholera outbreak occurred in 2008 when 4 000 people succumbed to the disease across the country.
"Water shortages are a serious problem in this area (Kuwadzana). We go for three to four days without water,” Chibupwe said.
We go for a week sometimes without even water for cooking and washing dishes, let alone water to flash in toilets. We’re really exposed to such diseases as cholera and typhoid.
“Although we now have boreholes, they run out of water quickly leaving us with no option but to scrounge for the resource from unsafe sources.”
Last week, Kuwadzana resident Wellington Mariga, took the City of Harare to court to force the council to provide potable water to the suburb.
Mariga also wanted a court order directing the council to deploy water bowsers within 24 hours.
He said in this landmark case, that he lost a number of friends and relatives in 2008 to cholera and could not afford losing his loved ones again.
“What has moved me to make this application is also the fact that l felt l cannot sit on my laurels and allow the same scenario to repeat itself when such a consequence could be mitigated by supplying clean and safe drinking water,” court papers in possession of The Standard read in part.
Mariga said he cited Kuwadzana, Dzivaresekwa and Glen Norah high density suburbs in his application as some of the worst affected areas.
"The high density suburbs fall under the jurisdiction of the City of Harare which is responsible for service delivery in terms of the Urban Councils Act,” court papers in possession of The Standard read.
“This includes the provision of adequate, constant, clean and potable water to all residents.
“l must highlight that the provision of adequate, constant, clean and potable water by the City of Harare to residents, particularly in times of public health emergencies is both a statutory and constitutional imperative.”
He said the City of Harare had for many years failed in its mandate to provide for adequate, constant, clean and potable water to residents of Harare, resulting in recurrent cholera outbreaks.
“Some residents have not received any water supplies at all and have had to rely on shallow wells and boreholes for water,” Mariga said. “The consequences are too ghastly to contemplate.”
According to available statistics, at least 80% of recorded cholera cases in Harare have been traced to Kuwadzana.
Mariga said failure to provide clean water was a violation of his rights as provided for in Section 77 of the constitution.
Speaking at a post-cabinet media briefing last week Information, Publicity and Broadcasting Services minister Jenfan Muswere said the country recorded 1,744 new suspected cholera cases over the past week, compared to 1,259 registered the previous one.
He said the training of city health promoters in Chitungwiza and Harare started last week targeting 300 community members, who will spearhead door-to-door campaigns.
Muswere said community dialogues, inter-faith discussions and sensitization of key stakeholders on cholera are planned for this coming week in high cholera incidence districts.
However, an inquiry by The Standard showed that people have scant information about cholera, how it spreads and its devastating effects if left unabated.
While local authorities and central government in partnership with several donors are implementing emergency services, they are clearly falling short and lives are being lost.
At a shopping space in Kuwadzana Phase 4, a stone’s throw away from the cholera treatment satellite centre established on November 8, it is business as usual.
Food vending stalls are thriving in open spaces along streets and around the shops, suspicious bottled water is being sold everywhere while mounds of uncollected garbage are littered around the area.
The general lack of hygiene in the area is breathtaking.
Two weeks ago, a 44-year old man known as Vinegar died after complaining of stomach pains and other cholera-like symptoms for two days.
“He had eaten food sold by these street vendors,” one of his neighbours said.
A fortnight ago, government gave Harare City Council a seven-day ultimatum to remove vendors from the streets, blaming them for fuelling the spread of cholera.
However, the informal traders have stayed put with Vendors for Economic Development (Vendors 4ED) national chairperson Samora Chisvo saying they were not going anywhere.
“We are not fighting our government, but Harare City Council,” Chisvo told The Standard.
“In response to the ultimatum on the eviction of vendors, our position is that vendors are not solely to blame for the cholera crisis.
“We don’t want to be used in political wars where the Harare City Council puts conditions that affect vendors.
“We blame the Harare City Council for the cholera crisis. "They are not collecting refuse, we have no proper toilets, and we have no running water...”
Mercy Makuwatsine from the council’s corporate division said she was not in a position to comment and directed all questions to council head of corporate communications Stanley Gama, who was not available.
The seven-day ultimatum has since passed, but vendors are still operating in various undesignated places especially in Harare CBD.
Approximately 10% of the people who get sick with cholera develop severe symptoms such as diarrhoea, vomiting, and leg cramps.
In these people, rapid loss of body fluids leads to dehydration and shock. Unless treatment is found quickly, death can occur within hours.
Most people do not want to be associated with this medieval disease and hence the initial denial when one develops symptoms, making it hard to contain the disease.
Patients like Chimunda, whom The Standard later learnt was transferred to Sally Mugabe Hospital, are taken to the hospital but sometimes it would be too late.
“Cases are stabilising but we are concerned about what will happen during the rainy season where Cholera is bound to spread,” said a nurse at Kuwadzana polyclinic, who spoke to The Standard on condition of anonymity.
Her concerns are valid if one considers how the outbreak is being treated – with apparent lethargy and laxity by relevant authorities at the moment.