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Writes Community Working Group on Health (CWGH)
The Community Working Group on Health (CWGH) commends the government for taking bold and tangible measures to address major public health challenges through its supreme law, the Constitution, the Public Health Act, and indeed other legal and policy frameworks. There have also been corresponding structural arrangements in the government-wide mechanism to include the presidential declaration as we saw during COVID-19, previous cholera and measles epidemics, the inter-ministerial and multisectoral formations, the national cholera taskforce, the interagency coordination committee in line with ensuring adequate attention to all the determinants of the major public health challenges. In terms of cholera, the country took a severe beating during the 2008/9 epidemic but quickly learned key lessons to effectively detect and control the subsequent ones, which became fewer, less frequent, and less intense.
Targeted vaccination also ensured that hotspots were doused and some population immunity prevented further infections and severe disease. We applauded the crafting of the 2018-28 National Cholera Elimination Road-map; the 10-Year Promise, which had brought together all sectors and entities influencing cholera and its determinants to jointly address the menace once and for all.
We are therefore concerned at the lack of attention to the effective implementation of this impressive paperwork. It has translated into avoidable illnesses and deaths. To this end, the CWGH urges the government to urgently ensure adherence to its Constitutional, legal, and policy provisions on cholera and related diseases. We want to see long-lasting and sustainable mechanisms to stop the current and future outbreaks of cholera so that we regain back our dignity and health. Cholera has already claimed an innocent life in the Kariba district of Mashonaland West province. The country cannot afford a repeat of the 2008/9 cholera disaster that saw over 4,000 people succumbing to the contagious disease, in a situation that could have been prevented or avoided.
The onset of the rainy season, the persistence of water and power challenges, poor sanitation, and the piling and uncollected cabbage in most towns and cities make it more urgent than ever for the government to take definitive measures before the country plunges yet again into an uncontrollable outbreak. This is at a time when the healthcare services have been struggling.
While CWGH acknowledges the current government efforts to contain the spread of the disease by sharing vital preventative information among communities and distributing Personal Protective Equipment (PPEs), we strongly feel that such actions are piece-meal and divergent from the comprehensive cholera elimination plan which sought to address the root causes of the epidemic.
We have many questions to ask, especially why creating more health problems in a system that can hardly treat even simple illnesses anymore? What about the saying “prevention is better than cure” when most cities and towns hardly adhere to the laws and standards for adequate safe water, waste management food standards, and housing? We have whole housing developments inhabited without water, sewerage, and waste management, water quantity and quality never checked nor documented, and beverages and foods now just prepared and sold by unapproved persons in unlicensed premises. All these contraventions of the Public Health Act, bylaws, and other statutes place the public at great health risk and exposure to cholera and related diseases.
We call upon the government to reconsider and reprioritize population health and start effective implementation of the proven strategies that address the root causes of a cholera outbreak. It is practically illogical to treat cholera patients and return them to the same deplorable conditions that caused them to fall ill in the first place.
There is a need to address the social determinants of health as elucidated in the Constitution and said legal frameworks and the 10-Year Elimination Plan. CWGH calls for rekindling of the multi-sectoral coordination to eliminate cholera by increasing access to clean and sustainable water supply at the household level including access to basic sanitation facilities and providing hygienic living conditions.
It should be pointed out that access to clean water, sanitation, and hygiene efforts are much more effective when people are aware of the risks as well as what they can do to prevent illness. Hygiene promotion efforts should therefore be coordinated and multi-sectoral with the communities taking centre-stage. Currently, the communities continue to bear the brunt of having to scrounge for water, manage their human waste, and household waste, and still care for the increasing numbers of sick relatives and pay huge out-of-pocket to systems that provide poor service. It’s a crime against humanity.
The cholera outbreak of 2008-2009 was a marker of the need for investment in water and sanitation infrastructure. Sadly, we continue to lose lives to a primitive and medieval disease like cholera that is avoidable, preventable, and treatable!
