Harare, Zimbabwe — Cholera outbreaks used to occur in five-year cycles, but recent decades have seen annual surges. This year, Zimbabwe recorded more than 7,000 cases and declared a state of emergency.
Linnet Mapuranga, 27, a mother of three, noticed her 7-month-old's upset stomach first. A few days later, her 3-year-old and 9-year-old had similar symptoms, and by the fourth day, everyone in her household was sick.
''I knew something was wrong. We went to the local clinic, and it was discovered that we all had cholera,'' she says.
Mapuranga, who lives in a house with five other families in Glenview, a high-density suburb of Harare, Zimbabwe's capital, says in June of this year, 10 of the 15 people who live there were diagnosed with cholera.
''My baby could not breastfeed. He was dehydrated, and his eyes were visibly shrunken and lifeless. I was stressed, and I could not think properly. My whole family was sick, and I thought I was going to lose them,'' she says.
Periodically, Zimbabwe is hit by cyclones, droughts and floods, owing to climate change and its effects on temperature and rainfall patterns over time, according to research by the United Nations Educational, Scientific and Cultural Organization. The frequency of these floods and droughts is rising, with their effects linked to repeated cholera outbreaks. In February, the country was hit by Cyclone Freddy, which caused flooding and yet another cholera outbreak.
Since 1998, Zimbabwe has recorded yearly cholera outbreaks, according to the World Health Organization Regional Office for Africa. Prior to then, outbreaks were on a five- to seven-year cycle.
Cholera outbreaks follow a fairly cyclical pattern that coincides with the rainy season. In recent decades, there have been two large outbreaks in Zimbabwe: one from 2008 to 2009, which resulted in over 100,000 cases and over 4,000 deaths, and another from 2018 to 2019, which resulted in 10,000 cases and 69 deaths across the country's cholera hot spots. This year, the country experienced yet another outbreak.
In response, Zimbabwe declared a state of emergency. There have been more than 7,000 instances of cumulative suspected cases thus far, with over 143 suspected cholera deaths.
Climate change and cholera
According to a 2019 study on the effect of climate change on cholera, published in the National Library of Medicine, ''There is the evidence of relationship between climatic parameters and the burden of water-borne diseases such as cholera, particularly in undeveloped/developing countries.'' The study says that increases or decreases in average rainfall can lead to floods and droughts, which can affect the concentration of bacteria, affecting human health.
A 2017 study on climate change in Zimbabwe in the Journal of Law, Policy and Globalization found that the main contributor to cholera outbreaks was inadequate sanitation during floods or droughts.
According to an article in Multidisciplinary Digital Publishing Institute, a publisher of scientific journals, climate change has an indirect impact on water resources, food production systems, population displacement, and the prevalence and incidence of infectious diseases.
Globally, cholera is a major public health problem, causing illness to an estimated 4 million people and over 140,000 deaths annually. In Africa, cholera annually infects 150,000 people, leading to 3,000 deaths in the 17 countries where it is prevalent.
Concilia Mwale, 43, says her 12-year-old son had a near-death experience with cholera.
Mwale was away visiting her sick mother when she got a call from her neighbors that her son wasn't feeling well.
''When I got back, my son had been transferred to a local hospital, and he was in a critical condition, and because of his condition and cholera infection, I wasn't allowed to see him,'' she says.
The mother of four says she relied on water from her neighbor's borehole and tests later revealed it was contaminated with sewage.
She says sewage usually flows into the neighborhood due to burst pipes. When it floods, the contaminated water seeps into wells and boreholes.
Mwale, who has lived in Glenview for over 12 years, says she relies on water from manmade wells for household use, while neighbors' boreholes provide drinking water.
Nomsa Rambire, 34, who has had typhoid, a waterborne disease similar to cholera, three times, links her woes to contaminated water. ''First, it was in 2014, then the second time in 2019, and this year was the third time, and at all times, it was the water that I was drinking that caused the infection.''
At the time she had typhoid, all her family members were infected with cholera.
''We don't drink tap water and the tap water is erratic in terms of supply. Now, since the cholera outbreak, the water is available, but it looks contaminated with green elements in it. It doesn't look safe to drink,'' she says.
Mwale and Rambire are among the tens of thousands of people who can't rely on access to water from the City Council and find themselves depending on unsafe water sources that worsen with flooding.
