Global solutions on cholera and other waterborne diseases.

Costa Matyavira.

 What is littering?

Littering is the improper disposal of waste products. It is largely a deliberate act. According to a study by Keep America Beautiful (KAB), litter may include anything like cigarette butts, bags, wrappers, beer and wine bottles, plastic bags, plastic bottles and construction waste. Litter is a breeding ground for bacteria so it facilitates the spread of diseases.

What is raw sewage?

According to United Nations Environment Program(UNEP)), raw sewage is untreated sewage which may contain water, nutrients, solids, pathogens(including bacteria, viruses and protozoa), helminthes( such as intestinal worms and worm-like parasites), oils and greases, runoff from streets, parking lots and roofs, heavy metals( like lead and mercury} and toxic chemicals such as pesticides. Raw sewage discharged into rivers and oceans is a threat to human health and the environment.

 What is cholera?

The World Health Organization (WHO) states that cholera is an acute diarrheal disease caused by eating food or drinking water contaminated with the bacteria vibrio cholerae. Cholera transmission is closely linked to inadequate access to clean water supplies and sanitation facilities. Providing safe water sources and basic sanitation is a measure of cholera control.

How do litter and raw sewage propagate the spread of cholera and other waterborne diseases such as dysentery and typhoid?

Litter consist of Pampers (disposable diapers). Pampers contain the faecal matter of babies. Bedridden adult patients with diarrhoeal diseases at home and in hospitals use diapers.   The waste wrapped in these pampers and diapers may contain the bacteria that cause cholera and other waterborne diseases. If it rains the dirty pampers are washed away into the rivers.

Scenario 1

Suppose there is improper disposal of garbage and wastewater in Gweru where the Tokwe River originates, it means small rivers around Gweru town transport the waste into the Tokwe River and eventually to Tokwe Mukosi Dam in Masvingo which is the largest inland dam. Remember that Tugwi/Tokwe River is a tributary of the Runde River. All its waters are poured into the Runde River and finally into Save River, then into Mozambique. Almost everyone using the Tokwe River, Tokwe Mukosi Dam, Runde and Save River as water sources will be infected.

Scenario 2

Imagine there is reckless disposal of litter and raw sewage in Zambia where the Zambezi River originates. The infected waters will flow from Zambia to Angola, along Namibia’s northeastern border and the northern border of Botswana, then between Zambia and Zimbabwe and finally into Mozambique. Whatever cholera control measures are taken by countries downstream (Zambia and Mozambique) they will never be effective if countries upstream (Zambia and Angola) continue to dispose of water and litter in rivers. A large number of Africans are going to be infected by bacteria that cause cholera and other water-borne diseases.  Such instances might be happening along the Nile River in Africa. The Nile River supplies Egypt, Sudan, Ethiopia, Uganda, DRC, Kenya, Tanzania, Rwanda and Burundi.

In addition, some people in towns and rural areas defecate and urinate on river banks. This fuels the spread of cholera, particularly in the rainy season. It is clear that human ignorance of proper disposal of litter and raw sewage is the major contributor to water pollution and the spread of water diseases.

Recommendations

Collaborative efforts need to be made by all countries regardless of political and religious affiliations. Apart from World Cleanup Day which is celebrated on the third Saturday of September annually,   the President of Zimbabwe Cde Emerson Mnangagwa also launched a clean-up programme in December 2018 urging all citizens to clean their environment between 8 am and 10 am on the first Friday of every month. However, for such programmes to be specific, measurable, achievable, relevant and time-bound (SMART), motivational factors have to be put in place.  Supportive factors include;

1. a) Monthly cleanup programmes such as the one launched by President Emerson Mnangagwa must be a continental event done on the same day and time. All continents must put it into practice. This promotes instant cleanup of the environment by all countries upstream and downstream leading to almost total elimination of waterborne diseases
2. b) First families- if possible all first families around the globe including those from powerful states such as America, Russia and China should take it as a norm to head cleanup campaigns. Such a positive gesture was made by the First Lady of Zimbabwe Dr Auxillia Mnangagwa. She joined hands with spouses of ministers, deputy ministers, permanent secretaries, the mayor of Harare and churches in cleaning the city of Harare in March 2024.

 

1. c) Musicians, church leaders, wrestlers, athletes, and boxers amongst others are crowd pullers. They have a positive effect on cleanup campaigns. It motivates the public to clean up the environment with prominent singers like Alick Macheso, Makhadzi, Beyoncé and wrestlers such as Roman Reigns and John Cena.
2. e) All professionals such as Doctors, nurses, teachers, police officers and soldiers should take a leadership role in such campaigns.
3. f) UNEP should penalise countries that discharge raw sewage into rivers. It should also reward all countries that participate in environmental cleanliness campaigns.
4. g) Peaceful negotiation to end wars around the world. Wars pollute the environment. They disrupt the cleaning campaign cycle. There is loss of lives of heroes who should have lead in sanitation programmes. Objectives are achieved in a peaceful environment. The UN-Secretary general Antonio Guterres has always insisted on calling for peace around the world, especially in Gaza and Ukraine war.

Remember that Prevention is more effective than curing,