New approach to sanitation helps reduce cholera deaths

Nakuru County health officers show a pupil how to keep proper hygiene by washing her hands during celebrations to mark an Open Defecation Free (ODF) Day in Naivasha. The ODF campaign has reduced cholera deaths in Migori County. [PHOTO: Antony Gitonga/standard]

Kenya: A new approach to sanitation introduced in Migori County three years ago is credited for the low number of deaths following a cholera outbreak in February this year.

According to the County Deputy Public Health Officer Kennedy Ombogo, the Open Defecation Free (ODF) campaign that was initially started in Kuria sub-county is fast bearing fruit. The campaign is all about encouraging residents not to relieve themselves in the open, but to use latrines instead.

“In the 97 villages that have already gone ODF, there were zero deaths. Those who died had not gone ODF,” Ombogo said. According to Ombogo, the ODF campaign started with the training of 20 community members. So far, courtesy of the World Bank’s Water and Sanitation Programme (WSP), 137 people have been trained.

“So far, 952 out of the 2,388 villages in the county have benefited from ODF,” said Ombogo.

Ombogo, however, noted that the deaths that did occur happened at night within communities where there was no transport and referral was a problem. He revealed plans to make the whole of Migori County an ODF zone by the end of this year.

So far, the two sub-counties of Kuria East and Rongo are competing to be declared ODF. “The rest of the sub-counties are in hot pursuit and we hope with continued support and a good working relationship with the WSP, access to basic sanitation is guaranteed for the people of Migori, an area that was once known as the epicentre of cholera,” Ombogo added. This is evident in Rongosub-county which was where the outbreak started. The 35 villages hit by the outbreak were not ODF. The 97 that were ODF did not experience the outbreak.

“Cholera has killed many of our people in the past and now that we have been given the knowledge, having gone to the field and noted that even those who have access to basic latrines still are at risk of getting sanitation-related infections from the people practising open defecation, we have agreed in principle to rid the county of cholera,” Jane Owinyo, a resident, said. Owinyo and her colleagues have developed an approach whereby they urge those who do not have latrines, to construct them.

Community members who are not able to put up sanitary facilities due to disability or old age are assisted to construct and use them so that the community becomes ODF.

“Those who do not have latrines and are capable are being punished heavily by being forced to collect faeces from the shrubs where they help themselves,” she added.

The teams engage in village triggering, a process that has helped control outbreaks of cholera as villagers are often on high alert.

Due to the occasional outbreak of cholera in the region, Migori County has developed a Sanitation Bill.

According to the Chief Public Health Officer Dr Kepher Ombacho, one in six Kenyans practises open defecation. He, however, said that open defecation, especially in densely populated communities, presents a health and security risk to individuals and poses serious public health risks to communities.

“Improved sanitation is a strategic tool in poverty alleviation since it has immense intrinsic value because of the dignity, privacy, convenience and social status they offer,” he noted.