HARARE, 7 January 2008 (IRIN) - A diarrhoea outbreak that has hit hundreds of people in the Zimbabwean capital, Harare, is being attributed to a combination of factors, including a failure by the local city authority to provide clean water and collect refuse in residential areas.

Harare's director of health services, Stanley Mungofa, told journalists during a recent tour of Mabvuku and Tafara, two of the capital's low-income suburbs hardest hit, that more than 400 cases had been reported in these areas.

"There has been an increase in diarrhoea cases, with 459 reports of diarrhoea being received towards the end of 2007. The figures of diarrhoea cases received so far are way above what is normally experienced at this time of the year," he said.

A nurse at Harare's Glen View clinic, who declined to be identified, told IRIN that while cases were concentrated in Mabvuku and Tafara, the rest of the capital had not escaped unscathed.

"Most parts of Harare have gone without water for several weeks and garbage has not been collected throughout the city, and that means the whole city has an environment conducive for the spread of waterborne diseases."

Health care workers on strike

Medical services have been severely stretched since health workers embarked on a strike at the beginning of year to demand higher salaries. The wages of doctors and nurses are rapidly eroded by the world's highest inflation rate, officially cited at 8,000 percent but estimated at 25,000 percent by independent economists.

Doctors are paid Z$60 million monthly (US$30 at the parallel market rate of Z$2 million to US$1), while nurses earn Z$25 million a month (US$12.50). Government has offered health personnel a 600 percent wage hike if they return to work.

Precious Shumba, spokesperson for the Combined Harare Residents Association, a civic organisation advocating good local governance, said the incidence of diarrhoea could have been avoided but for the interference of the ruling ZANU-PF government in 2001, when a government-appointed commission, staffed by ruling party loyalists ill-equipped to deliver services to the capital's residents, replaced the city's elected authority.

"The Harare municipality used to provide clean and reliable water to residents until the government started meddling in the affairs of the city by awarding water supply to the parastatal Zimbabwe National Water Authority (ZINWA), which has failed dismally to provide clean water all the time."

The two worst affected residential areas have not have had access to potable water for months and during that time have experienced sporadic outbreaks of waterborne diseases, including cholera.

"While some homes have gone for as long as three months without water, the spreading of waterborne diseases has been encouraged by failure of the commission running Harare to collect refuse from residential areas," Shumba said.

"Residents now dump garbage in open areas, which has caused an increase of flies in many residential areas, making it easy for diarrhoea to spread. Many sewerage pipes have burst but they are never attended to on time, resulting in raw sewage flowing in residential areas and creating a health time bomb in the process," she told IRIN.

Water for a few

Elias Mudzuri, former executive mayor of Harare and member of the opposition party, the Movement for Democratic Change, told IRIN that during his term of office he had arranged twinning agreements with European cities, in terms of which Harare would have received assistance with refuse collection through the training and the delivery of vehicles to dispose of household rubbish.

"However, following the sacking of the elected Harare municipal leadership by the ZANU-PF, all the arrangements that were in place, especially with the city of Munich, in Germany, were cancelled, as they insisted that they would only partner [cities with] democratically elected municipalities," Mudzuri said.

"Most of the problems being experienced in Harare are generally to do with the fact that people with no history in local governance were hand-picked to run the capital city, which is not an easy thing to do."

Health services director Stanley Mungofa confirmed that the diarrhoea outbreak was attributable to sewer blockages, unreliable water supplies and uncollected domestic refuse. The city is also experiencing unusually high levels of seasonal rainfall.

The diarrhoea outbreak has finally moved the authorities to pump water to the affected suburbs, but at a cost: according to ZINWA chief engineer, Albert Muyambo, "We have prioritised Mabvuku and Tafara areas and cut off other areas," leaving most of Harare's other suburbs without water.

Health and Child Welfare minister David Parirenyatwa told IRIN that health personnel had been deployed to affected suburbs to monitor the situation. "As far as I know, there have been no deaths caused by the diarrhoea outbreak, although some people have been hospitalised."

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