Invoke the Public Health Act to eliminate cholera
Oct 28, 2009
AS Kampala suburbs and some parts of the country brace for the cholera epidemic, Ugandans and the powers that be seem to react as if it is normal. Cholera is a bacterial infection of the food canal acquired through eating or drinking faeces — fresh at w
By Dr. Myers Lugemwa
AS Kampala suburbs and some parts of the country brace for the cholera epidemic, Ugandans and the powers that be seem to react as if it is normal. Cholera is a bacterial infection of the food canal acquired through eating or drinking faeces — fresh at worst.
If cooked, no infection would occur in the individual. This is, therefore, not to say that all those suffering from cholera have engulfed or imbibed fresh human excreta and not any other animal’s because cholera is essentially a disease of man only.
In the olden days, cholera was so rare in Uganda that even medical students at Makerere University Medical School had one cholera bed that was used for demonstrations. The disease was, however, known to be endemic in the densely populated poor communities in India and not anywhere in Uganda then.
Uganda has now inherited India’s position of the 19th Century in addition to other backward infections like jiggers. One simple question is: Why has Uganda been relegated to being the pearl of cholera?
Because simple by-laws enshrined in the Public Health Act, such as simple personal hygiene have been neglected. People defecate in rivers and other water bodies, whence their excreta is adulterated and eventually consumed unboiled by those upstream.
Food handlers sell food in soil on road sides or near broken sewage systems with abandon. Kalerwe market or landing sites on our lakeshores are cases in point. Hoteliers rarely have their staff medically examined.
The African culture of hand shaking, with the hand washing habit being rare in most populations, especially after toilet use, transmission of oral faecal diseases is apt to be rampant.
As lately as the 1970s, the local village chief (Mukungu) would ensure presence and use of a latrine, drier for utensils and availability of a garbage disposal pit.
The village chief would even insert a 10 to 15 foot reed into the pit latrine to ensure that household members box their stool therein. And that is why cholera was a fairy tale at that time. Today, cholera is common because we have flouted the Public Health Act.
Where are the authorities in this country embarrassing scenario of the 21st century when the country is nursing backward diseases like cholera, dysentery and jiggers?
Using the Public Health Act, the Government should:
Re-invigorate and facilitate the work of health inspectors and assistants at every sub-county
Train all LC1s in basic hygiene and empower them to take legal action against households without utilities for basic hygiene.
Empower enforcement officers to arrest anyone selling food staffs in local markets without basics like stalls.
Have all food handlers medically examined every year.
Re-introduce village, sub-county and county hygiene competitions like it used to be in the 1960s and 1970s. These competitions not only covered health matters but food security by ensuring granaries in every homestead, a point Ugandans have missed hence becoming the pearl of World Food Programme dependants.
Tree planting was also captured under this concept of health competitions. For example, no household member would encroach on food in any granary or cut a tree without the knowledge of the local chief. Under the same concept, registration of births and deaths took place at the local level, hence giving vital statistics for the country.
Therefore, unless the Government and all Ugandans wake up, Uganda will further plunge into an abyss of backward diseases such as cholera, which it is now nursing.
The writer is a medical doctor
AS Kampala suburbs and some parts of the country brace for the cholera epidemic, Ugandans and the powers that be seem to react as if it is normal. Cholera is a bacterial infection of the food canal acquired through eating or drinking faeces — fresh at worst.
If cooked, no infection would occur in the individual. This is, therefore, not to say that all those suffering from cholera have engulfed or imbibed fresh human excreta and not any other animal’s because cholera is essentially a disease of man only.
In the olden days, cholera was so rare in Uganda that even medical students at Makerere University Medical School had one cholera bed that was used for demonstrations. The disease was, however, known to be endemic in the densely populated poor communities in India and not anywhere in Uganda then.
Uganda has now inherited India’s position of the 19th Century in addition to other backward infections like jiggers. One simple question is: Why has Uganda been relegated to being the pearl of cholera?
Because simple by-laws enshrined in the Public Health Act, such as simple personal hygiene have been neglected. People defecate in rivers and other water bodies, whence their excreta is adulterated and eventually consumed unboiled by those upstream.
Food handlers sell food in soil on road sides or near broken sewage systems with abandon. Kalerwe market or landing sites on our lakeshores are cases in point. Hoteliers rarely have their staff medically examined.
The African culture of hand shaking, with the hand washing habit being rare in most populations, especially after toilet use, transmission of oral faecal diseases is apt to be rampant.
As lately as the 1970s, the local village chief (Mukungu) would ensure presence and use of a latrine, drier for utensils and availability of a garbage disposal pit.
The village chief would even insert a 10 to 15 foot reed into the pit latrine to ensure that household members box their stool therein. And that is why cholera was a fairy tale at that time. Today, cholera is common because we have flouted the Public Health Act.
Where are the authorities in this country embarrassing scenario of the 21st century when the country is nursing backward diseases like cholera, dysentery and jiggers?
Using the Public Health Act, the Government should:
Re-invigorate and facilitate the work of health inspectors and assistants at every sub-county
Train all LC1s in basic hygiene and empower them to take legal action against households without utilities for basic hygiene.
Empower enforcement officers to arrest anyone selling food staffs in local markets without basics like stalls.
Have all food handlers medically examined every year.
Re-introduce village, sub-county and county hygiene competitions like it used to be in the 1960s and 1970s. These competitions not only covered health matters but food security by ensuring granaries in every homestead, a point Ugandans have missed hence becoming the pearl of World Food Programme dependants.
Tree planting was also captured under this concept of health competitions. For example, no household member would encroach on food in any granary or cut a tree without the knowledge of the local chief. Under the same concept, registration of births and deaths took place at the local level, hence giving vital statistics for the country.
Therefore, unless the Government and all Ugandans wake up, Uganda will further plunge into an abyss of backward diseases such as cholera, which it is now nursing.
The writer is a medical doctor