R 050731Z DEC 08 
FM AMEMBASSY PRETORIA 
TO SECSTATE WASHDC 6640 
INFO AMCONSUL CAPE TOWN 
AMCONSUL JOHANNESBURG 
AMCONSUL DURBAN 
DEPT OF HHS WASHDC 
CDC ATLANTA GA 2417 
SOUTHERN AF DEVELOPMENT COMMUNITY COLLECTIVE

UNCLAS PRETORIA 002643 
BT 
USAID FOR BUREAU OF GLOBAL HEALTH AND AFR/SA 
HHS/PHS FOR OFFICE OF GLOBAL HEALTH AFFAIRS WSTEIGER 
CDC FOR GLOBAL HEALTH OFFICE SBLOUNT 
NIH FOR JHERRINGTON 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO AMGT AMED KSTH KSCA SENV SF ZI
SUBJECT: CHOLERA OUTBREAK IN SOUTH AFRICA 
 
¶1. Summary: An outbreak of cholera has been reported in South 
Africa. This is a result of cholera cases crossing the Zimbabwean 
border into the South African town of Musina in the Limpopo province 
and slowly spreading throughout the country. South African 
Government spokesperson Themba Maseko said the Government will 
assist Limpopo health authorities in dealing with the outbreak as 
the number of cases identified is increasing and they can no longer 
cope. End Summary. 
 
¶2. Harare 1054, sent November 26, provides a detailed description 
of the cholera outbreak in Zimbabwe as well as the Government of 
Zimbabwe's (GOZ) response and the response of donors. 
 
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Cholera Outbreak in South Africa 
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¶4. The South African town of Musina in the Limpopo Province is near 
the main border crossing between the two countries. Many 
Zimbabweans have crossed the border into Musina and deaths due to 
the cholera outbreak have been reported. The December 3rd National 
Outbreak Committee Situational Report on the cholera outbreak in 
South Africa has reported 486 cumulative cholera cases. The 
majority of these cases were Zimbabweans coming into South Africa to 
seek medical attention and a few were South Africans who travel on a 
regular basis between South Africa and Zimbabwe. Ten deaths were 
recorded and more cases of cholera are still being identified. 
 
¶5. The cholera outbreak is spreading quickly in South Africa. 
Limpopo province has reported 455 cholera cases, Gauteng reported 26 
cases, KwaZulu-Natal reported two cases, Mpumalanga, Eastern Cape 
and the North West province have each reported one case. Limpopo 
Department of Health spokesperson, Phuti Selobi, is reassuring the 
South African public not to panic because the two countries do not 
share a common water source. 
 
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South African Government Response 
------------------------------------ 
 
¶6. South African Government spokesperson Themba Maseko said the 
Government will assist Limpopo health authorities to deal with the 
outbreak as the number of cases identified is increasing and they 
can no longer cope. The South African Government has responded to 
the situation with extra medical personnel and facilities being 
setup along the border to help curb the crisis. Three re-hydration 
centers have been set up so that people do not have to travel long 
distances to get treatment. The Department of Health has negotiated 
to have one of the centers set up in the "no man's land" between the 
two countries. Aid groups such as World Vision and Doctors Without 
Borders fear that the outbreak will worsen in Zimbabwe as the rainy 
season progresses. 
 
¶7. The National and Provincial Departments of Health mobilized staff 
and supplies to deal with the outbreak. Additional health 
professionals such as doctors, nurses, epidemiologists, and public 
health specialists were deployed to provide assistance in Musina. 
Minister Hogan added: "The National Multi-sector Committee shared 
information on the current status in South Africa and in Zimbabwe. 
There was consensus that much is being done in both countries by 
various stakeholders to address the outbreak and its consequences." 
¶8. Other measures that the South African Government have taken to 
Q8. Other measures that the South African Government have taken to 
help curb the cholera crisis include talking to the Southern African 
Development Community (SADC) and the World Health Organization (WHO) 
about measures to deal with the outbreak. South Africa has also set 
up a task team to deal with the outbreak in Limpopo. The team is 
led by the Department of Health and will include the Departments of 
Foreign Affairs, Water Affairs and Forestry, as well as Provincial 
and Local Government. Other Departments will join the team on an as 
needed basis. 
 
¶9. Minister of Health Barbara Hogan briefed the media on Wednesday, 
November 26, 2008 and said: "While South Africa was under pressure 
to respond to its own health problems, the country was obliged to 
assist its neighbor. I do not think the scale of the problem is 
large enough to stretch our resources. We will provide any 
assistance required by the World Health Organization. There is a 
humanitarian crisis in Zimbabwe. Under no circumstance will we want 
to stop people who are sick and in need of treatment from entering 
the country." 
 
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Comment 
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¶10. The South African public health system is already overburdened 
in providing health services to its population and a cholera 
outbreak to South Africa will worsen the situation. There are 5.7 
million South Africans living with HIV. TB is the most common 
opportunistic disease affecting people with HIV in South Africa. An 
estimated 353,000 people were diagnosed with TB in 2007, of which 70 
percent were also infected with HIV. Infant mortality also is high 
at 53 deaths per 1,000. The new Minister of Health Barbara Hogan is 
quickly engaging South Africa's many health challenges, but the 
cholera threat is adding onto an already Herculean list of problems. 
 
Bost