SHOOTING DOWN CHOLERA
…vendors commandeered off the streets
THE antidote employed to plug the menacing cholera cases in Lusaka may scuttle some routine errands, but the holistic approach which includes the deployment of the military is inevitable and requires all interest groups to move in tandem.
Lusaka which has lately experienced a population explosion has drifted into an abyss of unkept surroundings which calls for all and sundry to expend their energies in a well-coordinated fashion.
A number of factors have triggered the population boom that has scathed the face of the hitherto garden city.
Firstly, people have been drifting to Lusaka searching for favourable living conditions under the belief that “money is in Lusaka” and that business as well as job opportunities abound. The effect has been that the physical infrastructure cannot support the teeming population.
Secondly, the youth have swarmed Lusaka believing that it has sufficient learning institutions particularly at tertiary level. Henceforth, the capital city beams with the youth segment on the streets and other areas.
Unplanned settlements have continued sprouting out.
It is no surprise therefore that the capital city has been afflicted with social problems; cholera is just an offshoot and perennial consequence of the larger challenge which requires a critical analysis. How did cholera start this time around?
Health ministry head of communications and external affairs Stanslous Ngosa recalled that Government declared cholera as an outbreak on October 6, 2017 after two patients exhibited severe vomiting and diarrhoea in Lusaka at Chipata level one district hospital.
Thus in a period of three months the number has catapulted from two patients to a heartrending of almost 2, 000 cholera cases out of which 42 people have died.
Comparatively, in 2016 Lusaka had a cumulative 953 patients from the 1, 179 cholera cases in which 31 people died. Chibombo had 23, Ndola 28, Mazabuka 50 while Monze had 49 cases. Rufunsa had eight and Kabwe recorded two.
Nsama in Northern Province recorded 66 patients in the 2016 cholera outbreak mainly because of the influx of refugees from the neighbouring Democratic Republic of Congo (DRC).
At the time, Lusaka was identified as the source of the outbreak as the first case was detected in the sprawling Kanyama Township before the scourge spread to Chibombo. This excludes the Nsama cholera which was contracted from the asylum seekers.
Even now, Kanyama still reigns as the focal point having a recurring record of this serious but preventable illness.
According to a recent World Health Organisation (WHO) report, the main causes of cholera in Lusaka are associated with consumption of contaminated water, contaminated food, inadequate or poor sanitation. Poor hygiene practices have also been cited.
Under the circumstances, Government has taken drastic measures which on face value appear inconveniencing. Residents must strictly adhere to these measures to shoot down cholera!
With such a reality, it is just appropriate that Government has closed all markets in Lusaka and also banned street vending of any kind.
It is also befitting that gatherings of more than five people have been banned including Church programmes, funerals, social events in bars and weddings in cholera affected areas.
In this holistic approach, the residents must take centre-stage in the fight against the ravaging water-borne disease.
Information must be couched appropriately before it is disseminated to the public in a sharp and attractive manner.
It would be illogical for anyone person to start apportioning blame or to remain aloof at this critical instance when residents, local authority, health personnel, the media, civil society are expected to be neatly woven together in confronting the devastating outbreak.
Political undertones will only work to distract the team which includes men and women in uniforms, who have so far commandeered all vendors out of the streets.
In fact, President Edgar Lungu during his tour of selected areas stressed that the fight against cholera is not a political matter, but a concern of every citizen.
“This is not political issue. It concerns all the people. We need to work together. The Lusaka City Council and the ministry of Local Government should have long addressed some of these problems, but went to sleep,” the President said.
Zambia Army spokesperson Colonel David Sanene said during a ZNBC televised programme at the weekend that there is nothing strange about armed forces being involved in emergency operations.
Of major concern is the haphazard manner in which structures are being erected in sprawling townships and in unplanned settlements where shallow wells are dotted around sewer tanks.
Most densely-populated townships in Lusaka and other areas have pit-latrines which share the underground water with wells. Overflowing faecal matter finds its way into the wells and other sources of drinking water.
Waste disposal is as unplanned as the settlements themselves!
The markets and accompanying mountains of garbage are not a strange sight in these social amenities while public conveniences are in fact not convenient for both traders and customers who tip-toe on flooded floors.
Vendors had previously taken over the streets and shop corridors, trading in merchandise ranging from fresh fish, ready-toeat food, and electronic devices to clothing, much to the chagrin of shop owners and members of the public.
Worth noting is the fact that from the outset that the Government did not allow the willy-nilly type of street vending in which a large army of vendors literary took over the central business district (CBD) of Lusaka.
The State allowed controlled street vending which the local authorities have lamentably failed to manage. One would not fathom how such huge numbers of vendors get relief in the absence of public lavatories in the city centre of Lusaka.
It is also true that the mind-set among residents needs a change in terms of how they handle waste matter disposal. Some residents discard garbage in undesignated areas even when there is proper provision for waste disposal and management.
Thus ignorance and sheer “I don’t care attitude” lingers
among some residents not only in densely populated areas, but also in elitist communities.
Therefore, more information is required on cholera and other serious communicable diseases if the country is to effectively placate the perennial outbreak of diseases. What then constitutes cholera?
According to www.who.int, a WHO online publication, cholera is an acute diarrhoeal disease that can kill within hours if left untreated. It is caused by ingestion of food or water contaminated with the bacterium vibrio cholerae.
Most people infected with vibrio cholerae do not develop any symptoms, although the bacteria are present in their waste for 1-10 days after infection and are shed back into the environment, potentially infecting other people. The publication adds that researchers have estimated that each year there are 1.3 million to four million cases of cholera and 21, 000 to 143, 000 deaths worldwide.
As a long-term measure, uncontrolled street vendors must immediately be banned while more public conveniences should be established in all busy streets such as Cairo Road, Cha Cha Cha, Freedom Way and Lumumba roads.
Some street vendors have misconstrued Government’s decision to allow them to peddle their wares in an orderly manner to mean lawlessness. Motorists have not been spared by the vendors who surge at any automobile that slows down.
As an immediate intervention, councils countrywide must work towards designating specific areas for street vending where all facilities as such as lavatories must be established. Street vending must not be a haphazard affair!
Some markets have remained unoccupied years after they were constructed such as the New Nakadoli market in Chimwemwe Township in Kitwe. One of the reasons vendors troop to the street is to avoid paying market levy. Drainages in all areas must be clearly defined at the planning stage while blocked ones must be worked on and maintained on a regular basis.
The planning and development departments in all councils have erroneously narrowed their mandate to demarcating and giving out plots. They must widen the scope.
A multifaceted approach is key to the control of cholera and requires a combination of surveillance and monitoring of water, sanitation and hygiene, social mobilisation, treatment, and oral cholera vaccines to be used each time there is an outbreak.
In the meantime, authorities should continue with welldesigned health education programmes, chlorine distribution, contact tracing and environmental health monitoring and evaluation. Zambia must be more proactive by fully exploiting the cholera prevention and preparedness committees countrywide. It is sad that councils and other stakeholders only react when there is an outbreak.
The perennial outbreaks attract international media attention which reflects badly on the country which is in a hurry to attract more investment.
All residents and other stakeholders must now join the armed forces in shooting down cholera