JOHANNESBURG, South Africa - Thousands of Zimbabweans are dying, uncounted and out of sight in a silent emergency as hospitals shut, clinics run out of drugs, and most cannot afford private medical care, health groups say.

Even as deaths from a cholera epidemic climbed into the hundreds, international and local organizations say many more are dying needlessly in a disaster that critics blame on President Robert Mugabe's government.

The toll will never be known, according to Itai Rusike, executive director of the Community Working Group on Health - a civil society network grouping 35 national organizations.

"Zimbabwe used to have one of the best surveillance systems in the region," Rusike said in a telephone interview. "But phones are not working, nurses are not there, so their information system has collapsed. . . . It is very difficult to tell how many people have died."

"These are symptoms of a failed state," he said in a telephone interview. "Nothing is working."

'Recipe for disaster'

The British charity Oxfam agreed with estimates of thousands of unreported deaths due to the collapse of the health system and said the situation would get worse with the onset of the rainy season, which lasts until February.

"When you look at people who are already weakened by hunger, many already weakened by HIV and AIDS, and with rainy season comes malaria, and we know anthrax is spreading - it's really just a recipe for disaster," spokeswoman Caroline Hooper-Box said in neighboring South Africa.

She said many people Oxfam interviewed in Zimbabwe said they had cut back to one meal in three days. Some are trying to survive on insects and berries.

'A very high risk'

Once a major food exporter, Zimbabwe has been crippled by shortages of necessities including food and medicine as Mugabe, the leader since independence in 1980, clings to power.

As businesses collapse, unemployment has risen to 80 percent, with the majority of the population depending on handouts from a growing diaspora; more than a third of the population has fled, many to South Africa and former colonizer Britain, but some as far as New Zealand.

Save the Children, a British charity, said hundreds, if not thousands, of pregnant women and their children "stand a very high risk of death."

Zimbabwe director Rachel Pounds said the United Nations reported that 700 women were recently turned away from hospitals in Harare that were no longer able to provide maternity services.