Rains wash away hope in a land ravaged by cholera

As disease sweeps Zimbabwe killing thousands, Daniel Howden witnesses the devastation in the squalor of Harare's townships

In Harare, the rains have come. They are falling on a city gripped by a cholera crisis that refuses to be talked out of existence.

The water is soaking through piles of uncollected rubbish, flooding the reeking open sewers of the townships and driving the foul water into the dams and reservoirs. In the waterlogged soil lie scores of recently buried bodies, few of them wrapped in the regulation plastic that would stop the bacteria seeping into the underground streams that feed the city's bore-holes. The rains are drowning government claims that the cholera crisis is over.

The official UN death toll stands at more than 1,000 but the reality is on an entirely different scale. International aid workers are reliant on Zimbabwe's ruined health ministry for numbers and admit in private that the figures quoted in Geneva are up to three weeks out of date and exclude those who leave hospitals and go home to die.

Onias Chimbabara has been collating his own statistics. Walking from house to house in Chitungwiza, the mouldering township 20 miles from Harare where the outbreak began, he has been recording cholera deaths and infections and doing the little he can to help. In a battered blue exercise book he has the names of eight of his friends and neighbours who have died and four more who are close to death. The numbers seem modest until Mr Chimbarara's explains that there are only 100 people in his ward. In the next ward, six have died, he says, in the next six again, and so on throughout the whole township. "People here have diarrhoea and skin problems and the mosquitoes are breeding in the sewerage," he says.

No one is paying him to do the count, he volunteered, and his hollow cheeks and tired movements are testament to his own brush with cholera. Chitungwiza is a playground for the intestinal disease, which in its severest form is among the most rapidly fatal illnesses known. The sewerage system stopped working six years ago. Rubbish collections stopped at the beginning of this year, and filthy, stinking water is available fitfully through what is left of the water pipes.

"We petitioned the council to collect the rubbish and fix the sewerage but we have got no response," Mr Chimbarara says. Rain drums loudly on the corrugated roof. "Now with the rains it's getting worse, everyone is complaining of stomach pains."

The corrupt local council is bankrupt so residents tried to collect money for diesel to get the rubbish trucks moving but everyone is broke; so far, they have just 20 litres.

This is not a natural disaster or even a simple case of poverty. The sewerage system worked well enough in Chitungwiza until 2002 when the area voted overwhelmingly for the opposition Movement for Democratic Change. Thugs from Robert Mugabe's Zanu-PF party responded by vandalising the sewerage pumps.

As we spoke, a black and white television showed Mr Mugabe loudly addressing a conference of that same party in nearby Bindura. "Zimbabwe is mine," he told them, wearing the same loud m'zambia patterned shirt he loathes but trots out to play the populist. He would "Never, never surrender!" he shouted, banging the table. The coming of the rains is supposed to be good news. In Mr Mugabe's native Shona, they are called Mwaka ye kurima , the coming of the summer rains for planting. But the country's once-thriving agriculture has degenerated into a desperate effort to stay alive, which in Chitungwiza means old women planting sweet potatoes amid the rubbish on the mud-banks of cholera-infected sewage ditches.

"Everyone is hungry," says Mr Chimbarara. In his backyard is a locked toilet, its rusting door was closed permanently soon after the pumps were smashed, when pouring muddy water down the bowl stopped working. An educated and thoughtful man, he seems embarrassed to say there have been "no flushing toilets for six years".

Six feet away is the replacement latrine which feeds stinking, grey, faecal-laden water into a shallow ditch that trickles past the vegetable patch into a similar ditch next door.

Asked what he can do for all the people that he is trying to help, he shrugs. "All I can do is tell them to go the clinic."

Catherine's clinic in Waterfalls suburb is typical. She is a nurse who until last week worked at the Beatrice Hospital for Infectious Disease. She was watching an average of 13 people a day dying at Beatrice alone. Most patients had clear signs of malnutrition, "skin damages, flaking off like old paint in adults". The children have swelling in their lower limbs, hands and feet. "You don't survive [cholera] if you're malnourished," she says. "It's hard to find a vein to put the drip in."

She is talking in an empty clinic. People know there are no drugs. "We have no medicine, all we can do is refer chronic cases to the hospital." At the hospital, patients are treated with rehydration drips that bring them back from the brink. "Then they are on their own," she says. The hospitals have had no antibiotics since the turn of the year, so patients are handed a prescription and told to go and buy the drugs they need at the pharmacy. "If you have US dollars you can get anything," Catherine adds. Those who do not have hard currency just "go home and die", she says. The battle for survival depends on cash. Getting cash and especially hard currency in a collapsed economy ravaged by hyperinflation is nigh-on impossible.

The announcement by the central bank that it was setting a new monthly limit on withdrawals of 10bn Zimbabwean dollars (£33.50) drew crowds to the banks. Every outlet in Harare was surrounded from early morning by queues of hundreds of people. Army trucks deposited entire platoons outside the banks, not to protect them but to get some money. By dusk, the same queues had been drenched and disappointed. There is not enough paper money to feed this insatiable disaster. The road to Rose's house in Warren Park is signposted with lost friends and neighbours. "The boy in that house died of cholera," says the driver. A few doors further, "A young girl in that house died of cholera". On the left, "A grown woman died of cholera".

Rose is among the few who had South African rands from relatives south of the border. She used that to save her two children. She took them out of the cholera treatment camp at Budiriro after she saw conditions there and realised there was no medicine. Her son cannot remember anything about the clinic but her daughter remembers "people groaning and crying out". It cost Rose the equivalent of £81 to pay the private doctor who stopped her children from dying.

Hopes that the epidemic could be contained have been dashed. Although the World Health Organisation has yet to confirm it, the disease has spread to all 10 districts of the country, says a non-government organisation worker, speaking on condition of anonymity. "The peak will come in the rainy season," she says. "The technocrats at the health ministry are not in denial. They know this is an emergency. It's the politicians."

Like many others, she observes that Zimbabwe's society has fallen apart in the past six months. "Things the country was able to contain in the past it can no longer contain." What prevents an even worse, more widespread disaster are the NGOs.

Mr Chimbarara goes on with his sad, self-imposed task. He has already lost his brother, who was shot eight years ago by Zanu militia during the farm invasions. His mother was beaten near to death after the ruling party lost elections in March. "Where are we going?" he asks plaintively. "We are being buried in a shallow grave; we are being buried alive."