Friday, 18 September 2009

Cholera in Burundi

According to World News, there is currently a Cholera outbreak in Bujumbura, spreading rapidly in its crowded outer suburbs and even in the richer area of Rohero. Presumably the fact that everyone in Burundi drinks the tap water, even in rich areas, isn't helping here; I wonder if there are adequate supplies of clean or bottled water, and how the price will be affected. Cholera is not uncommon in Burundi, but it is always a tragedy. Even by East African standards some of Bujumbura's slums are ill-constructed and unsanitary, having been completely destroyed in the war and only rebuilt in the last few years. In these kind of conditions, cholera can spread like wildfire.

The article notes the problem of getting people to hospital, but doesn't mention the almost total lack of facilities once patients arrive there. While in Burundi I was advised that if I ever got sick I should go to the university hospital and refuse to leave, but it's small and the other clinics are woefully inadequate. There are also problems of supply of drugs, with bottlenecks and difficulties of supply, and, according to Morgan, of the wrong type of drugs being available due to kickbacks. I'm not sure how these factors will specifically affect the fight against cholera, but they can't help.

Thinking of cholera, I think of the first time I came across the disease - in a book charting the social history of London, talking about cholera outbreaks in the 19th Century. Cholera is a part of the life that our country has left behind - urban slums, extreme poverty, and lack of sanitation and nutrition for the poor. At the time there was more than poverty standing in the way; they weren't able to prevent it because they didn't understand the nature of its spread. Now, we don't have that excuse. If anything, diseases like cholera are a reminder that what we are glad to see as our past is very much a reality for many people in the developing world - and an indictment of the fact that, while we might be pretty good at vaccines, we're not very good at the interventions that can save even more lives, of even more people - like clean water and sanitation.

Reading this kind of news, I think first of my friends, living in Rohero and Kinindo, and I hope they and their families are well. Then I think of some of the young people living in poorer areas, like Kinaba, that I interviewed, and I'm terrified for them. Thinking of real people with lives and ambitions, whose lives are now at risk from a preventable disease is distressing. This outbreak will pass, as they always do, but it is a constant reminder of how far we need to go to attain even basic standards of living for millions of people.

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