“I am feeling a little uncomfortable,” says Henry quietly, a middle-aged gentleman politely looking up at Clara from where he is lying on the dirty floor. Henry is so dehydrated his cheeks are completely sucked in and his eyes stand out in his closely cropped skull. Clara Chamizo, a first-mission nurse for MSF’s project in Beitbridge, is seeing the extreme absurdity of this statement. She is standing in the middle of tens of cholera patients, lying on the dirt in the backyard of Beitbridge’s main hospital. Cholera overwhelmed this Zimbabwean border town of about 40,000 like contaminated wildfire.
Cholera patients are treated outside as demand exceeds space in Beitbridge , Zimbabwe. November 2008.
Photo by MSF
“Normally cholera starts with a few cases and then we have the peak after a few weeks,” explains Luis María Tello, the MSF Emergency Coordinator who arrived a few days after the first cases were reported and is surprised to see such numbers. Although investigation is still needed, he thinks this may mean that “a lot of people got the cholera from the same source at the same time.”
On Friday, November 14, when the Zimbabwean Health Authorities in Beitbridge first reported cholera to MSF, there were 5 cases. Two days later there were already more than 500; by the end of the week over 1,500.
Patients were first placed inside Beitbridge’s main hospital, most lying on the cement floors in very poor hygiene conditions. With only two cleaning staff, a shortage of chemicals and water and no working toilets, decontamination was impossible. On Sunday 
morning, the situation had deteriorated to the point where patients were left on the dirt behind the buildings, so that excretions could be absorbed in the ground.
The sight was appalling. Patients lying in the dry dust under scorching 45 degree heat. All asking for the life-saving drip (Ringer Lactate IV fluid) in their vein. There wasn’t even any water to give, the supply cut most days.
Clara and Veronica Nicola, the MSF doctor who is also Beitbridge’s Project Coordinator, were the only MSF expatriates in the town when the emergency hit. Veronica, an Argentinean pediatrician who has been on several MSF missions, says she has never had to insert so many catheters in one day in her life.
“For me the hardest thing was to be able to concentrate on one person,” explained Veronica later. “There was a man lying next to one of the trolleys under the sun. By the time I got to him he was in shock, we tried to get a vein like ten times, but then he started gasping and he died right there in front of our eyes.” She pauses for a minute and then adds, “If I had seen him half an hour before we might have been able to do something about it, but there were so many people lying there, people calling you. But still,” she adds thoughtfully, “we could have done something.” In her calm manner she summarizes, “It was very bad.” In one week 54 people died.