Harare — Health officials in Zimbabwe's capital, Harare, have detected several cases of typhoid fever in the past week, adding to fears that a water crisis will fuel the spread of infectious diseases.
The city's health director, Prosper Chonzi, said six cases of typhoid had been confirmed, with more expected to emerge.
"The conditions on the ground - frequent water cuts and poor sanitation - are conducive to a typhoid outbreak," he told the Thomson Reuters Foundation.
Last year, more than 40 people in Harare were hospitalised due to typhoid, a bacteral infection that causes fever, headaches and constipation or diarrhoea.
Health officials have been deployed to affected areas including Hopley, a sprawling township without sewers and tap water, to contain the situation and identify suspected cases.
"As long as there is no constant supply of water to residents, we will continue to have sporadic cases of such outbreaks," Chonzi warned.
Separately, at Roosevelt High School, nearly 50 students were recently hospitalised due to shigellosis, a diarrhoeal disease that thrives in places with poor water and sanitation.
In Zimbabwe's biggest referral hospital Parirenyatwa, a 32-year-old nurse who did not want to be named, said she feared the city's worsening water problems could lead to her own two young children falling sick with a deadly waterborne disease.
"I live in the townships, and there we do not have water four days of the week from 4am to 10pm, and no water at all for the other three days," she said, tending to a child suffering from severe diarrhoea.
"When available, the water is visibly dirty, brownish or greenish in colour, and smells like raw sewage," she added.
The city authorities deny the water coming from Harare's taps is polluted.
But it is clear that frequent and prolonged droughts - including the current dry spell linked to the El Niño weather phenomenon - have wreaked havoc on Zimbabwe's water supplies.
As Harare struggles through its third drought since 2013, the city's main reservoir, Lake Chivero, cannot keep up with water demand for domestic use and irrigation.
In December, the city was forced to cut its already inadequate household water supply by 18 percent to 450 million litres a day, just over half of daily needs, leaving thousands of residents without enough safe water for drinking and washing.
As a result, Harare's inhabitants fear an impending epidemic, like the 2008-2009 cholera crisis that originated in the capital, killing 4,000 people and affecting 100,000 more across the country.
As drought has shrunk Chivero's water levels, siltation is making things worse. The lake's capacity has shrunk one fifth in the last 60 years, the Environmental Management Agency says.
In late 2015, Chivero was only 40 percent full, before a bout of heavy rain raised it to just over 70 percent, according to the Zimbabwe National Water Authority.
But water volume isn't the only problem. City spokesman Michael Chideme said the lake was also "heavily polluted" with raw sewage and industrial chemical waste, as well as fertiliser and pesticide run-off from urban farming.
A 2014 ministerial committee report blamed Harare for pumping 3,885 megalitres of raw sewage into Lake Chivero each month.
Several industrial and mining companies discharge harmful chemical waste into the Manyame and Mukuvisi rivers and other tributaries that feed the lake, degrading water resources and corroding pipelines, the report said.
The pollution has pushed the lake's pH levels above 8, an alkaline state that increases water treatment costs.
Harare now spends $4 million on chemicals and power each month to purify water - about $800,000 more than it would cost for less polluted water.
"So for us to treat water to required standards, the logical thing was to reduce the amount treated," Chideme told the Thomson Reuters Foundation.
CLEAN WATER ACCESS PLUNGES
A combination of drought, ageing infrastructure, pollution and a ballooning population makes it almost impossible for the city to adapt to a water crisis it has suffered for 15 years.
A 2014 survey by the government and international aid agencies showed the number of Harare households with access to clean drinking water and sanitation had plummeted to just below 40 percent, from 95 percent in 2009 - the fastest decline among Zimbabwe's 10 provinces.
Chideme said the city has sunk 240 boreholes in the worst-affected areas to try to bridge the deficit, but experts say it will not be enough.
"The 20-litre minimum water requirement per capita which the World Health Organisation recommends for basic daily hygiene has been a challenge," Khumbulani Murenga, head of the independent Institute of Water and Sanitation Development, said by email. "Water cuts will further deepen this challenge."
With the water supply to some townships, such as Mabvuku and Hatcliffe, completely cut off since early December, health experts warn Harare is sitting on a time bomb.
"Untreated or poorly treated drinking water may contain traces of dangerous pathogens... that cause diarrhoea, cholera and typhoid," said Vivek Solanki, a doctor at Harare's Trauma Centre.
And it could be years or even decades before the city's 2.1 million residents get safe drinking water again.
Water scarcity is predicted to worsen across southern Africa, with a 2012 World Bank report predicting that dam and lakes levels will fall by up to 50 percent by 2080 due to the effects of climate change.
For nurse Simukai, the threat is more immediate. "The risk of the spread of waterborne diseases, particularly among children, is probably at its highest since 2008," she said, checking the sick boy's temperature as another nurse fitted him with a saline drip.
"The only way we can help contain it is through public education, health promotion and changing attitudes - and improving sanitation and waste management," said Harare health director Chonzi.
(Reporting by Jeffrey Gogo; editing by Jumana Farouky and Megan Rowling. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers humanitarian news, women's rights, trafficking, corruption and climate change. Visit http://news.trust.org)