The outbreak of cholera in some provinces of central and northern Mozambique has been worrying the health authorities and other organizations working for the well-being of citizens throughout the country.

According to the latest figures released by the Ministry of Health (MISAU), at least 18 people have died as a result of this disease in the country. The first case of cholera was recorded in the district of Lago, in the northern province of Niassa, spreading to the central provinces of Tete and Sofala, and then to the southern province of Gaza.

In Tete province, according to sources heard by the Citizen Observatory for Health (OCS), Moatize district, specifically in the administrative post of Kambulatsitsi, Mecunga locality, was the most affected by this outbreak. In order to contain the situation, it was created a center to aid the patients suffering from this disease.

According to the sources, the situation is under control, since the number of patients coming to the centers with diarrheal diseases and vomiting has reduced significantly.

The same scenario of stability is being seen in Sofala, with the district of Caia being the most affected, with a cumulative of 400 positive cases registered. On the other hand, the districts of Marromeu, Chemba and Chibabava registered cases of diarrhea, but without the conformation of cholera.

However, Rui Semente, health activist in Sofala, speaking to the OCS, said that taking into account that cholera is endemic disease and rain continues to fall in Caia district, the scenario may return, therefore it is necessary to adopt measures to contain the disease are continuously.

“In this district, people do their physiological needs in the open. Whereas the rains continue to fall, we may again register cases of diarrhea. Efforts must be made to prevent lives from being sacrificed by a preventable disease”, he said.

About this situation, the OCS believes that the lack of a multisectoral plan, involving the municipalities, the publicly owned company of water, FIPAG, the ministries of Health and Public Works, Housing and Water Resources, contributes to the spread of the disease.

Resorting to an explanation from the coordinator of the Public Participation Pillar in the OCS, António Mathe, sanitation of the environment and access to drinking water constitute main determinants of health, and multisectoral coordination is urgently needed to respond to cases of cholera.

For the coordinator, the responsibility for removing and dealing with solid waste, as well as ensuring the management of sanitation in the environment lies with the municipalities themselves, “however, good practices are scarce.”

Mathe also lamented the fact that sanitation infrastructure, for the most part, is old and decrepit. As such, there is a need to rebuild it. In the coordinator’s opinion, drainage ditches are not in a good condition for the passage of dirt water, paving the way for the outbreak of cholera.

“Does the water that is distributed in our homes arrives with the necessary conditions for consumption? This issue requires a multisectoral response” he said, adding that “it is also necessary that the restrooms be assessed to measure the state of the toilets.”

He justifies this need with the fact that in a survey, carried out by the OCS last year, it pointed out that a large part of the restrooms in the health units were in deplorable condition and some without access to drinking water.

“It is assumed that the health unit is a safe place. However, the research we conducted points out that due to critical conditions in the restrooms, patients, instead of being healed, contract other diseases”, Mathe said, adding that “one of the main measures of Covid-19 was precisely frequent hand washing, but also the practice of personal hygiene, which will coincide with some requirements that are important to prevent cholera.”

For the coordinator, if the Covid-19 response plan had the desired efficiency we would not be witnessing these cholera contaminations.

Mathe further said that good food preservation should be ensured in markets and beyond.

“Food washing and hygiene in food handling are obviously issues that directly affect nutrition. If we have people or citizens who cannot feed themselves properly. This is also going to be an enabling risk factor for entry of diseases like diarrhea and others. So, this issue can be considered a risk factor for contamination.”

As a recommendation, the OCS believes that the Ministry of Health should create teams at health facilities and other places of greater crowding to sensitize people about the outbreak of cholera.

It is also necessary to recover the Community Based Activists to establish communication between the community and the health facility by disseminating important messages on how to prevent cholera.

“A contingency plan, where we could monitor the evolution of some predictable diseases in this rainy season, as is the case of cholera, would be an alternative”, Mathe said, calling for vigilance at border posts, since cases of cholera have entered Mozambique through Malawi.

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