UN Integrated Regional Information Networks - December 10, 2008

He is also living with HIV and recently started taking antiretroviral drugs (ARVs). One morning he woke up with excruciating stomach cramps; a few hours later he was vomiting and having diarrhoea.

Mwedzi's wife, Doreni, quickly organised a wheelbarrow and ferried him to the Budiriro Polyclinic, one of the Cholera Treatment Centres set up by the government and being run with the assistance of the World Health Organisation (WHO).

At the clinic, Mwedzi and his wife were shocked when a nurse insisted he did not have cholera. "When she checked my medical history chart, she noticed that I had just recently started taking ARVs. She told me that the diarrhoea and vomiting I was experiencing could be side effects of the drugs, and encouraged me to go and see a doctor," Mwedzi told IRIN/PlusNews.

Three days later, after another bout of diarrhoea, Mwedzi was back at the clinic; this time he was admitted and spent a week there fighting for his life.

"My husband lost so much weight that the doctor has advised us he should stop the ARVs until they are certain his kidneys and liver and other vital organs are functioning well," said Doreni. "So we are back to square one; we will have to find money for liver and kidney function tests yet again."

More vulnerable

As the cholera epidemic in Zimbabwe continues to claim lives, people living with HIV are particularly vulnerable.

Deputy President of the Zimbabwe HIV/AIDS Activist Union (ZHAU), Stanley Takaona, told IRIN/PlusNews that a number of their members had contracted cholera, and although HIV negative as well as positive people were susceptible to the disease, those with immune systems already weakened by HIV were particularly at risk and had more difficulty recovering.

"This disease leaves people completely wasted; it is very hard for many of our members to recover," he said. "Other people living with HIV have not been so lucky, but documenting deaths in this section of the population is a major challenge for us."

Dr Douglas Gwatidzo, chairman of the Zimbabwe Association of Doctors for Human Rights, commented that the cholera outbreak had also had the affect of diverting attention away from Zimbabwe's HIV/AIDS crisis which claims the lives of more than 400 adults every day, according to UNICEF.

Cholera is a highly contagious waterborne disease that usually occurs during Zimbabwe's rainy season and is mostly limited to rural areas with poor sanitation and no clean water supply. The disease was rare in towns and cities, where most homes had treated tap water and adequate toilet facilities.

The current cholera outbreak began in August, before the onset of the rainy season, and Harare and other cities and towns have been hard hit. The outbreak in urban areas has been blamed on the constant water cuts, poor garbage collection and unrepaired burst sewage pipes resulting from Zimbabwe's economic meltdown and the inability of the government to deliver basic social services.

On Wednesday, the UN estimated that the outbreak has already caused 746 deaths, but independent health organisations have claimed that the real figure is even higher.

Similar symptoms

Due to a lack of information about the exact symptoms of cholera, people with HIV have been coming to cholera treatment centres with diarrhoea, a common HIV-related opportunistic infection. Tsitsi Singizi, a communications officer at UNICEF, the UN children's fund, said many of these people were being exposed to cholera as a result.

"UNICEF and its partners are doing the best they can to ensure that our treatment centres stay as clean as possible, so that the next person seeking treatment does not pick up infection," he added.

According to the international medical humanitarian organisation, Medecins Sans Frontieres, at least 1.4 million people are at risk of contracting the disease if the outbreak is not contained by addressing its root causes.

But, three months into the cholera epidemic, sanitary conditions in most town and cities remain dire.

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