MINISTERIAL STATEMENT ON CHOLERA

Ministerial Statement on the Outbreak Of Cholera In Lusaka

Presented to the National Assembly,  by
Dr. Chitalu Chilufya MP,  Hon. Minister of Health

12th October 2017

Mr. Speaker,
Thank you for granting me this opportunity to present a Statement on the outbreak of Cholera in Lusaka district and to indicate the measures that Government has taken to stop the spread of the disease.

Mr. Speaker,
I wish to inform the House that currently there are confirmed cases of Cholera in Chipata, Mazyopa, Kanyama, and Ngombe compounds of Lusaka District. There is also on record one patient who travelled from Kasenga village in Chisamba District who was diagnosed upon arrival in Lusaka

Cholera is a disease caused by bacteria called Vibrio cholerae, mainly spread through contaminated food and water. Symptoms include acute onset of diarrhea and/or vomiting, abdominal pain, muscle cramps, and body weakness. If untreated, the infection can result in rapid dehydration and death within 24 hours.

Sir,
The current outbreak was declared on 6th October 2017, after laboratory confirmation of two initial cases that presented to Chipata Level One Hospital on 4th October, 2017. As at 6PM on 11th October, the cumulative number of cases was 37, with the youngest being a 3-month old baby who was certified dead within a few minutes of arrival. The child tested positive to the cholera rapid diagnostic test. Twenty (20) out of the 37 stool samples tested from the affected patients were positive for Vibrio cholera. Currently, only three (3) patients are under admission and receiving appropriate treatment at Chipata and Kanyama Cholera treatment centers. One patient, a child, absconded aided by the mother from Kanyama Cholera treatment center. The other patients stabilized after receiving treatment and have since been discharged.

Risk factors associated with Cholera in the affected communities include poor hygiene practices, erratic supply of clean water, and poor sanitation. As of this date, five (5) water samples tested from Chipata compound, specifically from boreholes B95, Mazyopa School and A16 as well as the B96 and Lusaka water trust tanks indicated contamination with fecal coliforms. Further analysis indicated presence of Vibrio cholerae in boreholes B95 and A16.

With the foregoing, we have no option but to shut down the affected boreholes in our quest to stop the spread of the disease.

Mr. Speaker,
The Ministry of Health has put in measures to control the outbreak. Some of the interventions that we have instituted include:
1. Case management
Cholera treatment centers have been opened in Chipata and Kanyama to specifically manage Cholera cases. These have been staffed with Doctors, nurses and other health workers. The treatment centers have also been provided with adequate medical supplies and drugs to support patient care.

2. Contact tracing
Environmental Health Technicians and Community Health Workers have been deployed to trace all contacts of the affected patients. This is critical to quickly identify those who may have contracted the infection so that they are screened and given appropriate treatment and hence stop further spread of the infection. In addition, door-to-door distribution of household chlorine, and chlorination of water sources is on-going.

3. Health Education
Health promotion messages are being given to the public through various strategies including use of mobile public address systems, and distribution of printed materials such as brochures, leaflets, and posters. Messages are also being disseminated through community radio stations and the public broadcaster, ZNBC.

4. Environmental Management
Water sampling has been enhanced in the affected communities and extended to the rest of the province to ensure that contaminated sources are identified as soon as possible in order to institute appropriate remedial measures. Chlorination of water sources is ongoing and in partnership with the local authority, waste management has been enhanced with more trucks mobilized to remove the garbage in affected areas. This however needs to be escalated further by thoroughly cleaning up the affected areas including markets and streets through a multisectoral approach. Inspection of public facilities including markets, food outlets and other trading premises has also been intensified in the affected communities.

5. Multisectoral Response
The Ministry of Health is working in collaboration with various partners including the Lusaka City Council, Lusaka Water and Sewerage Company, the Zambia National Service (ZNS), the Disaster Management and Mitigation Unit (DMMU), World Health Organisation (WHO), UNICEF, USAID Discover Health, Pharmanova and CIDRZ in providing alternative supply of clean water to affected residents using water bowsers. Working with the DMMU, works are underway to erect tank stands to mount fifteen (15) by 10,000 liters water tanks to supply clean and safe drinking water to affected areas. Further, the Lusaka Water and Sewerage Company has been directed to provide a waiver for the affected communities and supply water at no cost to the consumer at the point of collection.

Working with the Lusaka City Council efforts have been stepped up to clean the affected areas. The street vendors and the public at large have been engaged to address the potential risk of spreading the disease through food sold in the open on the streets.

Mr. Speaker,
I wish to inform the house that my Ministry has given this outbreak the serious attention it deserves, considering that the affected areas are densely populated. In this regard, I have called upon all the levels to ensure that they activate the Rapid Response Teams and intensify activities to contain the outbreak. At the national level we have mobilized the multisectoral national epidemic preparedness, prevention, control and management committee to guide the response to the outbreak.

Mr. Speaker,
In conclusion, I appeal to residents in the affected areas and the nation at large, to observe high standards of personal hygiene, including washing hands with soap and clean water before handling food and after using the toilet. Raw food such as fruits must be thoroughly washed and cooked food should be heated before consumption. Water can be made safe by boiling or chlorinating it. I urge our people to avoid buying and selling food from undesignated trading places such as streets. Further, mass gatherings should be avoided, unless absolutely necessary. I also wish to call upon our citizens, especially in the affected areas, who may experience symptoms of Cholera to present themselves to the nearest health facility for assessment and treatment as quickly as possible.
To my fellow members of Parliament, my appeal is that we help in sensitizing residents in our respective constituencies, ensuring that we support preventive measures and promote health and hygiene practices among our people.

Finally, I would like to assure the Nation that the Government through the Ministry of Health and its partners is responding actively in order to keep the outbreak under control and ensure its resolution within the shortest time possible.

Mr. Speaker, I thank you. God Bless Zambia.

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