"Mr. G… may have begun vomiting during the night and most likely experienced muscle spasms and sharp abdominal pains. At a certain point, he would have been overtaken by a crushing thirst. But the experience was largely dominated by one hideous process: vast quantities of water being evacuated from his bowels, strangely absent of smell and colour, harbouring only tiny white particles. Clinicians of the day dubbed this 'rice water stool'. Once you began emitting rice-water stools, odds were you'd be dead in a matter of hours.
"Mr. G would have been terribly aware of his fate, even as he battled the physical agony of the disease. One of cholera's distinctive curses is that its sufferers remain mentally alert until the very last stages of the disease, fully conscious both of the pain that the disease has brought them and the sudden, shocking contraction of their life expectancy. The Times had described this horrifying condition several years before in a long feature on the disease: 'While the mechanism of life is suddenly arrested, the body emptied by a few rapid gushes of its serum, and reduced to a damp, dead… mass, the mind within remains untouched and clear, – shining strangely through the glazed eyes, with light unquenched and vivid, – a spirit, looking out in terror from a corpse.'
"By Friday, Mr. G's pulse would have been barely detectable, and a rough mask of blue, leathery skin would have covered his face. His condition would have matched this description of William Sproat from 1831: 'countenance quite shrunk, eyes sunk, lips dark blue, as well as the skin of the lower extremities; the nails… livid.'"
From The Ghost Map, by Steven Johnson
This is a description of the first victim to die in the Soho cholera outbreak of 1854, the outbreak that led to Dr John Snow identifying the cause of the disease – contaminated water. 1854. Since then we've known how to avoid cholera and how to treat it – simple rehydration. Nobody should die of cholera in the 21st century. Nobody should even catch cholera in the 21st century, it's a straightforward case of keeping sewage away from drinking water. Sanitation. The fact that cholera even exists in the world should be a major source of shame for all of us.
News of the massive cholera outbreak in Zimbabwe should provoke outcry. Chronic mismanagement by Robert Mugabe has left 'his' people without clean running water and a sewage system that is leaking. It doesn't take much of the cholera bacteria to leak into groundwater near a bore hole – or just to have sewage standing in cesspools or the street – and cholera will break out. This is why it's a constant threat in refugee camps and other places where huge numbers of people have to spend signficant amounts of time in places without proper sanitation.
But this is happening in cities. Hospitals are closing and don't even have the basic rehydration salts to save lives. The seasonal rains are starting, which will wash contaminated water into even more sources of drinking water and make the pandemic worse. The Zimbabwean government is trying to hide the scale of the disaster, claiming only hundreds have died, rather than the thousands that are not only being reported but are likely, because of cholera's virulence, to have died.
And I had to search for reporting on this disaster because the main news sites are overdosing on the orgy of violence in Mumbai. A terrible situation, but one that has killed (as of now) approximately 125 people. Channel 4 News just suggested 300,000 are affected by cholera in Zimbabwe. Read the first three paragraphs again: this is an appalling way to die. It's just not necessary. And it's happening because the rest of the world (not just the West; African leaders too) stood by and let Zimbabwe collapse.
We should be rioting in the streets. This is a disgrace.