Bernard Olayo
28 June 2009
opinion
AS THE DEATH TOLL FROM cholera continues to rise, we need to ask ourselves why the disease continues to kill Kenyans so late in our development history.
Our health experts know how to prevent the disease, and health education messages on how to prevent the disease are disseminated. Most people know these facts already.
In previous years, cholera outbreaks were mainly confined to Nyanza, Coast, Western and North-Eastern provinces. However, during the current epidemic, areas like Rift Valley, Central and Nairobi provinces have also been affected.
The response to the epidemic has been predictable, with bureaucrats underestimating the magnitude even as major hospitals reported many cases.
Most of the officials have focused their prevention efforts on health education with messages urging the affected communities to improve hygiene and sanitation standards.
In doing so, however, we have failed to acknowledge certain basic principles about the disease that could help us prevent future outbreaks.
Cholera is a disease of poverty and the increasing spread of the disease across the country is an indication of the rising number of indigents in our society.
The absence or shortage of safe water and sufficient sanitation, combined with a generally poor environment, are the main reasons why the disease is spreading so rapidly.
Typical at-risk areas include peri-urban slums, where basic infrastructure is not available, as well as camps for internally displaced people, where minimum requirements of clean water and sanitation are not met.
THE PROVISION OF SAFE WATER and sanitation is a formidable challenge, but it remains the critical factor in reducing the impact of cholera outbreaks and preventing future outbreaks.
With frequent water shortages in Nairobi and water vendors selling the vital commodity at prices above the reach of most poor people, Nairobi is now in the throes of cholera. It is not as though the people choose not to be clean; the problem is that they cannot afford it.
The post-election violence is an important factor in looking at the current epidemic since is left many displaced people vulnerable to cholera, especially in places like Rift Valley and Central provinces where the disease was previously non-existent. Cholera remains a global threat to public health and one of the key indicators of lack of social development.
Recurrent epidemics and the inclusion of new areas that were previously not affected should be a wake-up call to all, that the very poor among us are increasing and urgent measures need to be taken to save them from dying early from such preventable diseases.
Kenya is a signatory to the UN Declaration on the Millennium Development Goals. I know the country is not on track for achieving most goals, but unless the government takes measures to achieve goal No. 1 "Eradication of Extreme Hunger and Poverty", then we should prepare for worse outbreaks in the future.
Dr Olayo is a public health specialist.
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While the good Doctor does show his understanding of the causes of cholera, he fails to mention that most of this cases have increased dramatically since the Clashes of 2007 and 2008. The movement of people to congested areas where sanitation provisions are not adequate to support the influx of external and internal refugees is the primarily cause of most of the current cases of cholera. The government failure to address the internal refugee issues is the culprit and though the ministers and our esteemed leaders have seen it proper to award themselves hefty pays, the issue of the forgotten Kenyans in the internal should keep them awake since the existence of this refugee camps is an indication of a failed government. There is a moral and financial obligation for all kenyans to be aware that the suffering of a large segment of the Kenyans should be a kick to our bottoms to aspire us to demand better government, better provisions of basic physiological needs necessary to support life and above all to demand that greed as practised by our leaders causing harm to others should be prosecuted as crimes against humanity.