Cholera cases were reported on Friday in the Mozambican city of Beira, adding a risk of deadly illnesses for hundreds of thousands of people who are scrambling for shelter, food and water after catastrophic flooding in southern Africa.
“There is growing concern among aid groups on the ground of potential disease outbreaks,” the International Federation of the Red Cross and Red Crescent Societies (IFRC) said.
“Already, some cholera cases have been reported in Beira along with an increasing number of malaria infections among people trapped by the flooding,” it said in a statement.
Cyclone Idai battered Beira, a port city of 500,000 people, with strong winds and torrential rains last week, before moving inland to neighbouring Zimbabwe, where it flattened homes and flooded communities, and Malawi.
The storm killed 242 people in Mozambique and 259 in Zimbabwe, and numbers were expected to rise, relief agencies said. In Malawi, 56 people died in heavy rains before the onset of Idai.
Cholera is spread by faeces in sewage-contaminated water or food, and outbreaks can develop quickly in a humanitarian crisis where sanitation systems are disrupted. It can kill within hours if left untreated.
As survivors gathered in informal camps and health officials warned of the danger of cholera and other diseases, Unicef executive director Henrietta Fore said the situation on the ground was critical, with no electricity or running water.
“Hundreds of thousands of children need immediate help,” she said, estimating that 1.7 million people were affected by the storm.
About 45km west of Beira, in the village of Guara Guara, the government set up a makeshift camp for people rescued nearby, with little water and no toilets.
As for many such camps, progress was slow as aid had to be delivered by helicopter.
"The help is coming, but it's coming very slowly," said Esther Zinge (60), from near the town of Buzi, adding that what did arrive had to be given to children first.
“The conditions are terrible, and more people keep coming.”
On a beach in Beira, where the Red Cross estimated 90 per cent of the city was damaged or destroyed, survivors clutching infants and bags disembarked from rescue boats beside a ship marooned on the sand and began receiving Red Cross help.
United Nations secretary-general António Guterres said he was saddened by the "heart-wrenching images of human suffering" and urged the world to step up support for the relief effort.
In Zimbabwe’s Coppa Rusitu Valley, a township in Chimanimani near the Mozambican border, hundreds of homes were flattened by large rocks and mudslides from a nearby mountain, burying some residents, who never stood a chance, as the cyclone unleashed its fury at night when most were sleeping.
Relatives and rescuers were digging through the debris, hoping to find bodies, but some of the rocks were so big they need blasting, a Reuters witness said. Most people lost relatives, workmates or friends in the township, which also housed government workers, including police.
Some survivors have taken refuge at churches and centres offering temporary shelter
Zimbabwe's president, Emmerson Mnangagwa, said on Thursday night he had come face to face with horrific accounts of people grieving the loss of family and friends in Chimanimani.
Some survivors have taken refuge at churches and centres offering temporary shelter as they deal with the trauma of their losses, while private citizens, international aid agencies and the government rushed humanitarian aid to affected areas.
Zimbabwe’s minister for energy Joram Gumbo said the pipeline bringing fuel from Beira had not been affected by the cyclone, but the docking terminals at Beira port had been damaged.
He said Zimbabwe had 62 days' supply of petrol and enough diesel for 32 days, which is in short supply and has led to long queues in the capital. In the city of Mutare, near Mozambique, diesel shortages were worse, according to a witness.
In Beira, Saviano Abreu of the UN humanitarian arm OCHA said the main problem with getting aid to relief camps outside of Beira was that they could be reached only by helicopter, since floods had cut off roads, and helicopters were scarce.