JOHANNESBURG, 14 January 2009 (IRIN) - Aid agencies in Zimbabwe hope a "massive" step-up in the cholera awareness campaign in the next few days will help bring the death toll down to manageable levels.

As the number of deaths in the outbreak shot past 2,000 and notched up another 1,000 cases within days, the UN World Health Organisation (WHO) attributed the surge to the spread of the disease deeper into the interior.

"The outbreak has spread to the rural areas during the Christmas break – there has been a lot of movement of healthy carriers [of cholera bacteria] back and forth," said Oladapo Walker, the WHO Inter-Country Support Team coordinator in Zimbabwe.

He added that the Zimbabwe Health Cluster was concentrating on launching an awareness campaign that included distributing information leaflets, water treatment tablets, oral rehydration salts, and washing soap and buckets.

Cholera-related deaths in communities have continued to climb, but in treatment care centres the incidence has fallen, showing that "there is a need to step up awareness", said Amanda Weisbaum, the emergency manager of Save the Children, UK, in Zimbabwe.

Poor communications between Zimbabwe's ten provinces and the WHO head office in the capital, Harare, which is responsible for collating the figures, had seen sudden spurts in numbers as new figures were added whenever lines were operational.

Communications improved after a cellphone provider, Echonet, offered them a toll-free line. "We have also provided 23 free SIM cards to all the provincial medical directors [in the 10 provinces] and the data managers," said Walker, but added glumly that things were "not perfect yet – none of the lines were working yesterday."

Aid agencies have been struggling to control the epidemic in a country where the health system has collapsed, the government is broke, and the inflation rate is unofficially in the trillions of percent. They are hoping the cholera prevention and information campaign will bring down the numbers.

The response to the cholera outbreak has also been affected by an ongoing strike by medical personnel, who had not received their salaries in months. The Health Cluster has managed to convince some of the doctors and nurses to resume work in the Cholera Treatment Centres (CTCs) by offering them additional money.

"We paid them during the Christmas break till 1 January. They are still working, as we are still trying to negotiate more money and help them get their arrears," Walker said.

Food was the other incentive that had drawn medical personnel back to work. The World Food Programme (WFP) stepped in to feed 12,600 people in the 22 CTCs, said Richard Lee, the agency spokesman. WFP has also chipped in with logistical support by putting their vehicles at the cluster's disposal.

The government, the Reserve Bank of Zimbabwe and UN agencies have also donated enough fuel to keep the aid effort on the road, said Walker.

But what the effort really needs, according to Weisbaum, is to ensure that every household has access to water purification tablets, and realises "the importance of keeping their drinking water clean – otherwise nothing is going to help."

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