February 21, 2005
The girls came home from school the other day talking about something that really shocked me – Cholera. You see, their school sits at the base of Mt. Ndirande, and there is an outbreak of Cholera in Ndirande. Teachers told the students to boil all water (which we do routinely) stay away from fresh fruits and vegetables that can’t be peeled or cooked, and to wash their hands as often as possible. It is very serious.
I have to admit that I did not know a lot about Cholera, so I went to the internet to do some research. The World Health Organization (WHO) says that Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhea that can quickly lead to severe dehydration and death if treatment is not promptly given. Vomiting also occurs in most patients. Although 90% of the people who get cholera have mild or no symptoms, people who become acutely ill can die within hours if they do not receive immediate medical attention. They must be re-hydrated and given electrolytes.
Unfortunately this disease usually hits young children the hardest, although breastfed infants seldom contract it. The WHO considers it the seventh pandemic. It broke out in 1961 in Indonesia and has worked its way west through east Asia and Bangladesh (1963), India (1964), Russia, Iran and Iraq (1965-6). It hit West Africa in 1970. It had not been in Africa for over a century, but quickly spread through the continent, becoming an epidemic. Since then it has also swept through South America.
What causes sudden outbreaks like the ones in Ndirande, Limbe and Zingwawa? Contaminated water. In crowded slums like Ndirande, where there is no running water or sewage system, the rainy season washes all kinds of filth out of pits and into gutters and gullies which wind their way into the water supply.
Health authorities say that five people have died so far, and over a hundred and fifty more are acutely ill. We don’t know how much longer the outbreak will last, but we will be forgoing salads and boiling all water for a while. We have also made sure that Alfred and Michael and their families do the same.
This is one more thing that we would not be experiencing if we were in Pennsylvania this year. It is not something we anticipated, but one of the results is that we will probably never take flushing the toilet for granted again.