It’s sad Kenyans still die from cholera that can be avoided by washing hands
What you need to know:
- Every confirmed cholera case in any village is a sign of poor sanitation and hygiene, often arising from lack of clean water.
- People drink the raw waters of Lake Victoria. There is a clear link between the high child mortality and the ever present health hazards.
- Local health centres are ill-prepared to handle cases, and Rongo Sub-County Hospital, for example, is over-crowded.
As a son of Homa Bay, born, bred and schooled in the county up to secondary level, and as a public health officer with professional experience within the county, I think I can say why cholera struck.
I am sure this will not be the last cholera outbreak unless a major investment in public health and sanitation happens — fast.
Every confirmed cholera case in any village is a sign of poor sanitation and hygiene, often arising from lack of clean water.
Why, in this age, would people die from a disease that’s preventable by mere washing of hands or cooking well? I take it as the result of poor public health governance.
The statistics on the ground do not lie. Various government reports will confirm that only 2 per cent of the more than 1.2 million residents of the county have access to clean and safe piped water. About 14 per cent of residents lack basic sanitation, and many more lack latrines.
Residents are prone to water-borne disease outbreaks. Homa Bay must be the town with one of the most serious water shortages; the service provider lacks the technical capacity to supply the growing population, let alone widen its supply network.
ENVIRONMENTAL POLLUTION
The result is a lowering in the quality of life, reduced urban productivity, increased burden of health care and unmitigated environmental pollution.
People drink the raw waters of Lake Victoria. There is a clear link between the high child mortality and the ever present health hazards.
Homa Bay enjoys a large section of the lake and boasts four rivers — Awach Tende, Awach Kibuon, Riana and Kuja. The argument has been that tapping the lake waters, given the hyacinth infestation, would be expensive and problematic. But what about the rivers?
A water supply plan from the immense fresh water sources is the way forward. It is not in drilling the 50 boreholes the governor promised last week. The county’s ground water has quality issues, is too salty and generally unsafe for human consumption. There is evidence from Pala in Karachuonyo to Koguta that the high fluoride levels in the ground water has health risks.
Plan International, World Vision and other agencies have done tremendous work in community-led sanitation in the county. But even without NGOs, what energy or funds does it take to put up low cost toilets, even for the urban poor?
The county government needs to take better care of its health professionals. Late payments and poor working conditions have demoralised medics to the extent that service delivery has deteriorated.
TRANSITION CHALLENGES
The challenges in the transition of public health to devolved units have immensely affected community health, especially extension work. Disease surveillance, reporting, documentation and progress have backtracked. The frequency of field visits and supervisions have reduced, perhaps due to untimely fuelling of motorbikes.
Local health centres are ill-prepared to handle cases, and Rongo Sub-County Hospital, for example, is over-crowded. Many will tell you they avoid Homa Bay County Hospital because no quality healthcare is offered there.
The county’s ministry of health must go back to the Homa Bay County Integrated Development Plan and borrow insight so as to get disease surveillance and sanitation back on its feet.
The three main diseases that the government must give equal focus and responsive prevention strategies to, are Aids, malaria and water borne diseases, including cholera and typhoid. The burden of Aids might have blocked its eyes from the other real public health risks.
OFFER LEADERSHIP
This cholera outbreak will once again put the spotlight on our county and most likely attract more NGOs, but the county must offer leadership.
Health workers must be motivated and tooled to mobilise villagers to take personal hygiene and sanitation seriously. If cholera killed nine people in two days, what would an Ebola outbreak do?
In the final analysis, Africa’s problem in disease surveillance and response to disease outbreak is uniform. The continent is under-staffed, ill-equipped, unprepared, and teeming with poor learners.
Mr Juma is a public health officer and community mobilisation expert based in South Sudan. ([email protected])