Demand for water is outpacing supply
Innocent Ruwende, the former spokesperson for the Harare City Council, says the council is not producing the required amount of water at its treatment works.
He says, water demand is around 1.2 billion liters per day, ''while the capacity was at 780 million liters per day. Actual water provision stands at 420 million liters per day owing to leakages and theft of treated water. Harare's population has grown, and there is need for new water sources.''
Zimbabwe's population increased by 16.2% between the 2012 census and the most recent, in 2022. It now stands at 15.1 million people, up from 13 million.
Ruwende says temperatures are rising as the climate changes, and heavy rains and droughts are becoming more intense.
According to the Ministry of Environment, Water and Climate, Zimbabwe's mean surface temperature has risen by about 0.4 degrees Celsius from 1900 to 2000. The planet's average surface temperature has risen by about 2 degrees Fahrenheit (1.1 degrees Celsius), mostly in the past 35 years, states a United Nations report.
''In Harare, rains are expected in October at earliest, but that has not always been the case. We have been forced at times to decommission Prince Edward water treatment plant and Harava Dam after they dried up,'' Ruwende says.
Climate change is causing water shortages
Lisben Chipfunde, head of amenities and environment in the Harare City Council, confirms that the water shortage, particularly during the 2019-2020 rainy season, impacted residents.
Chipfunde says Prince Edward Dam, the source for Prince Edward Water Works, ran out of water due to drought, and the Harare City Council had to supply water to the whole of greater Harare from one center, the Morton Jaffray Water Works.
''A number of residential areas had to endure prolonged periods without water,'' Chipfunde says, ''thereby forcing residents to turn to unprotected and contaminated water sources such as wells and boreholes.''
Chipfunde says the temperature increase has also resulted in heat stress and increased water demand, ''which exacerbated an already dire water situation.''
Leonard Unganai is a policy and program manager with Oxfam, a global movement against poverty, and has worked on various climate change programs. ''One of the areas that is affected worst by climate change is availability of water. If water resources are affected by climate change, then that will in turn affect water supply,'' he says.
According to the World Health Organization, catastrophic events such as floods and cyclones impact infrastructure, weaken health care systems, and result in disease outbreaks and significant mortalities.
Unganai says it is also important to interrogate whether there is adequate infrastructure for clean water and sanitation services aside from climate change impacts.
Worsening crisis and policies
Rueben Akili, the director of the Combined Harare Residents Association, a nonprofit that advocates for effective municipal service and good local administration, says people turn to unsafe water sources when climate change impacts their water supply.
Akili says that when there is an increase in temperatures, water in reservoirs depletes faster, which affects supply. ''When we don't have water supply, communities start to look for water in unprotected sources. At the end of the day, diseases start to erupt,'' he says.
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According to research published in 2017 by the International Institute of Science, Technology and Education, Zimbabwe's climate change policies have not taken into account the projected effects and breadth of climate change. Such effects include more cholera cases and the prevalence of diseases like cholera and malaria in a wider area.
Similarly, an article by Climate Centre, an organization that works to reduce the impact of climate change, states that not much is being done across the world to eradicate cholera, despite the increase in cases. In 2022, 30 nations reported cholera outbreaks, including in regions where the illness had been eradicated for decades.
Addressing climate change in Zimbabwe
Akili says local authorities need to be more proactive in addressing climate change and its effects.
''Local authorities need to come up with climate resilient measures to inform the way we respond to issues like climate change. We also need to protect the wetlands, which are the sources of water, and look around issues around regreening through planting trees,'' he says.
Chipfunde says they are already implementing climate adaptation and mitigation programs.
''On climate change adaptation, the city is promoting the use of new and renewable sources of energy such as solar projects on city's clinics and offices; starting solar farms for energy generation; development and implementation of urban resilience; and greening the city through afforestation and reforestation by tree planting.''
But for residents like Mapuranga, the concern persists. She worries that she hasn't seen her last infection. ''Our water supply is erratic, and l believe that's where our cholera problem lies,'' she says.
Rambire looks back at the time her whole household was sick and worries about the future. ''I had so much fear, and I thought I was going to die. The City Council should ensure that there is regular supply of clean water to minimize these outbreaks.''
Linda Mujuru is a Global Press Journal reporter based in Harare, Zimbabwe.
