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Grappling with Lukanga Swamps cholera outbreaks

A MAKESHIFT house built at one of the fishing camps in the Lukanga Swamps in Kapiri Mposhi. PICTURE: CENTRAL PROVINCE MEDICAL OFFICE

“LUKANGA Swamps have become a sewerage pond. At the moment, we are eating fish from a sewer.”
This is how Kabwe Municipal Council director of public health Paul Mukuka recently described the sanitation situation in the Lukanga Swamps in Kapiri Mposhi district following the latest outbreak of cholera.
Mr Mukuka expressed these worries at a recent Central Province epidemic preparedness prevention and control management committee meeting held in Kabwe where various stakeholders deliberated on what could be the lasting solution to the recurrent outbreaks of cholera in the swamps.
In justifying why an early fishing ban needs to be imposed as a plausible measure to control cholera in the fishing camps in the swamps, Mr Mukuka said other than in the swamps, the disease is also a threat to human life in other areas in Kapiri Mposhi, Kabwe and Chibombo districts.
“We can’t talk of sanitation in the Lukanga Swamps, we can’t talk of putting up toilets there, there is nowhere to build toilets,” he pointed out.
Mr Mukuka said an early fishing ban could be a practical solution to the frequent outbreaks of cholera in the Lukunga Swamps.
In 2013, Kapiri Mposhi recorded 47 cases of cholera, 41 cases in 2014 and there was no outbreak in 2015.
Most of the cases were recorded in the Lukanga Swamps.
Since September 11 this year, Central Province has recorded 36 cases, and of these, 27 have been documented at Waya Rural Health Centre in Lukanga area, five in Kapiri Mposhi urban and three in Kabwe.
Twenty-seven patients were admitted to Waya Rural Health Centre, two died while 25 were discharged after undergoing treatment.
According to the World Health Organisation, cholera is an acute intestinal infection caused by ingestion of food or water contaminated with the bacterium called vibrio cholera.
Cholera spreads through contaminated water and causes severe diarrhoea and dehydration. Being an acute diarrhoeal ailment, cholera can kill the affected person within hours if left untreated.
“Let’s have an early [fishing] ban…that is the solution to this old problem,” Mr Mukuka said.
Kapiri Mposhi public health officer Nephat Banda said 40 suspected cases of cholera were reported in the district out of which 32 were confirmed cases of the water borne disease.
The first victim was a male adult. The source of the outbreak was Chibeke, one of the 12 lagoons in the Lukanga Swamps.
“The cause of this outbreak is because the water [in the swamps] is highly contaminated,” Mr Banda said.
Cholera outbreaks in Chibombo have been attributed to the district’s location and, Chitanda, Makoka, Twalumba, Ipongo and Itumbwe are the areas prone to epidemics in the district.
As part of efforts aimed at preventing cholera, Agnes Phiri, an environmental health technician in Chibombo, said traditional leaders around the Lukanga Swamps have been engaged on the matter.
“We have continued with health education and promotion. There is need for active surveillance by community-based volunteers who are based in the fishing camps,” Ms Phiri said.
Whenever there is an outbreak of cholera in the Lukanga Swamps, Kabwe, which last recorded an outbreak in 2012, is usually put on alert.
“The initial two cases experienced in April 2016 by the district were linked to the Lusaka outbreak,” Kabwe district environmental health technician Nona Wakung’uma said. “From the recent outbreak, all the four cases were from Lukanga Swamps.”
Ms Wakung’uma said the early closure of the Lukanga Swamps will be an important step in preventing the outbreaks of cholera in Kabwe.
She also called for collaboration among stakeholders such as Lukanga Water and Sewerage Company, disaster management and mitigation unit, Kabwe Municipal Council and line government ministries in preventing any possible outbreaks of the disease.
Central Province surveillance officer Shadrick Mufwaya said the recurrent outbreaks of cholera in the Lukanga Swamps is a serious matter.
“There is no land [in the swamps], it’s water and reeds all over,” Mr Mufwaya said. “They [fishers] don’t have where to build toilets and there is little that can be done to provide sanitation facilities for them.”
Cholera in the Lukanga Swamps usually breaks out between July and September when the water level is low.
With such a scenario, bacteria accumulate in the shallow water.
Central Province deputy permanent secretary Felix Mang’wato lamented that cholera has remained a serious problem in the Lukanga Swamps.
“The normal fishing ban is there to give fish enough time to breed but we are also trying to control cholera with the fishing ban,” Mr Mang’wato said.
As observed by health authorities, Mr Mang’wato said there is need to pay attention to the period cholera breaks out in the swamps.
Mr Mang’wato said it is evident that an early fishing ban needs to be implemented because it is a lasting solution to addressing cholera in the Lukanga Swamps.
“We have noted that from July to August and onwards, that’s when we start having cholera cases in the Lukanga Swamps.”
The countrywide annual fishing ban starts on December 31 through to the last day of February.
Mr Mang’wato said it is important to take appropriate measures to reduce cholera outbreaks in the swamps because the disease spreads to Kabwe, Kapiri Mposhi urban and Chibombo.
“Water samples were taken from various points in the swamps and all of them indicated high bacterial levels. The outbreak is attributed to poor sanitary conditions and lack of clean water,” Kabwe district medical officer Tiza Mfune said.
Dr Mfune said the recent outbreak in the province affected fishermen and fish traders, and the cases recorded in urban Kapiri Mposhi and Kabwe are linked to the outbreak in the Lukanga Swamps.
Kapiri Mposhi district commissioner Peter Mwiinde blamed the fishermen for outbreaks of cholera in the Lukanga Swamps because they do not observe hygiene standards.
“I am advising fishermen in the swamps that they should observe the highest levels of hygiene to avoid any outbreak of cholera,” Mr Mwiinde said.
He said health officers in the district face numerous challenges in conducting healthcare programmes in the Lukanga Swamps because of lack of a boat.
Provision of a boat will be a positive development in carrying out health sensitisation programmes in the swamps and this will help prevent cholera.
“I am appealing to the Ministry of Health to provide our district medical office here in Kapiri Mposhi with a boat for operations in the Lukanga Swamps,” he said.
Following the outbreak, the department of fisheries which also polices the annual fishing ban was assisted with a boat which was used to distribute chlorine and carry out health sensitisation programmes.
The Ministry of Health quickly responded to the outbreak by providing technical support to control the epidemic.
UNICEF provided testing kits and liquid chlorine which was distributed in all the fishing camps in the swamps.
The Ministry of Health also moved in with the cholera immunisation programme targeting 5,000 people in the fishing camps as one of the measures to contain and prevent any further outbreaks.
“We have started the immunisation in fishing camps in the Lukanga Swamps. We are targeting to immunise 5,000 people,” Central Province medical officer Rosemary Mwanza said.
Dr Mwanza said cholera in the swamps has now been contained because of the medical officers’ quick response to the outbreak, treatment of patients, disinfection of affected areas, distribution of chlorine and intensification of health sensitisation programmes.
“Right now, we are distributing chlorine in the fishing camps and we are emphasising on hygiene as one of the measures to stop cholera,” Dr Mwanza said.
As for the early fishing ban, stakeholders feel it is a positive step in controlling and preventing recurrent outbreaks of cholera in the Lukanga Swamps, urban Kapiri Mposhi, Chibombo and Kabwe districts.

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