Let’s keep our eyes open on cholera

cholera outbreak

CHOLERA should be given attention at this juncture in Zimbabwe after the country recorded 281 suspected cases. The government has allocated about US$24 million to help contain the disease which first struck in Chegutu on February 12 this year when an index case was recorded in farming town of Mashonaland West.

Today, eight provinces are battling cholera with only Matabeleland North and Midlands being spared at the moment. Such places as Beitbridge, Buhera, Chimanimani, Chikomba, Chiredzi and Mbire are in serious trouble as the disease threatens to indiscriminately claim many lives like it did in the not-so-distant past.

The first global cholera pandemic occurred in the Bengal region of India, near Calcutta, starting in 1817 through to 1824. Zimbabwe had its first case of cholera in 1972 which did not give much trouble. However, there was a severe cholera epidemic in the country from 2008 to 2009 which saw 98 585 cases being reported and 4 287 deaths recorded within a space of nine months. Another outbreak was to follow in 2018, running for six months up to 2019 when 69 people died, while at least 10 421 people were affected.

Cholera is both a food and water-borne bacterial disease that is caused by vibrio cholerae, a toxin-producing bacteria. The disease arises after ingesting food or water contaminated with the bacterium. Contamination of water bodies with cholera is fatal and addressing issues of safe water and sanitation is very critical to cholera control. Crowded cities and towns are witnessing people using unprotected water sources. The deteriorating sanitation infrastructure is leading to such issues as raw sewage flowing in towns and cities. Informal traders have gathered everywhere, selling fruits and vegetables, thus increasing the risk of cholera.

We are lucky that COVID-19 is on a downward trend in terms of both incidence and prevalence rates. Economic hardships amid high unemployment are, however, fuelling all the risk behaviours surrounding cholera. Lack of good hygiene, absence of clean water and sanitation are major factors that are fuelling the spread of cholera. Access to clean water is rare for many, especially those in overcrowded towns and cities. Vendors are everywhere in the towns and cities where hygiene services like ablutions and running water are poor. All this coupled with poor sewage management and general absence of smartness spell disaster.

Garbage is everywhere and one wonders why policymakers are tolerating such things in our cities and towns. Corruption has virtually paralysed service delivery in councils and municipalities, heightening the cholera threat, yet many who are involved in such unethical practices are walking scot-free.

There is too much leniency on the part of the prosecuting authorities in our country. In China, corruption can attract capital punishment such as death by hanging. Our people continue to engage in corrupt activities simply because hardly anything happens to them to the point that they even brag about it.

The current cholera cases should be an eye-opener, if we are to remain on top of the situation and it is prudent to have preventive strategies. Complications of cholera can include severe dehydration, renal failure and even death.

As a nation, we should not perennially cry about the absence of water and sanitation when there is great potential to mitigate against such. Towns and cities have watched roads develop huge potholes, as well as mounds of garbage in every other open space.

Why are councils not fixing the garbage issue? Why do we have problems with clean water supplies? Harare city, for instance, can stretch for four good days without water when diseases like cholera are knocking on its door almost everyday. Sewage flows are the order of the day while we are busy dreaming that we will easily contain the dreaded disease when it strikes. We should thank dedicated medical practitioners who always work hard to bring relief to the populace, especially during outbreaks such as COVID-19 and cholera. In view of recent cholera cases in our country, it is wise to observe at least some of the following:

  • More funds should be availed for the cholera fight taking cognisance of the fact that border screening should be done. We should not forget that cholera was in Zambia and Malawi first before cases were detected in Zimbabwe.
  • Garbage removal should be robust to avoid water pollution. Enhanced sanitation should be in municipal or council DNA.
  • Safe and clean water supplies should be there without fail if cholera is to be contained easily.
  • Health education should be upscaled through many media platforms. Hand-washing and sanitisation remain key to cholera control.
  • Surveillance remains critical so that cases cannot go out of control.
  • Contact tracing of the cholera cases is critical so that possible contacts are quickly investigated.
  • Stocks of essential drugs should be maintained which include antibiotics like cotrimoxazole, intravenous drugs and fluids in high volumes for hydration in case of serious illnesses. The country should never run short of the required drugs which are life-saving in the event of a cholera attack.

Let us keep cholera under control!

Johannes Marisa is president of the Medical and Dental Private Practitioners Association of Zimbabwe. He writes here in his personal capacity.

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