Poverty strikes again: Cholera

This morning I received a text stating that of the 37 cases of suspected Ebola, none have tested positive for the disease.  That’s the good news.

The bad news: Accra is suffering from another cholera outbreak.  (I say ‘another’ because it is a frequent condition.)  Depending on how the cases are tabulated, it seems there have been between 870 and 3,000 cases reported since June.  Forty people have died so far.

Source: Humanosphere

Source: Humanosphere

What is cholera?

From the World Health Organization website:

“Cholera is characterized in its most severe form by a sudden onset of acute watery diarrhoea that can lead to death by severe dehydration. The extremely short incubation period – two hours to five days – enhances the potentially explosive pattern of outbreaks, as the number of cases can rise very quickly.

About 75% of people infected with cholera do not develop any symptoms. However, the pathogens stay in their faeces for 7 to 14 days and are shed back into the environment, possibly infecting other individuals.

Cholera is an extremely virulent disease that affects both children and adults. Unlike other diarrhoeal diseases, it can kill healthy adults within hours. Individuals with lower immunity, such as malnourished children or people living with HIV, are at greater risk of death if infected by cholera.”

How do you get it?

From the Mayo Clinic website:

“When humans ingest cholera bacteria, they may not become sick themselves, but they still pass the bacteria in their stool. When human feces contaminate food or water supplies, both can serve as ideal breeding grounds for the cholera bacteria.

Because more than a million cholera bacteria — approximately the amount you’d find in a glass of contaminated water — are needed to cause illness, cholera usually isn’t transmitted through casual person-to-person contact.

The most common sources of cholera infection are standing water and certain types of food, including seafood, raw fruits and vegetables, and grains.

  • Surface or well water. Cholera bacteria can lie dormant in water for long periods, and contaminated public wells are frequent sources of large-scale cholera outbreaks. People living in crowded conditions without adequate sanitation are especially at risk of cholera.
  • Seafood. Eating raw or undercooked seafood, especially shellfish, that originates from certain locations can expose you to cholera bacteria. Most recent cases of cholera occurring in the United States have been traced to seafood from the Gulf of Mexico.
  • Raw fruits and vegetables. Raw, unpeeled fruits and vegetables are a frequent source of cholera infection in areas where cholera is endemic. In developing nations, uncomposted manure fertilizers or irrigation water containing raw sewage can contaminate produce in the field.
  • Grains. In regions where cholera is widespread, grains such as rice and millet that are contaminated after cooking and allowed to remain at room temperature for several hours become a medium for the growth of cholera bacteria.”

Though the people in power should be aware of how the disease is transmitted, they seem indifferent or powerless to stop its spread.

Ghana government owes waste management companies

Source: Myjoyonline.com

Source: Myjoyonline.com

Earlier this year, it was reported that the government’s poor fiscal situation meant they were unable to pay Zoomlion and other waste management companies.  According to Zoomlion, Accra produces 2,500 tons of waste per day.  As of May 2014, the government owed 16 million Ghana cedis for over 8 months of work.  These operators have basically stopped serving Accra.  These operators, in turn, the waste disposal sites.

In a related matter, there also appears to be a shortage of waste dumping sites in and around Accra.  Accra’s trash continues to be uncollected. As a result, many people began dumping their trash into open gutters and

How urban Ghanaians live


For the vast majority of people living in Accra, drinking water must be found every few days.  There are no pipes running into people’s homes bringing water or removing sewage.  Thus, finding water to bathe is not always possible for the working poor.

Every morning, people must queue at public toilets or as The Chronicle describes, “…some people also prefer the beaches, bush, drains, and uncompleted buildings as places of convenience, while some defecate into polythene bags and dispose of them discriminately, especially into gutters/drains.”  That’s the reason I don’t swim in Accra’s local beaches.

Water trucks drive around town providing potable water to individuals, houses, and apartments.  Every house I have lived in has a large plastic tank that holds water used for washing and bathing.

Key Takeaway:  Cholera is an entirely preventable disease.  People become infected when they drink contaminated water, eat contaminated seafood and vegetables, and sometimes rice.

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