Africa in the time of cholera

Water-borne cholera is both preventable and curable. Africa is one of the very few continents where the disease is still endemic. Please agree with me that it is a huge crime against humanity. Cholera isn’t a cancer where we still not fully understand it nor can cure it. No people should die of cholera in 21st century as we know exactly what is it and how to deal with it. Yet, almost 90% of cholera deaths happen in Africa and most recently an outbreak in Eastern Uganda killed as many as hundreds in Bulambuli district alone.

Cholera is a water-borne virus that causes dehydration and acute diarrhoea. The infection happens when a person consumes water or food contaminated with the bacteria. The virus is spread through poor hygiene practices in places where people don’t use latrines or soap to wash their hands. According to a doctor who’s my neighbour, cholera in the East of Uganda came from the mountains where a dead person’s sheets containing excrements were washed in the river. The water then brought the virus to the city and further down, as the river flows, to Bulmabuli and nearby districts.

Cholera can kill in a day or two. After the virus colonizes the intestine where it multiplies and there it secretes a powerful toxin which interferes with water and electrolytes absorption. Usually by day two, the body collapses with constant purging and vomiting and sever dehydration causes muscle spasms and eventually death. This all can be prevented with a simple oral rehydration therapy (ORT) and adequate sanitation and awareness programs. And this is the saddest part which at the same time makes me immensely angry – how could we fail to eliminate cholera in Africa as we have done in most other parts of the world, if we know the disease and we know the cure?

We know that the promotion of the importance of hygiene through public campaigns and access to safe drinking water is crucial. A couple of weeks into the cholera outbreak I have seen health officers conducting workshops in villages around the district (!). My local volunteers were instilling good practices of washing hands properly and boiling water before drinking after each meeting we held. In the whole of Africa, the investment in prevention practices should be greater – from health campaigns, new boreholes, sewage disposals and latrine building. I believe that food shortage and lack of drinkable water is becoming the greatest crisis in Africa. Regional wars can erupt over the rights to water and land. I worry that large water bodies could already have cholera pathogens, including Lake Chad, Lake Victoria and Lake Tanganyika which can affect many countries from Nigeria, Cameroon, Zambia, Uganda and many more. I have read about using satellite images who could prevent the outbreak of cholera for up to a few weeks. Cholera or no, the subject of water and sanitation in Africa is hazard. We need more bottom up investment and more light on the sheer scale of the problem of cholera (and other preventable diseases) to avoid unnecessary deaths. For that we need less planning made by politicians and agencies and misused funds and more capacity and infrastructure building at the rural level to enable people take the task through shared responsibility.

Would you agree?







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