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In Zimbabwe, nearly 1,000 people have died from an outbreak of cholera. The disease is spread by contaminated drinking water. Public health experts say the outbreak is shocking because it's taking place in a country that until recently had all but eliminated the conditions that lead to cholera. NPR's Jon Hamilton has the story.
JON HAMILTON: A decade ago, Zimbabwe had water, sanitation, and public health systems that were among the best in Africa. But since then, the nation's infrastructure has gradually crumbled. Duncan Steele grew up in Zimbabwe. Now he works as an adviser to PATH, an international health group. He still makes regular visits to the capital, Harare.
Dr. DUNCAN STEELE (Senior Adviser, PATH): Even last year when I visited there, I did not have a problem drinking tap water in the hotel. Obviously, it's a nice hotel, and so on, but the water supply to the city was excellent in the past.
HAMILTON: Not anymore. In recent months, aging sewer pipes have burst or clogged, allowing sewage and bacteria to enter the water supply. At a press conference last week, U.S. officials said they had been expecting a cholera outbreak. Here's James McGee, the U.S. ambassador to Zimbabwe.
Ambassador JAMES MCGEE (U.S. Ambassador to Zimbabwe): The ability of the government to collect garbage is zero. People are either using boreholes, wells, for drinking water or they're picking it up out of the sewers themselves.
HAMILTON: Cholera is caused by bacteria that multiply in the intestine and cause severe diarrhea. The disease spreads when the bacteria from sick people gets into drinking water supplies. And that's what's happened as Zimbabwe's infrastructure finally gave out.
Ms. ANDRA TAMBURRO (Program Director for WASH in Schools Initiative, Water Advocates): Zimbabwe was the shining star of southern Africa.
HAMILTON: Andra Tamburro used to work in Africa for the U.S. Agency for International Development. Now, she's with the group Water Advocates in Washington, D.C. Tamburro says under the rule of President Robert Mugabe, the government failed to maintain water and sewer pipes. And in recent months it ran out of money to buy the chemicals that kill bacteria in drinking water. So when cases of cholera began to show up in Harare, officials simply shut down the water system. Tamburro says that's made matters even worse.
Ms. TAMBURRO: People are going now back to their traditional sources, whether it be rivers or wells, and they have been contaminated with the cholera bacteria.
HAMILTON: Cholera bacteria have even reached the Limpopo River along the southern border of Zimbabwe, and the outbreak has been carried to Mozambique and South Africa by sick refugees. Tamburro says Zimbabwe's experience shows how quickly health problems can return when a country fails to maintain water and sanitation systems.
Ms. TAMBURRO: This is more than the canary in the mine here. This is just a huge warning bell for a lot of countries and large urban areas where this is happening.
HAMILTON: The U.S. has sent disaster response teams to Zimbabwe to help control the cholera outbreak, but Ky Luu from the Office of Foreign Disaster Assistance says that will be a tough job because there has been so much damage to water and sewer systems.
Mr. KY LUU (Director, Office of Foreign Disaster Assistance, USAID): It is years and years of neglect. So it's not as simple as going in and sourcing one potential outbreak area here.
HAMILTON: The World Health Organization says more than 16,000 people in Zimbabwe have been sickened by cholera, and the number could quadruple during the next few months. Zimbabwe's rainy season has arrived, and rainwater tends to spread the cholera bacteria. Jon Hamilton, NPR News.