The Time of Cholera

By now we have all read of the cholera situation in Zimbabwe (or should have). It sucks - and has been caused by any number of mostly if not entirely preventable factors far beyond simply the gnarly water and sanitation situation there.

Although it is difficult to step back and look at the cholera outbreak more broadly right now, let me add a couple of thoughts:

- this crisis highlights the need for a holistic approach to water for people: safe drinking water supplies, sanitation facilities and hygiene (handwashing) interventions are all required. Cholera is not spread simply by water, but by water contaminated by human feces which has not been adequately treated, and by dirty fingers, food, etc.

- this cholera outbreak also highlights the need for tight language in appropriations for the Water for the Poor Act, the Water for the Poor Enhancement Act, and other related legislation, e.g. on child survival. That language needs to focus on people and poor. Period.

- safe drinking water and good sanitation facilities are both the prevention of and the cure for cholera. It is much more efficient to prevent cholera and other diarrheal diseases than to treat them. Ask Peru about the economic/financial costs of prevention vs. cure when a cholera outbreak cost their economy $1b+ a few years ago.

- cholera is now a regional health and economic issue, and could become a regional (southern Africa) security issue quite easily with the xenophobia prevalent in the region.

- Zim is not alone. Cholera outbreaks are occurring or have recently occurred in Kenya, Peru, the Philippines, Malawi, Zambia, DR Congo, Angola, Nigeria, Burundi, Guinea-Bissau, South Africa and others.

So: try to keep as many Zimbabweans alive in the short term, keep cholera from spreading beyond its current borders in the medium term, and let's do what we can to prevent it from happening again by addressing water, sanitation and hygiene in the long term.