Online Reporter
CHOLERA is a widespread disease with cases in most African countries and even if it can be eliminated in one country temporarily, it can spread from a neighbour.
President Mnangagwa wants a unified approach involving a multi-faceted and united approach to dealing with the disease. Other voices in the region have also echoed similar sentiments.
The spread between countries can be as simple as someone carrying some contaminated fruit, or even being ill themselves and contaminating a pond as they cross the border.
But since the only vector for the bacteria that cause cholera are humans, if there was no one suffering from the disease there would be no cholera to transmit.
Eliminating cholera is not that simple, but it is quite possible. For example, the disease was successfully eliminated from Europe and the Americas, even though there are still some very unsanitary areas in those continents and water authorities have been fined hundreds of millions of dollars for dumping raw sewage into rivers.
But because no one is ill from the disease there are no bacteria to breed in the insanitary conditions that still persist.
But cholera used to be a big killer in these continents in the 19th century, with the overthrown King Charles X of France dying of it in 1836 and President James Polk of the United States a few months after leaving office in 1849.
Epidemics of cholera swept through those rapidly growing European and American cities in the 19th century, killing thousands sometimes every year.
It was beaten back once the germ theory was accepted and the cholera bacteria were among the first identified. Engineering did most of the work by providing better water supplies and putting in the sewers, necessary since antibiotics that cured cholera were still half a century in the future.
Cities like London and Paris are still heavily reliant on the sewers late Victorian engineers dug and drilled as it became obvious that better infrastructure was needed. So even when these now need vast new investment, they did help kill off the disease.
So when we are dealing with an outbreak, as Zimbabwe is now in some areas and other African countries have been facing, we need to go beyond just treating those that fall ill, important as that is, and adopt the whole-of-Government approach stressed by President Mnangagwa in his address to the high level meeting in Zambia called by President Hakainde Hichilema.
Cholera has been identified as a disease of underdevelopment, which to some extent is true, but even poorer countries can combat the illness by concentrating on eliminating risks and providing solutions and resources for ordinary people.
With the better knowledge we have these days, we can for modest effort and finance, concentrate development where it does the most good, and for a lot of public health a safe water supply and better sanitation is not that pricey.
Zimbabwe, for example, sees the village borehole programme as an important medium-term solution to eliminating cholera and a host of other illnesses as well as upgrading the quality of life significantly for millions of people.
Once every family has access to adequate safe water we can start working out the small adjustments that might still be needed to eliminate cholera, or at least confine an outbreak to a single family.
Ensuring that all households in the country have access to clean water for drinking and cooking is extremely effective, hence the drilling of emergency city boreholes being ordered by the President as well.
Drilling boreholes in areas where cases appear, sometimes by accelerating the present programme, has proved effective in pushing back outbreaks, along with better health education.
Better sanitation is helpful, but people who are ill are not necessarily able to use that sanitation, hence the need to keep drinking and cooking water clean and safe and making sure that everyone uses that clean water to wash food like fruit and vegetables.
There can be an unfortunate feeling of immunity by some better off people, that they will not contract cholera. And then you get cases in northern Harare suburbs, largely because people have been careless and felt it could not happen in their area.
It is this ease of transmission between people who are only moderately careless that makes the unified African approach so important. There are no really safe areas so long as there are unsafe areas.
Emergency vaccination is seen as useful.
The vaccine coverage is only around six months, but that can be very helpful when eliminating cholera from a particular area, especially if those months are used constructively to create safe water sources, such as by drilling emergency boreholes, and cleaning up the environment and trying to sort out the sanitation.
A united African programme, as with so many public health programmes, is needed to defeat cholera. Only a handful of African countries are islands; the rest of us have neighbours and usually a lot of neighbours.
Diseases such as cholera and malaria need to be eliminated in our neighbours as well as in Zimbabwe if we are to be safe.
And we should not forget that our neighbours want action here, so they win, just as we want action there.
Fortunately, more and more countries now see and welcome the need for united and unified approaches, and experts are encouraged to talk with others and work out ways of acting together to build up successes.
