THE BLOG

To End Cholera By 2030 We Must Start With The Basics Of Clean Water And Sanitation

11/10/2017 09:05

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Early last year, a schoolboy named Wahiba slurped down a bowl of watery porridge in his school in the slum of Kibondemaji in Dar es Salaam, Tanzania, before racing to morning lessons.

By midday, he was doubled over in pain and home, vomiting in the courtyard. And by nightfall, he was barely able to walk with his father to the nearest health clinic, where he was promptly referred to a larger centre and put on intravenous fluids and antibiotics -- no doubt saving his life, and adding him to the list of an estimated 2.9 million cholera cases every year. Every single one of those cases is completely preventable.

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Here in the UK, we think of cholera as a Victorian disease, banished to history books by modern toilets and sewerage systems, and safely managed drinking water flowing from our taps.

But around the world, in crowded city slums and in remote communities which are days from proper healthcare, it's an illness that is real and recurring.

We associate cholera most with natural disasters and those fleeing, or trapped in, conflict, and indeed the present-day terrible outbreak in Yemen falls into that category.

What doesn't gain headlines are those smaller and often predictable outbreaks which occur in the same cities, even the same streets, year after year - usually during each rainy season.

Cholera results in diarrhoea and heavy vomiting, which can kill its victims in a matter of hours. Quick medical intervention with intensive rehydration can save lives - but that requires families to have the understanding, ability and finances to act, and medical professionals to recognise the symptoms quickly and respond accordingly.

The tragedy here is that virtually every cholera death is preventable. The UK physician John Snow stopped a cholera outbreak in London more than 150 years ago simply by removing the handle from a contaminated water pump, thereby taking it out of service. The city's first sewerage system followed not long after. This same approach can solve many of the other outbreaks in modern times.

Last week during a high-level meeting in France, for the first time ever governments, NGOs and donors committed to dramatically reducing cholera outbreaks by 2030 by trying to prevent them and prepare for them, as well as respond to outbreaks better. The 'road map' -- launched by the Global Task force for cholera control (GTFCC) -- has the ambitious goal of ending 90% of cholera deaths in the next 13 years.

The only way to make good on this promise is to ensure communities which suffer from recurring cholera outbreaks have access to clean water, decent sanitation and good hygiene practices including handwashing with soap.

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We've heard a lot this week about the importance of the cholera vaccine; this is an important method of controlling outbreaks. But there is no substitute for prevention through long term and sustainable water and sanitation infrastructure.

In Bangladesh, where WaterAid is working with partners to deliver emergency water points, latrines, shower facilities and hygiene kits to Rohingya refugee camps near Cox's Bazar, there is a race against the clock to ensure these services are delivered, alongside a mass shipment of cholera vaccine.

And in communities like Wahiba's, which is unlikely to make any headlines at all, a simple clean water tap has kept his family's household free of diarrhoeal disease over the last rainy season - a promising step towards ending the threat of this age-old killer.

As the cholera road map is launched, we applaud their vision. But it will take leadership, financing, and coordination to realise this goal.

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