Poor sanitation spawns cholera outbreaks

Lazarus Sauti

Poor water and sanitation infrastructure in countries within and across the Southern African Development Community (SADC) sets off cholera outbreaks that are ravaging the region.

Hein Zeelie, the Johannesburg-based United Nations Office for the Coordination of Humanitarian Affairs (OCHA) reporting officer, recently said that the disease, caused by eating food or drinking water contaminated with a bacteria called Vibrio cholerae, was rearing its ugly head in Southern Africa, infecting nearly 6 000 people in Mozambique, Malawi as well as in Zimbabwe.

Since the first outbreak in late December 2014, Mozambique has recorded 5 118 cholera cases with nearly 50 deaths. The situation in Tete province is the most severe.

Malawi has to date registered 60 cases with 2 deaths since its first confirmed case on 13 February 2015. All are related to the outbreak in Tete Province, Mozambique.

In Zimbabwe, 12 cases of cholera have been confirmed since late February 2015, with six cases in Mudzi district, bordering Mozambique.

This outbreak is fuelled by the fact that most, if not all, SADC countries face the dual challenges of improving both cholera treatment – access to basic health care, and prevention – improved water and sanitation systems.

Zeelie has the same opinion: “Poor water and sanitation infrastructure in Southern African countries is the main culprit of this outbreak. In the most affected province in Mozambique, which is Tete province, for instance, you are looking at less than half of people having access to clean water, and less than a quarter having access to improved sanitation.”

Dewa Mavhinga, senior researcher for Zimbabwe and Southern Africa with the Africa Division at Human Rights Watch, also shares same views: “The bottom line is the same: that there is not enough prioritisation for sanitation and health, not enough resources from these governments are being put towards health and preventing these diseases.”

More so, the World Health Organisation (WHO), a specialised agency of the United Nations that is concerned with international public health, added that cholera remains a challenge to countries where access to safe drinking water and adequate sanitation cannot be guaranteed.

Cholera is not only ravaging Southern Africa, but is also stalling socio-economic development in the region as the cost in human lives, medication along with national brands are too high.

Improving regional access to water, sanitation as well as hygiene is, therefore, a critical step to reducing Southern Africa’s cholera burden.

Mavhinga agreed, “Access to clean water is a human right, therefore, governments need to do more.”

The WHO shares same sentiments, “Provision of safe water, proper sanitation, and food safety are critical for preventing occurrence of cholera.”

There is, therefore, an urgent need for the governments of Mozambique, Malawi, Zimbabwe and other SADC member-states, to provide adequate and safe water, proper sanitation, food safety as well as prioritising the health of their citizens if the region is to ensure the curbing of this outbreak. This means health education and good food hygiene are equally important.

“Communities should be reminded of basic hygiene behaviours, including the necessity of systematic hand-washing with soap after defecation and before handling food or eating, as well as safe preparation and conservation of food,” added the World Health Organisation.

Appropriate media, such as radio, television or newspapers should be involved in disseminating health education messages.

As a stop gap measure, Zimbabwe’s Health and Child Care Minister, Dr David Parirenyatwa advised the public to avoid shaking hands with other people unnecessarily as well as to be mindful of what they eat.

“We should be vigilant – avoid shaking hands with other people unnecessarily – and we should stop shaking hands unnecessarily,” he added.

Governments in the region must also engage with development partners if SADC is to completely eradicate cholera and other water borne diseases.

Dr Parirenyatwa said that global partners can help governments “with the mobilisation and training of health professionals to deal with such outbreaks.”

Michel-Olivier Lacharité of the Médecins Sans Frontières (MSF) is of the view that rehydration therapy is the key element to treating cholera.

“Cholera is easily treatable with basic antibiotics and rehydration. Rehydration fluids are mixed with sugar and salts to replace those lost through diarrhea and vomiting,” asserted Lacharité.

Truthfully, as cholera is easy to treat as well as to spread, it is of paramount importance for SADC countries to improve preparedness so as to rapidly respond to water borne diseases such as cholera, but importantly, they must invest in water and sanitation infrastructure so as to eradicate cholera outbreaks.