Govt declares war on cholera as 128 die

By Edmund Smith-Asante

The government has declared war on cholera to stop its rapid spread across the country. 

The war entails using a “Sword and Shield” strategy, with the sword representing the targets or communities affected and the shield showing the responses to fight the outbreak.

Components of the strategy – which is already being employed by the Democratic Republic of Congo, Guinea, Guinea Bissau, Niger, and Chad – include early and targeted Water, Sanitation and Hygiene (WASH) emergency response to first suspicious cases in affected areas.

Others are responses based on preparedness, case mapping, population and practices at risk, WASH emergency response at risk but not yet affected areas, and sustainable WASH intervention in priority areas outside outbreak period.

The declaration was made last Friday, during the second meeting of the WASH in Emergencies (WinE) Technical Working Group since the outbreak of the disease in June.

According to the Chairman of the working group, Mr Kweku Quansah, Programme Officer of the Environmental Health and Sanitation Directorate (EHSD) of the Ministry of Local Government and Rural Development, the new move has become necessary because although the interventions that had been put in place were progressing steadily, they had not been enough to stop the disease from spreading rapidly.

He said the cholera outbreak was the severest in three decades and needed every workable approach to deal with it and should be seen as a war. 

As of September 14, eight out of the country’s 10 regions had reported a total of 16,527 cases of cholera and recorded 128 deaths with a case fatality ratio of 0.8 per cent, Dr Emmanuel K. Dzotsi, Public Health Specialist of the Ghana Health Service, told the meeting.

He said cholera was becoming endemic, looking at the trend of outbreaks, and that intervals had shortened to less than a year.

Dr Dzotsi also said the number of outbreaks reported so far this year had broken the 1983 record of 15,000 reported cases.

This year’s cholera outbreak began in Accra and had spread to eight other regions, he said, adding that the Greater Accra Region was currently in the lead with 12,120 reported cases and 97 deaths occurring in 15 districts.

Accra is followed by the Central Region with 1,024 cases and 21 deaths in 12 districts and then the Eastern Region with 845 reported cases and four deaths in 15 districts.

The others are Volta Region – 237 cases and six deaths in five districts; Ashanti Region, 160 cases and two deaths in 25 districts; Western Region, 93 cases with no deaths; Brong-Ahafo, 47 cases and one death, and the Upper East Region with one reported case in one district.

The disease has spread to 91 districts in eight out of the 10 regions in the country with no cases reported from the Upper West and the Northern regions.

He listed the most affected districts as the Agona West, Awutu Senya East, Nsawam, La Dadekotopon, Ledzokuku-Krowor, La-Nkwantanang-Madina, Shai Osudoku and Tema. 

Results presented from a case control study showed that the probability of infection was six times higher if one drank street vendored sachet water or ate street vendored food, while hand-washing gave 70 per cent protection and people with knowledge had 60 per cent protection.

Dr Dzotsi appealed to the Ministry of Local Government and Rural Development (MLGRD) to ensure enforcement of sanitation bye-laws, promotion of food hygiene and the provision of adequate waste management facilities by metropolitan, municipal and district assemblies.

Update on 100-Day Contingency Plan

The meeting heard that as part of the earlier 100-day contingency plan declared by the government, three radio messages had been sent to 216 MMDAs to take the issue of environmental sanitation seriously, especially on the evacuation of waste, intensification of enforcement particularly on open defecation and regular clean-up campaigns.

Other interventions carried out in the past 50 days include the establishment of more sanitation courts to make people do the right thing.

Further, the MLGRD had visited faith-based organisations or their heads such as the Chief Imam, the Catholic Secretariat and the Christian Council, to urge them to promote hygiene education in churches.

The United States development agency, USAID, has funded the provision of aqua tablet and its use, while cholera video and messages have been produced in the local dialects.

Writer’s email: Edmund.Asante@graphic.com.gh

This was first published by the Daily Graphic on September 23, 2014