Stem the shameful tide of cholera deaths

The latest cholera outbreak that has so far claimed over 50 lives and left nearly 2,000 people affected should trigger a multi-faceted approach to tackle the disease once and for all.

Cholera outbreaks have become perennial problems, where rains routinely overflow sewers and contaminate water supplies. This causes the disease in both urban and rural areas, which has exposed our unpreparedness.

The current cholera outbreak is the first under the devolved system of government, where the county and sub-county levels have been overwhelmed. Their ability to diagnose, manage, control and prevent cholera has been put to huge test. National government officials have been called upon to provide much-needed technical and personnel support.

However, besides lack of institutional memory for the county governments in handling similar public health challenges, some teething problems have been noted such as unequipped laboratories to test for the bacteria that cause cholera, a delay in taking specimen to the laboratory and in health facilities where present, the response is longer than the expected 48 hours.

Poorly trained health workers on integrated disease surveillance and response and a slow referral system have also delayed treatment for affected residents.

The number of affected counties has now increased to ten, and this is no time for blame game. Institutions mandated with the provision of clean water, regulating its provision and environmental watchdogs should fall into place to avert the already public health embarrassment in our cities and towns in this Twenty-first Century.

At the county and sub-county levels there should be increased support to health facilities to hasten case detection, confirmation and management of suspected cases of cholera.

Should they lack capacity, an efficient referral system must be enhanced to save lives and speed up recovery for those who test positive.

Public health facilities at the county and sub-county levels should also be more proactive in dealing with suspected cases.

Emergency cholera supplies should also be available in health facilities and high risk areas during outbreaks like the current one.

It is also important to ensure safe water supply at the point of use, improve sanitation, promote hand-washing with soap and food hygiene to prevent and control the disease. Aggressive health education should also be rolled out countrywide emphasizing the importance of personal hygiene like thorough and consistent hand washing, treating water for consumption and preparing food in clean environments.

Ensuring access to water disinfection methods and products to facilitate household water treatment and safe storage for both urban and rural populations, especially those at high risk of cholera is critical during this period of mitigation.

It is also prudent to assess all learning institutions for possible risk factors associated with cholera-like environmental sanitation levels, personal hygiene practices and availability of clean water.

It’s no secret that most public schools do not meet the minimum water, sanitation and hygiene standards and it would be a horrendous experience if the current outbreak spreads to the learning institutions.

At the household level, washing hands thoroughly with soap should be strictly adhered to, with infants and children included in the campaign to remain germ-free.

The county governments should also handle issues raised like lack of investment in proper sanitation systems, poor enforcement of existing laws that encourage illegal water connections and strictly enforce construction standards and up maintenance exercises.

After the outbreak has been contained, regular and routine assessment of water points and sources by Ministry of Water through the water boards and training of water service providers should be maintained.

Finally, since cholera is a disease largely related to personal hygiene, all Kenyans must be sensitised to play a huge role in maintaining cleanliness. Public health challenges require everyone’s input.