FT Hunger Action Diaries

Spreading awareness about cholera

In Bukavu and Goma, in eastern DR Congo, most of the talk recently has been about football and politics. Football because TP Mazembe, a Congolese team from Katanga Province, just south of here, amazingly made it to the final of the World Club Cup. The build-up to the final was massive, particularly since Mazembe beat the South American champions, though in the end a comfortable 3-0 win for Internationale of Milan meant the atmosphere watching the game was not the best.

Political talk has been around Vital Kamerhe, a major political figure who was born in South Kivu. After creating a new political party and declaring he would run in next year’s presidential elections, Kamerhe immediately came to visit eastern DRC and attracted major crowds in both Goma and Bukavu this last week.

The point is that everything in the DRC is not death and destruction – yes, even in the eastern part of the county. There are major humanitarian problems and massive challenges for the government, but it is also easy to lose sight of the fact that fleeing from conflict and disease is not the daily experience for a growing majority of people, even in this part of the country.

Even so, conflict, hunger and disease do affect a lot of people here and are more than familiar to the people Action Against Hunger works with. I met with UNICEF last week to discuss how we could deal with the cholera epidemics we tend to see at this time of year in the Kivus (bacteria gets washed into the lake each rainy season.)

Cholera is a relatively simple thing to avoid: drink clean water, use a toilet or latrine, and wash your hands before preparing food or eating. It’s also relatively simple to treat – with clean water and hydration salts – and it’s rarely deadly, except for in young children or people already weak or sick. But in eastern Congo it’s a massive problem. A recent trip to a place called Bulenga reminded me of why.

ACF is running a cholera response and prevention project in some of the communities around Lake Kivu, and the health zone around Bulenga has had over 800 cases of cholera and 14 deaths so far this year, with the vast majority coming in the last two months. Normally if there is an epidemic, we can go in, make sure everyone is drinking chlorinated water, reinforce messages on hygiene and on how to recognise cholera symptoms, and help the health centre isolate and care for cholera patients. We stop the transmission and then the epidemic stops, typically pretty quickly. But in this one area, we had been doing a response for one month and the numbers were increasing rather than decreasing. I wanted to see why.

During our visit I found out that this area hosts a widely dispersed population living in the hills of a peninsula around Lake Kivu. There are a couple of families farming here and no real roads or paths that connect them. People are used to just going down the hill to get water from the lake. This poses a big challenge: How do you ensure that people are drinking safe water?

Our team had done pretty much everything possible. We positioned health workers by the lake to put chlorine in the water that people come to collect, and we trained local volunteer health workers to pass the messages. But there are miles and miles of lake shoreline, and it’s impossible to cover it all so that there’s always a chlorinator close by. It’s also really difficult to pass basic messages on prevention, recognition and treatment of cholera when the only access to most of the area is by foot. It’s slow work changing people’s behaviour in these kinds of rural settings, particularly when it’s to prevent something.

So our discussion with UNICEF involved trying to work out what we could do in these kinds of situations. The problem, as is often the case, is that it’s easy to get money for short term emergency responses and save lives, but it’s much harder to get money to do the longer-term, community-based projects that would be needed to change behaviour and reduce risks. We talked about household water filters, local chlorine production, and ways to work better with the government health services. We are making progress.

There were massive cholera epidemics in the cities around the lake in the 1990s that would be unthinkable now, and a lot of the smaller towns have better access to clean water than they did a few years ago. But places like Bulenga show that we still have a lot of work to do in eradicating cholera in this part of the world.