The room suddenly fell silent. The local health official momentarily stopped his briefing of aid workers visiting the cholera treatment centre in Chitungwiza, a township 20 miles from Harare.

Right outside the open window four labourers in latex gloves were loading a rigid corpse, trussed up in black plastic sheeting, on to a pick-up truck that had come to take it away for burial.

It was a sight that reinforced the message of the official dramatically. Here in Chitungwiza, as in many other communities across Zimbabwe, the cholera epidemic is overwhelming the skeletal remains of social services.

The corpses of two other victims lay wrapped in blankets in the makeshift mortuary of the centre, which is in the former maternity unit of the clinic. Their deaths raised the total in this wretched, densely populated township to more than 80.

A dozen more people with severe cases lay listlessly on camp beds in the wards, buckets placed beside their heads and below the cutaway holes beneath their buttocks.

More than 170 other suspected cases arrived at the centre that day alone, although how many were suffering from diarrhoea, Aids, malaria or one of the many other diseases ravaging this broken land it was impossible to say.

Some were sent home with rehydration kits, others lay on benches with drips feeding into their veins. Sometimes one vomited.

“It's getting worse and worse,” said one demoralised nurse, and it was not hard to see why.

Barely 500 yards from the treatment centre, sewage gushed up from a broken pipe and streamed down the dirt road opposite. Children played barefoot all around the filthy, stinking quagmire. Five hundred yards in the other direction people were buying what little food they could still afford from a market surrounded by piles of rotting rubbish.

The health official said that he had almost no printed advice to distribute on combating cholera and there were only two people charged with hygiene promotion for a township of about 500,000 people.

Some clean water was being shipped in, but not nearly enough. Even the source of the cholera in Chitungwiza had yet to be determined. Half the residents in the town had no running water for a year and relied on shallow wells, which they dug themselves.

The rest received intermittent tap water but it came though cracked pipes running next to broken sewerage pipes. He had sent samples to the public health laboratory in Harare but without success: the laboratory was closed for lack of running water.

“The staff are making heroic efforts but it's clear they're overwhelmed,” one of the aid workers said.

The latest UN statistics show that 589 Zimbabweans died of cholera in the past few weeks and that 13,960 have been infected, but nobody believes these figures.

Many more will have died unrecorded in their homes or in villages far from clinics. “The figures are vastly unreported,” Phil Evans, the head of the British Department for International Development in Harare, said. “There are probably twice as many people with cholera as turn up for treatment.”

Western aid agencies have arrived in force after the Mugabe regime reluctantly appealed for international help last week. They are flying in medics, medicines and equipment.

Unicef is delivering 360,000 litres of clean water to Harare each day, distributing 80,000 buckets and jerry cans and 200,000 bars of soap, and has imported enough water purification tablets to last 3.5 million people four months.

The non-governmental organisations admit, however, that the epidemic is far from contained.

“It's like stepping on a balloon. Squeeze one part and it pops up somewhere else,” said Rachel Pounds, of Save the Children, in Harare. “This is the biggest outbreak of cholera in Zimbabwe's modern history,” said Roeland Monasch, the head of the Unicef mission, which is preparing for up to 60,000 cases.

The rainy season is also just beginning. Each deluge will send untreated sewage from countless broken pipes coursing through the streets and into the shallow, hand-dug wells on which millions of Zimbabweans now depend for water.

“It's the utter avoidability of this which is so shocking,” said Mr Evans, who scarcely bothers to conceal his anger. We knew it was coming because the Government would not change direction in ways that would have prevented it ... It's symptomatic of the national tragedy - the deep-rooted collapse of basic services.”

Cholera epidemics are normally not hard to control but in Zimbabwe circumstances are far from normal. The healthcare system has all but ceased to function — more than half of its nurses and doctors have left the country, a few of those who remain will work for the equivalent of barely 10p a month and most hospitals have closed.

Municipal water and sewerage systems have collapsed since Mr Mugabe's Zanu (PF) party — seeking additional revenues and powers of patronage — set up the Zimbabwe National Water Authority to seize control of them from opposition-run councils three years ago.

Forty per cent of Harare's water is now lost through leaks and last week the city ran out of purification chemicals.

In a country where millions are already weakened by Aids or malnutrition the fatality rate from cholera — although dropping — is far above the 1 per cent achievable in perfect conditions. In Chitungwiza it is 24.8 per cent, according to UN figures.

Running a mass public information campaign is hard because most Zimbabweans can no longer afford to buy newspapers or batteries for their radios, let alone televisions.

They cannot afford soap or the sugar and salt that cholera victims require for rehydration, or transport to reach treatment centres. Harare City Council is offering free burials in part to prevent destitute families surreptiously burying cholera victims in shallow graves.

Beyond advising Zimbabweans not to shake hands (they now touch wrists instead) the Government has almost entirely abrogated responsibility for fighting the epidemic.

The Department for International Development is augmenting the salaries of medics with US dollars to prevent the health system from collapsing and Save the Children pays them in food.

Unicef is organising rubbish collections and is importing chemicals to purify the water. Unicef and Oxfam are training more than 2,000 hygiene promoters.

“All that can be said for the Government is that it's no longer obstructing us,” one Western official said.

Unicef has commandeered the redundant milk tankers of the dairy board to transport water and co-opted the biggest Zimbabwean brewer to transport medical supplies. Save the Children has rented a petrol station to guarantee fuel supplies and barters old vehicles for building work.

“You have to work in ways we've never done before,” Ms Pounds said.

For once the regime of Mr Mugabe is paying a price for its almost criminal neglect of its people. The cholera epidemic is showing the world that Zimbabwe is a failed state. It is also spreading to South Africa, Botswana, Zambia and Mozambique, alerting them to the rising cost of leaving Mr Mugabe in power.

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