And as the political and economic crisis in Zimbabwe deepens, most hospitals have been forced to close their doors as they can no longer afford drugs, equipment or to pay their staff. "This cholera epidemic is manmade," Dr. Douglas Gwatidza, head of the Zimbabwean Association of Doctors for Human Rights, said in a telephone call with reporters. He said government programs to monitor disease outbreaks were in "disarray." Those few health facilities still open were trying to stop the spread of cholera but often at the expense of patients with other diseases. Gwatidza also said dysentery was becoming increasingly prevalent in a country already suffering from one of the world's worst AIDS epidemics. On Tuesday, riot police prevented health workers in the capital, Harare, from protesting against Zimbabwe's collapsing health care system.

Dr. Primrose Matambanadzo said the government needed to issue an urgent appeal for assistance. "There is a state of crisis," she said. "We need things functioning at hospitals now." Aid groups fear the outbreaks will worsen as the rainy season progresses and Medecins Sans Frontieres, or Doctors Without Borders, has warned that 1.4 million people are at risk. There is a state of crisis. We need things functioning at hospitals now. The international aid group World Vision said Wednesday that 44 people had died in the Zimbabwean border town of Beitbridge, including one of their staff members.

Beitbridge is one of the regions busiest border crossings and there are concerns that it is already spreading to other countries. South African authorities have responded to the crisis with extra medical personnel and facilities being set up along the border. Local health officials in Musina on the South African side of the border said two Zimbabweans died of cholera after crossing into the country while 64 patients were treated last weekend, the Star newspaper reported Wednesday. Meanwhile, the South African Press Association reported that a South African truck driver who travelled from Zimbabwe has been admitted to a Durban hospital, showing symptoms of cholera. Zimbabwe once had among the best health care systems in sub-Saharan Africa. But the country's economic meltdown has led to chronic shortages of food and gasoline, and daily outages of power and water. Mugabe, in power since independence from Britain in 1980, blames Western sanctions for his country's extreme financial woes. But critics point to corruption and mismanagement under his increasingly autocratic leadership.

Hopes were raised when Mugabe signed a power-sharing arrangement with the opposition in September, but little progress has been made toward setting up a unity government. The World Food Programme says that it has signed a new food aid deal to allow the UN agency to provide 350,000 tonnes of grain to millions in the strife-torn country. "The agreement is part of our long-standing partnership with the goverment of Zimbabwe. It runs until April 2010," said WFP spokesman Richard Lee. The $500 million agreement will provide food relief to poverty-stricken Zimbabweans over the next two years. AP