EDITORIAL: Response to cholera outbreak is worrying

The announcement by Nairobi Hospital that the number of staff members infected with cholera had risen to 52, including one death, by Thursday not only raises fears that the scale of the outbreak in the city and other counties could be worse than reported but also exposes the lack of a co-ordinated response to a health emergency.

The outbreak has been reported in Nairobi, Kajiado, Garissa and Machakos. There are reports that employees of two multinationals were recently quietly admitted to another city hospital.

Cholera is a bacterial disease usually spread through contaminated water. It is caused by consuming food or water contaminated with a bacteria called vibrio cholera. It causes severe diarrhoea and dehydration and, left untreated, it can be fatal in a matter of hours. However, it is easy to prevent and simple to contain if treatment is initiated in good time. A vaccine is also available.

The guidelines to avoid infection are simple: Use only treated water for hand washing, washing vegetables and drinking; only eat food in licensed premises; and observe general hygiene, including washing hands with clean water and soap after visiting the toilet and before handling food. But with the biting drought, several parts of Nairobi are experiencing a water shortage. That gravely compromises hygiene, especially in the informal settlements.

Infections of staff of some institutions have been traced to consumption of contaminated food supplied by contracted vendors. In a country where cutting corners to raise profits has become the norm, some vendors would rather bribe county government officials to get their staff certified than pay for the cholera vaccination, priced at Sh2,200 to Sh4,000 for the two doses.

The Kenya Medical Supplies Authority (Kemsa) confirmed Thursday that it has stocks of the vaccine at a more affordable price of Sh509 per dose in public hospitals but uptake by county governments has been low owing to “lack of funds”.

The response to the outbreak has been wanting. The Ministry of Health, particularly the Director of Public Health, ought to be leading emergency efforts to respond to the outbreak through an aggressive public education and communication campaign telling Kenyans how to avoid infection; the symptoms of cholera and where to seek treatment. But this is yet to be seen.

The devolution of health services is being blamed for the lack of a co-ordinated response to the outbreak. County governments are blaming their inaction on lack of emergency funds. The lethal combination of water scarcity, confusion, corruption in the county health inspectorates and sheer lack of leadership at several levels puts many Kenyans at risk of infection and death.