The World Health Organization (WHO) has raised the risk level of the current cholera outbreak affecting several countries to “very high”, based on its geographical expansion and the scarcity of vaccines and other resources to deal with it.
It is an acute, life-threatening diarrheal disease caused by ingestion of food or water contaminated with the bacillus
Vibrio cholerae.
According to the latest report on January 11, the number of cases and deaths reported in 2023 have exceeded those in 2022, with more than 667,000 affected and 4,000 deaths.
In total, at least 30 countries have reported cases since January 1, 2023, of which 17 are from Africa, making it the most affected region.
In the South-Eastern and Central African subregions, the Democratic Republic of the Congo (DRC) continues to grapple with nearly 1,000 infections reported weekly.
Zimbabwe is experiencing a rebound, especially in the provinces of Harare, Manicaland and Masvingo.
And Mozambique is also reporting new cases, indicating further geographic spread.
Active outbreaks also persist in Burundi and Zambia.
More information
Cholera crosses the Sudanese border and breaks into the refugee camps of South Sudan
Joseph Mwale, 39, a minibus driver and cholera survivor in Lusaka, Zambia, explains in a video shared on social media that he usually eats in restaurants and buys food on the street, as he has to rush to queue at the different bus routes at Kulima station.
Therefore, he does not know where he became infected with cholera.
“I remember that that day he had an upset stomach and was vomiting.
Then I became dehydrated and began to weaken.
So I ran to my wife's house.
My neighbor identified my illness as cholera and that's how they took me to the clinic.
I just remember waking up to a drip of water because I was unconscious.
My wife explained to me that she had contracted cholera,” Mwale explained.
This witness' account shows how the current cholera outbreak in Zambia, which the Government officially declared in October 2023, is affecting the population.
From that date, when cases were concentrated in Lusaka, until January 18 of this year, the country had reported 10,887 infections and 432 deaths in nine of its 10 provinces.
“The outbreak is spreading rapidly and the country recorded an average of 461 new cases every 24 hours over the last seven days,” the WHO published in its latest statement on January 20.
Neighbors of a neighborhood in Lusaka (Zambia) affected by a cholera outbreak walk through a flooded street on January 18.NAMUKOLO SIYUMBWA (REUTERS)
Several women fill buckets with water in a neighborhood affected by the cholera outbreak in Lusaka.
This diarrheal disease is transmitted through the consumption of contaminated water or food.NAMUKOLO SIYUMBWA (REUTERS)
Sick people receive treatment at an emergency cholera center set up to deal with a deadly outbreak at the National Heroes Stadium in Lusaka, Zambia.NAMUKOLO SIYUMBWA (REUTERS)
A worker unloads bottled water to distribute to patients at the temporary treatment center.
Maintaining hydration of those affected is essential to avoid a fatal outcome.
NAMUKOLO SIYUMBWA (REUTERS)
Dirty water runs through a residential area amid a deadly cholera outbreak in Lusaka, Zambia.
Poor water and sanitation infrastructure contributes to the spread of this disease.
NAMUKOLO SIYUMBWA (REUTERS)
View of a hole in the ground used by residents to draw water amid a deadly cholera outbreak in Lusaka.NAMUKOLO SIYUMBWA (REUTERS)
A woman receives the cholera vaccine at a temporary treatment center.NAMUKOLO SIYUMBWA (REUTERS)
A worker disinfects a medical vehicle at one of the clinics set up to treat cholera patients in Lusaka.
NAMUKOLO SIYUMBWA (REUTERS)
Sub-Saharan African countries regularly witness cholera outbreaks due to several factors, one of them climate change.
External events such as floods, for example, destroy sources of safe water and sanitation infrastructure, which favors the contamination of water with infectious agents.
According to the WHO, Cyclone
Idai
in March 2019 not only caused devastation as it passed through Malawi, Zimbabwe and Mozambique, leaving hundreds dead, thousands of homes destroyed and at least two million homeless, but it also revived the epidemic of this disease. disease in its wake.
Reliance on groundwater sources, especially through shallow wells, aggravates the situation.
These are susceptible to contamination and become silent carriers of the disease.
“Cholera is a disease of inequality.
It disproportionately affects the world's poorest and most vulnerable populations who lack access to safe water and sanitation.
The main causes are poor long-term water hygiene and sanitation conditions, aggravated by weather changes and climate change, leading to floods and droughts,” summarizes Paul Ngwakum, UNICEF Regional Health Advisor for Eastern and Southern Africa.
The specialist adds that the lack of adequate information on the part of the community and the poor care of the sick have also contributed to a high mortality rate.
From October to January 18, 2024, Zambia has reported 10,887 infections and 432 deaths in nine of its ten provinces
Structural lack of access to sanitation and poor hygiene contribute to cholera outbreaks.
Lack of adequate waste disposal mechanisms and limited access to clean toilets contribute to the contamination of water sources.
According to the WHO, the fight against cholera requires a holistic approach that addresses not only medical intervention but also improved sanitation infrastructure and hygiene education.
“Governments and partners must invest in basic services, especially for populations living in disadvantaged and poor communities at high risk of contracting cholera and other infectious diseases.
They must invest in water sanitation and hygiene, as well as quality primary health care services,” claims Ngwakum.
WHO and related organizations have made frantic efforts to combat the epidemic and the latest cross-border outbreaks of cholera in the eastern and southern African subregions, specifically in Uganda and Malawi.
The borders between Uganda and the Democratic Republic of the Congo, and between Malawi and Mozambique were selected for the intervention because these countries share a high burden of cholera disease.
“We are working with governments in Africa to map the hot spots with the highest risk and provide drinking water at collection and consumption points to the affected population,” details Ngwakum.
She says information and awareness-raising efforts are also being carried out to promote healthy behaviors, from maintaining hygiene and consuming drinking water to seeking early care when symptoms appear.
My neighbor identified my illness as cholera and that's how they took me to the clinic.
I just remember waking up to a drip of water because I was unconscious.
Joseph Mwale, Zambian cholera survivor
There is a vaccine against cholera, but there has been a shortage of it in recent months.
In 2018, Zambia, Uganda, Malawi, South Sudan and Nigeria launched large vaccination campaigns against this disease, which aimed to slow the spread, offering a lifeline to vulnerable populations.
However, problems of distribution, resources and access to remote areas were major obstacles.
In Zambia, the Government has recently received vaccines to complement the measures that were being implemented to control the current outbreak.
“We have received a shipment of 1.7 million single doses from Gavi [the Global Vaccine Alliance] and through UN agencies.
Unfortunately, we continue to see that some sectors of our community reject them.
This should not be like that.
The Government wants to protect its population and immunizations are another way to guarantee the health of our people," explained Sylvia Masebo, Minister of Health, in a press release on January 22, in which she added that the heavy rains and Flooding in Lusaka had hampered vaccination efforts.
“The international coordination group that manages the global stockpile authorized 2.2 million doses of oral cholera vaccines for Zimbabwe and another 1.4 million for Zambia, where the vaccination campaign is ongoing.
”Ngwakum concludes his list of requests.
Save the Children has also reported that around 4.3 million school-age children in Zambia will remain at home, "in an attempt to stop the worst cholera outbreak in 20 years, linked to climate change."
The Government's announcement this Thursday to keep schools closed for another two weeks comes after a delay in reopening after the Christmas holidays.
“Children throughout Zambia have lost the first five weeks of school this year,” denounces the NGO, which emphasizes that this health crisis “represents a threat to the well-being, education and protection of children that has not been seen since the covid-19 pandemic″.
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