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27.12.08

Politics in the time of cholera

They drink too much coffee up in the North of Norway. So now I can't sleep and I'm reading through old tabs.

I've had this moving and unsettling article in the NY Times open in my browser for two weeks now, since the morning after we returned from Africa. It deals with the cholera epidemic in Zimbabwe which Mugabe seems to be largely dealing with by hoping it goes away.

Does anyone even remember cholera anymore? Cholera is a gastrointestinal bacterial disease, fatal in roughly 50 % of untreated cases. It is one of the most unpleasant ways of dying known to man: basically death by diarrhea-induced dehydration, with victims evacuating - that's the clinical term - as much as 30 % of body mass in a matter of hours. It is simultaneously an easily cureable disease. It is one of those many "easily preventable causes" which kills 30.000 children every day, according to UNICEF.

Treatment for cholera is oral rehydration: drinking lots of water with salt and sugar in it. Also, washing your hands a lot. I told you it was easy. Not so easy when your government isn't doing it's job though. Not so easy when you don't have clean running water.

The failure to stop the death of many hundreds, possibly thousands, of people, is an indication of the profound, criminal incompetence of the Mugabe government. How criminal? Well, Oxfam & Unicef indicates that there will be roughly 60.000 cases by the end of January alone, and that 10 % of these will be fatal. The disease is still spreading.

A cholera outbreak is a good indicator of a failed state in two ways: 1) how it spreads and 2) how it is treated.

1) The disease spreads orally, via faecal matter. Basically the faeces of sick people needs to get into the drinking water. This represents a collapse of infrastructure: the government is not securing the water supply, containing and disposing of sewage and preparing properly for the rainy season (the direct cause of the outbreak, "leading to contaminated faeces being washed into water sources, as well as providing readily available but contaminated water", according to the excellent Wikipedia page on the subject. Incredibly, the administration is blaming the outbreak on the colonial days, despite having responsibility for the water & sewage system for almost 30 years. A spokesman is also claiming that the British are deliberately causing it as an act of genocide, instilling great confidence in the competence of the Mugabe regime.

2) Since treatment of cholera is simple, it should be possible to contain and deal with an outbreak provided one has a functioning health care system. It has not been remotely contained. It has not been dealt with (in fact, it seems to be spreading, with cases now being reported in Mozambique, Botswana, Zambia and South Africa). Unpleasant to think I was one day's travel by car away from a cholera epidemic.

Because of the economic crisis in the country, many of the country's hospitals have been forced to close in the middle of an epidemic. They can't buy supplies or pay staff b/c of lack of public funds and hyperinflation. Bad timing.

The crisis has intensified calls for the removal of pathological asshole Robert Mugabe from power in Zimbabwe. As well it should. Not dealing with this means you're not dealing with the most basic business of governing: securing health, security and care for the community.

So that was two weeks ago. The latest development is that two days before christmas, the US announced it had now changed its official stance from a nose-holding, but Mugabe-tolerant policy to an actively anti-Mugabe one. An American envoy calls Mugabe "a man who's lost it". Basically, they are saying they will no longer support any kind of power sharing deal (the deal which is still being negotiated now) that does not involve kicking Mugabe out on his octogenarian ass.

The problem is that the current interrim government in South Africa (since Thabo Mbeki stepped down a few months back) remains Zimbabwe's linchpin ally in the region. It is still trying to get the old power-sharing deal through. The one good thing about the almost certain fact of a Jacob Zuma presidency is that he might put renewed pressure on Mugabe to leave office. One of the very few policy differences between Zuma and Mbeki (notorious rivals) is on the Zimbabwe question, where Zuma has voiced slightly stronger objections to Mugabe. Though not a lot, mind you, and also, this is a man who believes that you can avoid AIDS by having a "vigorous shower" after unprotected sex. Good thing he won't be sitting at the top of one of the most HIV-infected countries in the world. But I digress.

In short, I guess what I'm trying to say is that I wish someone would magically create a completely new government in Zimbabwe as well as a functioning health system. That seems to be the best solution right now. Anyone out there have any strong connections in the underworld?

Updated to add: Just learned that the Nordic foreign ministers have released a statement calling for mr Mugabe's head on a pike (I paraphrase).

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