Sunday, December 6, 2009

Cholera deaths reflect the state of our nation

Sunday Nation 06 December 2009

Cholera is a disease caused by a bacterium spread mainly through faecal contamination of water. It is characterised by profuse diarrhea and rapid loss of body water, and is summarily fatal if untreated.

Interestingly, treatment for cholera consists of intake of copious amounts of clean water mixed with salt and sugar, a mixture that should be available at the most basic level in this country.

Hundreds of Kenyans have recently lost their lives to this disease, and many more continue to be at risk. The ministries of Health have reported deployment of medical personnel to all affected areas in an attempt to control the scourge, but new cases keep popping up in all corners of the country.

It is a hallmark of our times that even as we raucously debate a new constitution that guarantees a right to health, we continue to lose Kenyans to this primitive disease whose control is so painfully simple that it would be correct to term it a disease of absolute poverty.

For instance, the last outbreak of Cholera in the United Kingdom was sometime in the 19th Century, and the study of epidemiology owes its existence to the control of this particular outbreak.

Outbreaks of Cholera and other diarrheal diseases are practically unheard of in countries that have improved their waste disposal systems and ensured a steady supply of clean drinking water for their citizens.

After days in denial, the Public Health and Sanitation minister was heard lamenting that all it would take to control the disease is for Kenyans to “decide to live hygienically”.

She went on to deride the behaviour of poor Kenyans who decide to “go anyhow to the bush” and proceed to drink water contaminated by their own infected faeces.

The minister’s words are eerily evocative at this time in our development, and a brief lesson in history would be useful for the minister and this government.

At the height of the French revolution in the 18th Century, Marie Antoinette, then Queen of France, reportedly uttered the now immortalised words “Let them have cake”, when she heard hungry peasants demonstrating outside her palace over lack of “bread”. She paid the ultimate price for this alleged misstatement soon after this.

The conditions attending the period around the French Revolution are no different from what Kenya is going through today, and indeed a close reading of the French history of the time sounds like a rehash of Kenya’s present, complete with indecisive, lethargic leaders and atrocious conditions for the common citizen.

Even the clamour for a new constitution is reminiscent of the French “Declaration of the Rights of Man and of the Citizen” that was promulgated during the revolution and stands today as one of the key planks of human rights theory.

Kenyan politicians stand the risk of being exposed to the literal and figurative guillotine of citizen action if they continue making such careless statements and ignoring the acute needs of the citizenry.

Inability to supply clean drinking water to a majority of the population is an indictment on the state of our government’s priorities. Every single death that is attributed to Cholera means that our water and sanitation infrastructure is not up to scratch, and we cannot stake a claim to international greatness while still losing people to an illness whose cure is clean water mixed with salt and sugar!

Instead of continuing to insult the citizen with exhortations to choose hygiene over poor sanitation, the government must fulfill its responsibility to its citizens and endeavour to improve the water and sanitation situation in this country.

You cannot ask a poor person without access to adequate supplies of clean drinking water to “decide” to be hygienic when it is just not possible! It is also insulting to insist that a poor Kenyan boils the little dirty water available to him when he has no access to fuel to cook his food, let alone boil water.

If the government wants the citizen to “decide” to live “hygienically” as so graphically put by the Health minister, it must provide a real choice.

It must ensure supply of adequate amounts of clean drinking water to all its citizens. It must work to ensure that fuel is available and affordable to all people. Health facilities must be in close proximity to all Kenyans so that those with more severe infections have access to a facility where they may get intravenous fluids and even antibiotics as necessary.

As long as Kenyans continue dying of a disease caused by poor hygiene and whose treatment is mostly clean water, we must ask ourselves if we are upto the challenges of the new millennium and on track to achieve the Millennium Development Goals and our own vision 2030.

Dr Lukoye Atwoli is a Consultant Psychiatrist and Lecturer at Moi University’s School of Medicine

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