To end cholera outbreaks, address water and sanitation problems

Resident of Mathare slums in Nairobi is immunized against cholera on the first week of the drive that is geared towards curbing the spread of the disease. [Denish Ochieng, Standard]

The Ministry of Health issued an advisory late last year that six counties were dealing with a cholera outbreak. The ministry recently issued another alert indicating that the number of counties fighting the outbreak had increased to 15, with 4,566 patients in February of this year. This is a worrisome trend.

Kenya, however, is not the only country dealing with this concerning scenario. Ten other African countries are also dealing with the same. According to the World Health Organisation (WHO), the continent had 30 per cent more cholera cases in January this year compared to the whole of last year. Malawi is experiencing its worst outbreak in 20 years. If the situation is not addressed, the number of cases is likely to exceed that of 2021, which was Africa's worst year for cholera numbers in nearly a decade.

If left untreated, cholera, which causes severe diarrhoea and dehydration, can kill quickly - sometimes in a matter of hours. It is a bacterial disease that spreads easily through contaminated food and water and it is commonly found in peri-urban areas where there is poor sanitary conditions and no guarantee to get clean food. The current trend is concerning considering recent reports from the Kenya Medical Research Institute indicating that current strains are becoming resistant to commonly used antibiotics.

The national and county governments have responded quickly and decisively. Disease preparedness has been increased in all private and public health facilities and supplies to combat the outbreak are being distributed.

The Health ministry is also taking a proactive approach to the disease, which is commendable. It launched the first ever cholera vaccination drive recently, targeting at least 2.2 million children over the age of one in five of the worst-affected counties.

It's encouraging to see that the government is not treating this outbreak as a minor issue. In a country where travel is relatively inexpensive, cholera can spread extremely quickly especially since most people infected with the bacteria do not show symptoms but can still spread it to others.

The reality is that the situation on the ground is dire. According to UNICEF, access to safe drinking water in Kenya has increased by 12 per cent since 2000, but sanitation facilities have decreased by 5per cent, and 9.9 million Kenyans directly consume water from contaminated sources, while 5 million practice open defecation. Water.org, an international organisation that works to improve global access to safe water and sanitation, reports that approximately 28 million Kenyans lack access to safe water and 41 million lack access to improved sanitation.

If efforts do not wane, a quick response to the outbreak is likely to be effective in the short term. Treatment of those who already have the disease, as well as vaccination to prevent it from spreading to others in their communities, will undoubtedly keep the situation from deteriorating further.

However, in the long run, the systemic issues of water and sanitation poverty must be addressed. The WHO advises putting in place adaptable long-term water sanitation and hygiene solutions. These will not only aid in the fight against the recurring cholera outbreaks but will also help to prevent other water-borne illnesses. Furthermore, it will help to reduce the comorbidities of poverty and malnutrition that are common in cholera-affected areas.

As the adage goes, prevention is better than cure. So, if we do not quickly implement long-term preventative strategies in dealing with cholera, the past trends are very likely to continue, and we will be forced to deploy costly curative measures on a regular basis. To make matters worse, we will lose thousands of lives as a result of a disease that is easily preventable