VERY IMPORTANT: How to effectively deal with cholera outbreak in Nairobi

The current outbreak of cholera in Nairobi is a sign that water supply, city sanitation and food hygiene have reached unacceptable levels. The superficial attempts to address the outbreak might merely incubate the problem. Although the treatment of cholera is basically done through re-hydration, Nairobi faces challenges to this approach. For example, we have places that are currently experiencing lack of clean water.

Most of the households in Nairobi are not connected to the city’s sewerage system and are using septic tanks, which have been increasing in number and proximity. There is also an increase in dump sites and sewers near water sources. Furthermore, Nairobi also has cases of individuals who are bottling drinking water from shallow boreholes.

As such, addressing cholera by treating only the infected individuals might not be adequate in keeping the fatality rate below one per cent as globally expected.

The good news is that there are several approaches that can be implemented to prevent future cholera outbreaks in the city. On top of the list is to have clean water sources and subsequently guarantee clean food supply. We must address the possibility of the city water sources being contaminated from new sources due to unplanned urbanisation.

We need to ask and answer some pertinent questions like, do we have data on the safety of boreholes supplying water to the city? Some of the water being used in the city might be coming from shallow aquifers. Studies have shown that deeper aquifers are safer. Nairobi County government should set the minimum depths of safe water aquifers based on scientific data.

The water should also be regularly examined and data kept to monitor possible contamination. All public latrines should be fitted with treated water taps. Urgent plans should be made to budget and connect the whole city to a common sewerage infrastructure or enforce compulsory installation of water treatment plants in all household septic tanks.


Dr Josphert Kimatu, South Eastern Kenya University.