BY OLANDASON WANYAMA
Moroto district is on the brink of a severe cholera outbreak having survived the wrath of Hepatitis E just three months ago. The epidemic is now going into its second week and shows little sign of slowing down. It has quickly spread into all 12 settlements of Kanakomol village in Nadunget sub-county in Moroto district, killing three people and infecting 70 others.
The village, located five kilometres from the main Moroto Hospital, is home to about 700 Karimojong. Health authorities say the disease first struck towards the end of April, killing three people at a go before its confirmation by the Ministry of Heath last week.
Another 21 villages have also registered cholera cases in the last one week with records showing that 70 are admitted.
Some of the villages that are worst hit include; Campswahili, Nawanatau, Kakoliye, Nachogorom, Nakapelimen, Army barracks, Naitakwae, Nachele, Kambihizi. Kanakomol has the highest number of infections.
Cause of the epidemic
Andrew Oryang, the LC1 of Kanakomol village, attributes the outbreak to lack of clean water for human consumption. â€œOur two boreholes drilled by Moroto district authorities broke down a year ago. Since then, we have never had clean water,â€ he says. â€œA year ago, we collected sh150,000 and a bull for the Italian Co-operation and Development but nothing has been done.â€
The sh150,000 was community contribution towards the project and as it is in the Karimojong tradition, the bull was an incentive for the project implementers.
Oryang adds that cholera could also be due to people defecating in the dry river bed since most of them lack pit-latrines.
â€œWhen it rains, the water carries the waste to the sources situated on the river bank as it meanders through the villages,â€ he says.
Michael Omeke, the district health officer, says the outbreak is due to lack of safe areas of waste disposal. â€œMany villages do not have pit-latrines around their settlements.â€
Spread by water contaminated with human excrement, cholera is a result of not having safe water to drink and sanitation systems to dispose of waste away from the water sources.
â€œWe are helping respond to this worrying situation, but we continue to face numerous challenges,â€ Omeke says. â€œThere is a shortage of cholera kits and other essential medical supplies, rehydration supplies, antibiotics and gloves.â€
He adds that cholera could spread quickly due to the regular movement of a highly nomadic population and unprotected water sources which are in the interior and inaccessible.
â€œCholera may spread to the surrounding villages if authorities do not sensitise the residents,â€ Omeke warns.
Omeke cites inadequate beds and supplies for patients and limited skilled human resource as some of the hurdles the district is facing in the fight against the epidemic.
He says interventions remain localised in town. â€œThere is need for preparedness in the peripheral health units to avert possible negative outcome from emergency.â€
Omeke appeals to the Government for more funding in order to fight the outbreak.
Basic facts on cholera
-It is caused by an infection in the intestines and can kill in hours.
-Symptoms including severe diarrhoea which manifests in as little as two hours or up to five days after infection. This can lead to extreme dehydration and kidney failure.
-About 80% of the people infected with the cholera bacterium never develop symptoms. However, the bacterium stays in their faecal matter for seven to 14 days, leaving others at risk of infection.
-Of those who develop symptoms, 80% are mild to moderate while between 10% and 20% develop diarrhoea.
If left untreated, about 50% of cholera cases can be fatal.
Prevention and treatment Most cases (80%) can be treated through oral rehydration salts. These salts reverse dehydration and restore potassium levels following the onset of acute diarrhoea.
The most severe cases, in which the patient is extremely dehydrated, can be treated through intravenous fluids and antibiotics.
Provision of safe water and sanitation services, community outreach and awareness campaigns that stress the importance of personal hygiene, especially hand-washing, are essential in curbing cholera.
Always focus on the underlying causes of water and sanitation-related deaths, like water availability, water quality, waste management and community hygiene education, to best protect at-risk populations from cholera and similar illnesses.