Benin: Recurrent cholera still not a priority

COTONOU, 13 August 2008 (IRIN) - These cases have been reported in the capital's eastern districts of Enagnon, Dedokpo, and Segbeya, neighbourhoods that lack clean drinking water, waste disposal services, and indoor plumbing.

The government has set up a treatment centre next to Ayélawadjè health centre in eastern Cotonou to provide free medical assistance to affected people.

On Wednesday, more than 100 people gathered at the centre. One health worker who spoke with IRIN anonymously because he was not authorised by the Ministry of Health to comment on the outbreak said: “We have been seeing more and more patients in recent days. For the moment, we have things under control. We are the asking the population to help us fight the disease by observing basic sanitation rules.”

Dr. Paul Yada, an epidemic specialist at the African regional office of the World Health Organization (WHO), said while efforts like this camp are helpful to halt the epidemic, cholera is not only the responsibility of health officials.

He says cholera is most quickly spread in run-down urban areas that lack clean water sources or indoor plumbing. Yada says often, faeces in open spaces mixes with heavy rains, trash, dirty riverbeds and a neighbourhood's castaways, forming a river of waste that infects a community's drinking water.

“To really solve this problem, you need more people at the table than just health officials, and you need more resources,” says Yada.

The Benin government has renewed an education campaign on sanitation and what to do at the first signs of cholera infection.

Yada says countries' responses to cholera outbreaks tend to be fast, but that follow up is poor.

“After an epidemic, people stop these education campaigns. The problem is, you cannot change someone's behaviours in one week. You cannot stop teaching about sanitation just because the rains stop. This needs to go on year round. ”

Cholera is a recurring problem in much of sub-Saharan West Africa. Cases spike with the annual rains that generally fall between June and September, but infections happen year round.

The cholera bacteria is spread through contaminated food and water. If not treated, the first symptom of diarrhoea can lead to kidney failure, dehydration and death.

Last year, toward the end of Africa's rainy season, ministers of health from across the continent signed an agreement to develop comprehensive action plans to fight cholera.

WHO representative Yada says none have been submitted to WHO's regional office in Congo Brazzaville for funding.