Zambia

Zambia: Getting ahead of cholera

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LUSAKA, 18 December 2009 (IRIN) - As the rainy season in Zambia picks up, so does the threat of Cholera; around 60 cases have been recorded since mid-November, but the authorities and aid agencies hope education and improved infrastructure will help keep the waterborne disease at bay.

Most of the recent cases were reported in the southern province of Sinanzogwe, but the disease has also resurfaced in the capital, Lusaka, where two-thirds of the 7,000 cases in 2008 were recorded. In June 2009 cholera claimed 162 lives nationwide, 30 of them in Lusaka.

Jatal Zulu, whose family lives in the sprawling township of Mandevu, north of Lusaka, said cholera affected the area every year, "but people don't know much about it."

Some 75 percent of Lusaka's 2.5 million people live in peri-urban conditions. Unplanned high-density settlements have mushroomed around the capital, and Mandevu is no different: water pours from the tarmac main road into the dirt tracks between the shacks to mix with garbage and excrement from the open lavatories and settle in stagnant pools - ideal breeding conditions for the Vibrio cholerae bacterium that causes the disease.

Cholera is an intestinal infection that causes acute diarrhoea and vomiting and, if left untreated, can cause death from dehydration within 24 hours. It is spread by eating or drinking contaminated food or water. Contamination often occurs when faeces from someone with the disease comes in contact with a community water supply.

Cholera is easily treated with rehydration salts, but starting treatment early is critical; prevention is the best option. Lusaka District Commissioner Christah Kalulu is well aware of the health risks that come with the rainy season, but while others eagerly anticipate the first rains, she becomes anxious.

"We don't have enough money to put in place sanitation for everyone," she told IRIN. "The biggest problem seems to be the garbage ... In terms of disaster management, we had to do something about this," Kalulu said.

Together with members of parliament, her office launched Lusaka's District Disaster Reduction (DDR) programme in August 2009 to take measures to prevent an epidemic and "lessen the impact on communities".

About US$1.1 million of a proposed $2.6 million package to cover health, water and sanitation, bridges and crossings, garbage collection and drainage clearance has been raised, she said.

Other efforts by the DDR programme include installing dry toilets that separate urine and faeces, and replacing temporary water stands - put up last year in collaboration with the Lusaka Water and Sewerage Company - with eleven permanent water pipes.

Ongoing education and sensitization are essential to preventing the spread of the disease. Government and the UN Children Fund (UNICEF) have launched an awareness campaign called: "Your Life is in Your Hands".

UNICEF country representative Lotta Sylwander said education was vital in addressing cholera outbreaks, and the programme promotes hand-washing with soap at four critical times: before eating, before preparing food, after using the toilet, and after changing babies' diapers (nappies).

Popular entertainers are spreading the campaign messages in the high-risk areas of Lusaka, backed up by town-hall meetings, schools events, and public service announcements on radio. According to UNICEF, such campaigns are highly effective because they rely on peer-to-peer advocacy and education.

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