Battling recurrent cholera

TRADERS have been urged to ensure they prepare food in sanitary conditions. Right, huts built around the marshlands of Lukanga.

THE moment Lukanga Swamp became a perennial source of cholera contamination in Central Province, public health came under threat in the region.

Lukanga River is a source of water for some villages in Kapiri Mposhi, Ngabwe and Chibombo, but like any breeding water resource for fish, Lukanga Swamp is prone to pollution from unregulated human activities.
Central Province acting principal fisheries officer Stanslous Nyirenda says the Lukanga Swamp covers an area of 2,600 square kilometres and is shared by Kapiri Mposhi, Ngabwe and Chibombo districts.
The swamp produces a lot of fish such as breams, barbell and also Kafue Pike. Mr Nyirenda says fish production in Lukanga Swamp is about 1,200 and 2,600 tonnes per annum. Fishermen and their families have set permanent camps in the swamps where they live in unsanitary conditions, of course without toilets.
Mr Nyirenda said at the peak of the fishing season, the villages around Lukanga Swamp are inhabited by about 2,500 to 3,000 people.
When cholera breaks out in Lukanga Swamp, it normally spreads to Chibombo and Kabwe, usually through Makululu township, an unplanned settlement.
“There are fishing villages and camps. The problem that is in these fishing camps is that there are floating islands which don’t have sanitary facilities. Fishermen help themselves (relieve) on these floating islands,” Mr Nyirenda says.
The communities around the swamps depend on Lukanga River for drinking water, but the water body is vulnerable to contamination with vibrio cholerae due to poor hygiene in the swamps.
Mr Nyirenda says it is good that no case of cholera was recorded in the swamps last year after preventive measures that the Ministry of Health implemented to protect lives.
An outbreak of cholera negatively affects fish production, livelihoods of fishermen and the welfare of their families.
Every year, fishermen and their families spend months in the Lukanga Swamp, therefore contaminating water and threatening public health.
Water contamination arising from open defecation in the fishing camps is what triggers cholera outbreaks in the swamps.
After polluting the environment with faecal matter, the fishermen and their families would draw water from the swamps for drinking and other domestic uses.
When there are cholera cases in the swamps, Kabwe becomes an epicentre because the fishmongers normally trade from the markets in Makululu, New Kasanda, Kamanda and Town Centre. As for Makululu, apart from the Lukanga Swamp link, the unplanned settlement has shallow wells sitting near pit latrines.
The latest cholera outbreak in 2016 affected 30 people and claimed two lives.
But the current cholera outbreak which has affected over 3,000 people in Lusaka and claimed over 70 lives, has not affect Lukanga Swamp.
Here is the reason why. The cholera vaccine and high standards of hygiene have helped to keep cholera at bay in the Lukanga Swamp and districts where epidemics have become perennial.
The first dose of the Oral Cholera Vaccine (OCV) was administered to people in the swamps from October 28 to November 5, 2016, and the second dose from November 26 to November 30.
The target population was from one year of age upwards, among 5,000 people who are living in Waya catchment area.
Apart from vaccinating people, the Government went on to disinfect some areas in the swamps, distribute chlorine and sensitise people on cholera preventive measures.
The World Health Organisation (WHO) also provided two boats for monitoring and surveillance programmes in the swamps.
Central Province medical director Rosemary Mwanza says cholera has been contained in the swamps due to pragmatic interventions.
Dr Mwanza says people have learnt to prioritise good hygiene through sensitisation campaigns by the health teams.
So far, the Lukanga Swamp is cholera free, but to maintain this status, the people in the surrounding villages need to stop practicing open defecation.
And perhaps, the huts built around the wetlands should be razed and fishermen and their families should shift camp to the dry land.

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