HEALTH-ZAMBIA: Rains Bring "Preventable" Outbreak of Cholera

By IPS Correspondents Reprint | | Print |

Zarina Geloo

LUSAKA, Dec 16 2003 (IPS) - Six people have died from cholera and another 165 are reported to be in a serious condition as the disease sweeps through Zambia’s capital, Lusaka.

It appears that local authorities have been caught flat-footed by the outbreak. They are now engaged in a frantic bid to contain the disease, which is transmitted through contaminated water and food. Cholera typically occurs in Zambia during the country’s rainy season.

The city council of Lusaka is scouting for extra garbage collection trucks. It is also making urgent appeals to members of the public to assist it in clearing drains and burying rubbish in high-density parts of the capital where cholera has hit.

Lusaka Mayor John Kabungo told IPS that the council only had two trucks at its disposal, and could not regularly collect garbage in the city of 1.5 million people: “We need the private sector to come in and help us clear up. We need at least five or six more trucks.”

The public has responded by accusing the council of a lack of foresight.

According to the Director of Technical Services at the Central Board of Health, Victor Mukonka, cholera outbreaks never come as a surprise. On the contrary, they’re quite predictable.

“Cholera comes in waves, every two to three years, so it is not like the council did not know that an outbreak was imminent,” says Mukonka. “It should have started a warning and public awareness campaign early on. It was not proactive and now we have this emerging crisis,” he adds.

Davis Banda, who is nursing a cholera patient, agrees: “There is no excuse. We know that the rains bring cholera, and this time even the rains were on our side – they started late. It was if the rains were waiting for us to get our act together, but we were still caught unawares.”

Council Public Relations Officer Peter Kashiwa refuses to accept all responsibility for the crisis. “People should stop blaming the council for its failure to remove garbage and learn to keep their surroundings clean,” he says.

“Yes, we all know the rains are coming and the threat of cholera is present. But the council can only do so much with its meagre resources. Should people really wait for the council to tell them to keep their surroundings clean?” he asks.

Kashiwa says another reason cholera breaks out in high density areas is that some of these have not been designated as residential zones by the local authorities, and are therefore not serviced with proper drainage systems and clean water.

But the Member of Parliament for one of these areas, Henry Mtonga, says his constituency – Kanyama – is recognized by the council, but still not serviced. Kanyama has been hit hard by the cholera outbreak.

“I have been asking for another borehole to supplement the two we have the in area, to no avail. Now the entire water system is contaminated. The rains have caused seepage from toilets, ablution blocks and solid waste dumps into the drinking water,” says Mtonga.

“Instead of looking for excuses the council should admit it has not picked up the slack, and get their house in order,” he adds.

When tackled on this point, Kashiwe concedes that the council failed to do its job in Kanyama. But he maintains Lusaka residents should not wait for local authorities to collect garbage when matters get out of hand.

Cholera has also affected police stations and prisons. Authorities at two jails in Lusaka have been forced to quarantine inmates, suspend visits and halt deliveries of food for the time being.

The measures stem from a well-founded fear of the ease with which cholera could spread in the over-crowded jails. One institution built to house 260 inmates currently accommodates 1,339 people.

“We have four inmates with cholera. We have to quarantine them because you can imagine how it will spread in a congested place,” says a prison warder.

However, most prisoners rely on meals brought in from their relatives, as the once-a-day prison ration of nshima (porridge) and beans is inadequate. “It will be difficult to enforce this measure and I am very scared of what is coming,” says the warder.

The last time Zambia had a serious cholera outbreak was in 1992 when over 500 people died in the central Copperbelt Province, and had to be buried in a mass grave. Last year there were six deaths in the remote area of Sinazongwe, in southern Zambia.

Health experts agree that preventing cholera is a fairly straightforward matter of maintaining basic standards of hygiene. However, this has proved difficult in Zambia where 42 percent of the 10.5 million population does not have access to clean drinking water, and lacks adequate sanitation facilities.

“The starting point should be getting the town cleaned up and getting the water and sanitation people to ensure that everyone has access to clean and safe drinking water and proper sewer systems,” says Mukonka.

“It also means sensitising the people (to) the need to keep their surroundings clean, with garbage disposed (of) all the time.”

He said the council should observe the Public Health Act more strictly, to clear the streets of vendors. At present, these traders sell everything from fresh meat and fish to ripe fruit – the remainders of which lie strewn across the street when they leave. The act also allows the licences of restaurants and other food providers to be revoked if these places do not adhere to hygiene standards.

“We have so many epidemic emergencies to deal with, (that) cholera should not feature anywhere,” says Mukonka. “It is an unnecessary waste of time and resources because it is easily preventable.”