With the easing of the Covid-19 pandemic, Kenya experienced the quiet disappearance of not only face masks but also a crucial element of public health: accessible wash areas.

The absence of these facilities dealt a severe blow to hygiene practices, and the consequences were dire. As taps ran dry, and the production of soap and sanitizer declined, Kenya found itself grappling with a cholera outbreak of alarming proportions.

As of July this year, Kenya has reported a staggering 11,181 cholera cases, resulting in 196 tragic deaths, equating to a case fatality rate of 1.7 percent. This alarming outbreak began on October 19, originating at a wedding festival in Kiambu County and rapidly spreading across Kiambu, Nairobi, Murang’a, Kajiado, Nakuru, and Uasin Gishu counties.

Cholera outbreak due limited access to hygiene services

By early 2023, the initial surge in cases centered primarily around Nairobi and regions characterised by persistent drought, reliance on unsafe water sources, and limited access to sanitation and hygiene services.

To compound these concerns, Kenya faces the imminent arrival of El Niño, the recurring heavy rainfall phenomenon that, as seen in 2015, often signals another year plagued by cholera-related deaths.

Data from the Ministry of Health reveals a pattern of annual cholera outbreaks, with the highest number of cases recorded in 2015, followed by a decline in 2016 and a steady increase from 2017 to 2019.

Researchers estimate a staggering global toll of approximately four million cholera cases and 143,000 deaths. Cholera is undeniably a significant public health concern and a top priority in Kenya's Integrated Disease Surveillance and Response strategy.

Yet, the battle against cholera is far from simple, exacerbated by infrastructural challenges that leave large segments of the population without sewer lines, while haphazard water connections remain exposed to the elements.

The current outbreak, which began in October of the previous year, quickly escalated, with cases reported in 25 counties by 2023. This alarming trend can be attributed to various factors, including persistent drought, reliance on unsafe water sources, limited access to sanitation and hygiene services, and inadequate WASH (Water, Sanitation, and Hygiene) practices.

The hardest-hit counties include Suba South in Homa Bay County, Kamukunji and Embakasi Central in Nairobi, Mandera East, Machakos, Garissa, Wajir North, and Moyale.

An increase in waterborne diseases

El Niño, a cyclical weather phenomenon characterized by warmer-than-average sea surface temperatures in the equatorial Pacific Ocean, has already begun to exert its effects on Kenya, with far-reaching consequences that extend beyond climate and agriculture to human health.

Heavy and prolonged rainfall, a typical result of El Niño, leads to flooding, landslides, and an increase in waterborne diseases. Cholera outbreaks, exacerbated by heavy rainfall and poor sanitation conditions, thrive under these conditions.

Flooded areas can contaminate water sources with sewage, while overflowing rivers and damaged sewage systems provide ideal breeding grounds for the Vibrio cholerae bacterium.

The malfunctioning drainage systems in major towns and cities exacerbate the problem, a consequence of misuse and negligence. Blocked by mud, garbage, and polythene papers, these systems overflow even with moderate rainfall, posing health hazards and ideal breeding grounds for bacteria.

Poor waste management, exemplified by some residential apartments and buildings releasing sewage water onto roads and pathways, further complicates the situation.

Inadequate sanitation facilities in overcrowded informal settlements, like Kibera, lead to open defecation or "flying toilets," wherein waste-filled bags are discarded, contaminating the environment and increasing the risk of cholera transmission.

Despite significant challenges, the Kenyan government, in collaboration with international partners and NGOs, has been actively engaged in the battle against cholera outbreaks. Specialized treatment centers have been established to provide immediate medical care, reducing mortality rates.

Read Also: Kenya to roll out vaccines after 194 die of cholera

An oral cholera vaccination campaign initiated by the Ministry of Health, in collaboration with international partners, has successfully vaccinated over 1.6 million people.

Vaccination against cholera

 

A comprehensive Oral Cholera Vaccination campaign initiated by the Ministry of Health, in collaboration with international partners, has successfully vaccinated millions of people, resulting in a significant reduction in cases.

 

Efforts to improve sanitation facilities and provide clean drinking water in high-risk areas have also been underway, benefitting hundreds of thousands of people, particularly children.

 

Extensive public awareness campaigns have been launched, emphasizing proper hygiene practices, safe water consumption, and the importance of vaccination.

 

However, the ongoing challenges, including the need for improved sanitation and sustained preparedness, underscore the importance of continued efforts to combat cholera effectively. Addressing the root causes of cholera, such as poverty and poor access to social amenities and healthcare, may require a multi-sectoral approach.

 

Furthermore, recognizing the impact of climate change on cholera outbreaks, and developing climate-resilient strategies like well-maintained and regularly serviced drainage systems, is essential.

 

Collaboration with neighboring countries and international bodies to address cross-border cholera transmission and share best practices in prevention and control will further fortify Kenya's defenses against this preventable disease.

 

These recommendations, when implemented comprehensively with unwavering commitment, can better prepare Kenya for future cholera outbreaks and significantly alleviate the burden of this deadly disease on its population.

 

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