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Rumbidzayi Zinyuke-Health Buzz
Losing a loved one to any disease is incredibly hard to bear.
When it happens, people normally want to mourn together and mark the life of the departed through traditional funeral practices.
Some traditions demand that close relatives be responsible for washing and dressing the body of the deceased.
And as per the local culture, whenever people attend funerals, ‘kubata maoko’ is the utmost sign of showing compassion to the bereaved.
But as the current cholera outbreak continues to rage, death (which may or may not be related to the disease) has not stopped knocking on people’s doors, neither have the people stopped attending funerals.
These same funeral practices may actually heighten the risk of catching cholera from a dead body or from other mourners as relatives go about the traditions.
After three years of strict Covid-19 regulations, the world is slowly returning to normal, but the cholera outbreak requires people to ask the question ‘can we really return to normal?’
While it was hard to adjust to the Covid-19 regulations, people became accustomed to not greeting each other through handshakes, social distance became normal and everyone became more hygienic than ever.
But the World Health Organisation recently declared that the Covid-19 was no longer a global health emergency of concern, and governments have removed most, if not all, restrictions that came with the pandemic.
Suddenly, everyone does not feel the need to wash their hands regularly using soap or to sanitise as often as possible. Neither do people fear shaking hands at a funeral or any other gathering.
Everyone has returned to ‘normal’. And they do not want to hear about all those restrictions which made them feel stifled.
But can people safely return to normal when faced with such a problem as the cholera outbreak?
Zimbabwe has to date recorded 2 460 suspected cholera cases, 596 confirmed cases with 46 suspected deaths.
At least 16 deaths have been confirmed to be from cholera.
There could be more deaths or cases that have gone unreported, as was the case with Covid-19, where villagers would bury their relatives before health officials could determine the cause of death.
But that has not stopped people from gathering at those funerals or shaking hands as they commiserate with the families.
According to Dr Anthony Fauci, an American infectious diseases expert, people have to “break that custom, even after the Covid-19 pandemic”.
He says doing away with handshakes would not only prevent Covid-19, which is still being reported, but most likely help to prevent influenza and other infectious diseases.
This is why in Manicaland, authorities have placed emphasis on monitoring public gatherings such as funerals, which have been identified as one of the causes of the spike in cholera cases in the province.
According to the Ministry of Health and Child Care daily situation report, 1 030 out of the 2 460 suspected cases have been reported in Manicaland.
This is more than 40 percent of all suspected cases, making the province one of the hardest hit areas.
Manicaland Provincial Medical Director Dr Munyaradzi Mukuzunga recently flagged funerals as a possible source of the increase in cases.
“We are putting an emphasis on monitoring of gatherings as well as funerals because we realised that the rise in cases was actually attributed to funerals which we were not aware of and the communities were also not aware that the person had died of cholera. That became a transmission area,” said Dr Mukuzunga.
“We are happy that both the community and health workers are picking up the cases which means people can access healthcare early and avoid complications and deaths.”
While cholera is treatable, people die owing to lack of knowledge about the disease and what to do when they fall sick.
How does cholera spread?
Cholera is usually spread through contaminated water and is associated with poor water and sanitation conditions.
Water that is contaminated with human faeces is the most common source of the illness, and humans can be exposed directly (by drinking contaminated water) or indirectly (by eating contaminated food). Hands that are soiled can also contaminate food and water.
Therefore, shaking hands at a funeral or wedding then going on to prepare or eat food without washing can make someone sick. That is why it is important to regularly wash hands with soap before and after handling food.
What are the common symptoms of cholera?
The symptoms of cholera typically occur within two to three days of ingesting contaminated water. Some people will have a mild illness that does not differ from other types of viral diarrhoea.
If a person experiences severe symptoms, they typically have a sudden onset of profuse, watery diarrhoea.
The flecks of mucus in the stools are what led to the description of “rice water” diarrhoea. Vomiting may occur and some people (especially children) may develop a fever. If the diarrhoea is severe, symptoms of dehydration rapidly ensue.
What is the best treatment?
The most important treatment is rehydration (replacing fluids lost). Adequate rehydration is a life-saving measure. In severe cases, rehydration will require intravenous fluid (a drip).
In mild cases, rehydration can be achieved with an oral rehydration solution that can be drunk. These solutions are available at pharmacists and clinics.
How can I protect myself?
In areas of outbreak, it is important to identify the source of contamination. Handwashing remains essential to prevent the spread of the disease.
The use of safe water is key. Boiling water or treating it with chlorine tablets is important if water safety is a concern.
The water crisis in most cities in the country has resulted in increased borehole drilling but for areas like Harare, some of the boreholes have been declared unsafe as they contain traces of E. coli and coliform.
This has made most of the drinking water sources unsafe, leaving the option to use City Council water, which has also been suspected of not being entirely clean.
Harare City has decommissioned several boreholes and installed inline chlorinators to ensure water is treated at the point of collection making it safe to drink, but there are many others that are still in use without the chlorinators.
In Manicaland, authorities have also rehabilitated some water sources in affected areas while water quality monitoring has also been ongoing to ensure that the water sources being used by communities are safe.
Cabinet last month announced that the Water and Sanitation Hygiene sector was distributing non-food items including aqua tabs, buckets and soap as part of first-line defence in cholera prevention.
The sector was also involved in hygiene promotion in affected areas, with 500 community health volunteers having been trained on cholera prevention and management.
To shake or not to shake?
Handshaking is part of the local culture and it will still be there long after these diseases are conquered. As it was during the Covid-19 pandemic, people need to remain vigilant during the cholera outbreaks and always ensure their safety first.
Be that as it may, there are times when shaking hands may be unavoidable, it remains important for communities to be aware of the risks and how to avoid them.
Steps should be taken to reduce the risk of cholera spreading before and during a funeral or any other gathering.
Engaging health professionals should also help with the respectful and safe burial to prevent further spread of cholera.
However, being safe is a personal choice.
Because we are human and we always fall back to our traditions, being aware of the risks and how to protect oneself will help people stay away from practices that can spread the disease.
After all, prevention is better than cure.
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