How untreated water led to cholera outbreak in a Tanzanian village

Unyanja FM Radio

Patrick Kossima, Unyanja FM Radio
For a long time, Lundo, a village of over 1800 people in Nyasa District, mainland Tanzania has grappled with the constant challenge of access to clean and safe drinking water, something which has greatly contributed to outbreaks of dysentery and cholera.

Such was the situation between November 2017 and March 2018, where an outbreak of cholera resulted in deaths and hospitalizations. The water used here is not safe, according to Thomas Chilele, Lundo Village Executive Officer.

“People use water from boreholes and rivers, which is not treated,” he says, giving an example of the farming activities taking place on the banks of Lwika River, whose water is also used by villagers for domestic purposes. This, Chilele maintains, is a major health risk.

As far as he is concerned, 90% of the villagers use untreated water, mostly from unsafe sources like open water pans, which he equates to that coming directly from the river. Only 10% of them have access to water from properly constructed boreholes that can be covered after use, which incidentally, is not piped.

The main economic activity here is the cultivation of rice, which takes place in the Lwika River Basin. Access to piped water remains a huge challenge in the village given the enormous cost involved in providing this amenity. This can cost anything between 50-70 million ($22,000-31,000) Tanzanian shillings.

Chilele cites an example where 75% of villagers had access to piped water, courtesy of the assistance from DANIDA – a Danish aid agency. However this project came to an end in the years between 2000-2002 and has never been revived since, due to cost constraints.

And now, the biggest challenge facing people like Chilele is sensitizing the community to find ways of accessing safe water.

“We continue making noise to the government about having the water piping infrastructure re-installed, because it requires a considerable amount of money,” he explains.

Even so, given that cholera spreads very fast, Chilele says that efforts to educate the community on the importance of boiling drinking water, continues unhindered.

More than five deaths were reported and 147 people (80 of whom were women) were taken to a health centre in Lundo following the cholera outbreak. Some were hospitalized and others were referred to other health facilities for further medical attention.

It is reported that nearly 280 people per month have been visiting the health centre suffering from intestinal infections resulting from using untreated water or that which is not properly boiled.

Lisumbu Tambula, the deputy top physician at the health facility confirms that they receive a lot of intestinal infection cases, which can go up to 230 or 130 when the number is low. She attributes these health cases to the water from River Lwika Basin.

“Many of the patients use water from the river which they do not boil,” she says, adding that another source of infection comes from children playing in the area.

However, Tambula and her team have been emphasizing the need for villagers to be carrying boiled drinking water, whenever they go about their daily activities, something which she says has been well received.

She explains that vast majority of the community has heeded this call and is either now boiling drinking water or using water guard supplied by the government. This has seen a reduction in infection cases.

A big number of cholera cases began to be suspected on November 28, when the health center witnessed a sustained influx of persons seeking medical attention.

“We reported these cases to the district health officials who confirmed that they were indeed cholera cases,” she affirms.

The height of the outbreak was a particularly difficult time for caregivers, who were compelled to hold nightly vigils to save lives. It was especially challenging given that the facility was not sufficiently equipped to deal with the sudden upsurge of cases.

“We were overwhelmed because other facilities were facing the same problem,” says Tambula.

At the forefront of managing the situation were caregivers like Irene James Zoto at the health centre in Lundo, who were in direct contact with patients.

Diarrhea and vomiting cases were too many at the peak of the problem, so much so that a temporary emergency centre had to be opened to receive and quarantine patients.

The seriousness of the problem, narrates Zoto, was reflected in the fact that some patients had become incontinent.

“So it was our responsibility to assist them in every way,” she recalls adding that the government provided protective clothing for this purpose.

There was also the major challenge of providing hot meals to patients.

“And since we used to receive lots of meals from outside the facility, we had to make sure that they were hot before serving to patients,” says Zoto, insisting that any leftover had to be thrown away to make sure that it did not make its way back to people’s homes, to prevent spread of disease.

Zoto and her colleagues sensitized the community to always make sure that food is properly cooked and served hot and that it is well covered. This is in addition to observing proper hygiene practices, such as washing hands with soap after visiting the toilet and boiling drinking water.

This story was supported by a story grant from InfoNile and Code for Africa. It was originally broadcast by UNYANJA FM RADIO in Swahili.