Doctors struggling to save the victims of a cholera epidemic in Zimbabwe despite a lack of basic drugs and intravenous drips vented their fury last week outside the Parirenyatwa hospital in Harare, the capital.

They were joined by nurses in a demonstration to highlight the collapse of a once well-funded health service that is no longer up to the task of treating cholera effectively.

The response of President Robert Mugabe’s failing government has been to cover up the scale of the problem and to send in riot police.

Last Friday the World Health Organisation confirmed that 294 had died so far. Deteriorating sewerage systems and declining supplies of clean water have been blamed. The aid agency Médecins Sans Frontières said 1.4m were at risk. Thousands may die.

The government, which claims that 44 have perished, says it has contained the spread of the disease and sufferers are receiving proper treatment.

The hollowness of this claim could be seen outside the Harare hospital named after Tichafa Samuel Parirenyatwa, the first black Rhodesian to qualify as a doctor. His son David is the health minister, presiding over the degeneration of medical services. At first the demonstrators, whose salaries have been so eroded by inflation (estimated at 231m%) that they cannot afford their fares to work, tried to reason with the riot police.

“Who will treat your families if you beat us up? Are you paid enough to attack us?” they asked. Then the police began to beat them with truncheons.

Despite the intimidation, Primrose Matambanadzo, of the Association of Doctors for Human Rights, said medical staff would continue to protest. “Doctors are angry that the health system has collapsed and that they cannot help patients who should be easily treatable,” she said.

Gaining access to the Beatrice Road infectious diseases hospital in Harare, where some of the cholera patients are being treated, is a tense business. Security guards and administrators have been told to keep all visitors out – in an attempt to stop the epidemic being publicised. Nevertheless, it was possible to get in through a back entrance.

The hospital has three wards normally devoted to diseases such as tuberculosis. All these beds are filled with cholera victims. Patients lie on plastic cholera beds, some groaning and covering their faces, some horribly silent.

Thomas, a patient from Kuwadzana, a Harare suburb, fell ill on Monday. With constant diarrhoea, weak limbs and a sore head, he was lucky he could afford to see a doctor. But he explained that he feared the worst for his family because they did not have access to clean water.

Outside Beatrice Road, relatives stood waiting for news. It is often grim. The high death rate here is expected to worsen.

Last week the United Nations Office for the Coordination of Humanitarian Affairs identified eight outbreaks and nine places where the number of cases was increasing. Its report concluded: “It is very likely with the current water and sanitation problems in the country, low capacity of the government to deal with the outbreak, glaring gaps in response, coupled with the rainy season that has started, cholera outbreaks could get catastrophic and claim many more lives.”

A strong medical response, including treatment with inexpensive oral rehydration drips, should be able to keep nearly all the patients alive, say the doctors. But Zimbabwe’s enfeebled hospitals can offer nothing like the levels of care required.

The treatment plants have run out of the chemicals needed to purify water, according to the Harare Residents Association. “Sewage lies on the ground just a metre from Harare’s water treatment centre and there are no drips left to treat infected people in the hospitals,” said Barnabas Mangodza, its executive officer.

“We know that many hundreds of people are dying, but the government is only concerned with concealing the extent of the problem. They say they are not permitted to declare a national disaster.”

Aid agencies could quickly bring in medical supplies and set up field hospitals if the government appeals for help. But Mugabe is desperate to show no signs of weakness during talks on a power-sharing agreement with Morgan Tsvangirai, the leader of the opposition Movement for Democratic Change.

A rare sign of dissent in the state-controlled press came in a letter printed last week from Archibald Tapfuma, a Harare resident. “So many deaths are occurring because of cholera,” he wrote. “We need answers please.”

Annan snub

In an astonishing snub, President Robert Mugabe banned three prominent international figures from making a humanitarian visit to Zimbabwe yesterday.

Despite intervention by former South African president Thabo Mbeki, he denied visas to Kofi Annan, the former UN secretary-general, ex-US President Jimmy Carter and Graca Machel, the wife of Nelson Mandela.

Annan said no official reason had been given, but the state-controlled Herald newspaper reported that the group had been seen as antagonistic towards Mugabe’s government.

“We are disappointed,” Carter said.

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