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Cholera!

This is not the first time we are experiencing a cholera outbreak in Zambia.

Over the last two and half decades, we have had cholera cases almost every rainy season. We have even had some cholera cases outside the rainy season. But this outbreak stands out in terms number of cases and geographical spread.

Despite extensive efforts being made to contain it, it has continued to spread – the number of cases is rising everyday.

Commendable efforts are being made to improve sanitation and to raise awareness of the importance of best hygiene practices but cholera is nevertheless continuing to spread. The insurgency, and the efforts to quell it, have almost paralysed business and life in general.

Health experts fear the numbers of cholera cases could rise exponentially because of poor water and sanitation conditions in most of our compounds. Most of the cholera cases are concentrated in the overcrowded compounds of Lusaka with poor water supply and sanitation services. The clock is ticking. We must tackle this urgently to avoid further preventable suffering and loss of life.

There’s need to increase the number cholera treatment centres in all currently identified outbreak hotspots to provide urgent care for the most severely affected people.

To contain the outbreak, health workers need to quickly use oral rehydration salts to rehydrate patients who are infected but not yet severely ill. Where possible, suspected cases must be monitored in these rehydration sites for one or two days before being discharged.

It’s important to bear in mind that cholera can be treated with oral rehydration salts, antibiotics and nutritional supplements to support patients’ immune systems. There’s, therefore, need to stock our clinics with these supplies. Cholera can also be prevented with a vaccine through an organised campaign. There’s need to immediately roll out a vaccination campaign in the hardest-hit areas.

Crucial for the timely detection and referral of cholera cases, surveillance teams must conduct door-to-door investigations. Once a household has been identified as having a member with suspected cholera, the sick family member and anyone else showing symptoms must be referred to a nearby treatment or re hydration centre. In addition, teams of health workers must be deployed to spray shelters and homes and provide them with chlorine. Promoting good hygiene practices among communities is key to prevent further transmission of the disease. Door-to-door visits, awareness raising by posters, newspaper, radio and television advertisement are some of the methods that can be used to inform communities about how to avoid infection. There’s also need to set up hand-washing stations in hotspot areas, as well as cleaning and disinfecting latrines.

Some good work is being done by the technocrats, but much more needs to be done to contain the outbreak should it continue to spread. However, it seems our capacity is already stretched to the limit. Let’s seek international assistance before it’s too late. There’s no need to play down the crisis. We have been told by a colleague of ours in the health sector that the problem at hand is more dire than is being reported. This doctor friend of ours says the figures of cases being recorded are far less than what is actually on the ground. This is scary!

Our health institutions are already forced to divert resources from other life-saving programmes to rapidly respond to the cholera crisis. Without immediate and adequate action, this outbreak could spread to all areas of our country, or even become long term. Additional funds are urgently required to prevent the worst from happening.

We need a holistic and comprehensive response to this outbreak and a clear prevention strategy. The implications of not responding in a timely manner could be absolutely devastating for millions of our people who are already living in very dire conditions.

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