Rains in Sierra Leone aid deadly cholera's spread


Lack of clean water, bad sanitation and poor hygiene are a boon to disease, writes DEIRDRE VELDONin Freetown

THIS YEAR’S rainy season in Sierra Leone has brought with it a massive outbreak of cholera, killing at least 250 people and infecting up to 15,000 since June.

On a day of downpours in the slum of Mabella in Freetown, it’s clear how living conditions have aided its spread. Water runs through Mabella’s teeming market, carrying all sorts of food and detritus. As there are few public latrines, many defecate and urinate in the open, and this too contributes to the contamination.

Cholera is contracted by ingesting food or water contaminated with faeces. Lack of access to clean water, bad sanitation and poor hygiene practices have added hugely to the incidence of the disease.

There’s no waste collection here. Vast mounds of rubbish accumulate at intervals. In one massive dump beside the market, a dozen pigs happily swill around in the water and waste.

In Mabella, at least, people who come to fill drums and tubs with water from a non-governmental organisation (NGO) funded water pipe are offered chlorine. It looks a hit-and-miss affair, as people splash the chlorine into already full vessels.

The rural areas are also badly affected, thanks to dependence on streams and rivers and a lack of awareness of hygiene. At a clinic in Mara Chiefdom in Tonkolili district, two women are recovering from cholera on inpatient beds. Both were infected by the same person. Community health officer Alah Jimmy said: “This woman’s mother got it from the river and the river flows through their village. She was treating her mother at home, but she [mother] died three days ago. The older woman became infected when she was preparing the body for burial.”

President Ernest Bai Koroma has declared a state of emergency, and some NGOs have response teams in place. Irish agency Concern is targeting a population of 250,000 in Freetown and in Tonkolili with cholera-prevention kits containing chlorine tablets, oral rehydration salts, jerrycans for water and soap. The situation is helped by the work already done in building public latrines and creating safe water supplies. Community health clinics are playing a role in preventing further spread of the disease.

Tonkolili community nurse Nancy Seisa said: “We are telling people about proper hand washing, that they should use latrines, and we are getting chlorine tablets into people’s houses. Since our intervention, cholera rates in this area are coming down.”

Many are getting sick or dying in their communities, away from clinics or NGO help. Health workers believe this is leading to under-reporting of incidences too.

A typical person facing grave risk is Mohammad Cebola, a malnourished boy of 11 months. He attends the clinic at Magaburaka with his grandparents, as his mother died a few days ago of cholera. His step-grandmother, Adama Bangura said: “[My stepdaughter] was working at home and took food to her husband in hospital when she started to vomit and have diarrhoea. They tried to give her a drip, but it was unsuccessful and she died.” If he develops cholera in his malnourished state, he will die.