Going door to door to fight cholera

“You can protect your family from cholera!

“This disease scares me. I will lecture my children and tell them to wash their hands with soap. I hope this will keep my family safe!” On the street outside her house, Rosine is listening very carefully to the Red Cross volunteer explaining how simple hygiene measures can prevent further spreading of the cholera. She is looking at the pictures, designed for those who cannot read, and nods in approval.

A man in a street explains a sign to others.
UNICEF CAR/2016/MboutouA Red Cross volunteer explains how to prevent cholera in Bangui

On August 11, for the first time since 2012, the Central African Republic declared a cholera epidemic. The disease started in remote villages along the Oubangui River that separates CAR from the Democratic Republic of Congo. In those places, many of them impossible to reach by road, the population has little or no access to clean water. They rely on the river as their primary source of drinking water, and also use it as a toilet.

Many of these villages, upstream from Bangui, the capital, are in fact temporary settlements for fishermen from Bangui’s 7th district. They camp there for a few weeks during the rainy season, when the river is high.  When the first cholera cases erupted, sick and sometimes dead people were carried downstream – back to the capital – in crowded boats, which further spread the bacteria.

Bangui’s 7th district is therefore one of the hotspots for cholera in town. This neighbourhood was a priority for the deployment of Red Cross volunteers and social mobilizer who arrived to tell the neighbourhood: cholera can easily be prevented by using simple hygiene measures.

“We tell the people that they should wash their hands with soap frequently, treat the water (with bleach or boil it) before using it for drinking or cooking, avoid using water from the river, that they should use toilets, eat only well cooked, warm food, and that the street vendors should cover the food that they sell in order to avoid flies,” says Samuel Zouma, the local Red Cross committee coordinator. “People are concerned, because they are aware of cholera cases amongst their neighbours. Every time our volunteers go door to door for the sensitisation, they have a large audience and are asked a lot of questions.”

“Even the small kids on the street talk about cholera,” says Beaux-Arts Ngoabele, who is sitting with friends in a local bar. “I am afraid, because I have seen people carrying dead bodies around here; I have sensitized my family and from now on we will only use clean water.”

After three years of crisis, restoring basic services in CAR is just restarting. Many villages simply have no health facilities and the ones that do often lack workers, drugs or basic equipment. Cholera spreading during the rainy season is of course a concern: in August, it has already been raining so much that still water is everywhere, laying the ground for malaria, diarrhea and of course, cholera.

Another major concern is preventing cholera from entering the IDP sites in the country’s capital. 49,000 people still live in these camps and despite the continuous efforts, hygiene is still precarious.

In the biggest site, around Bangui’s Mpoko international airport, is home to over 20,000 people; there, the social mobilisation activities are carried out by IDPs themselves. Over the years, with UNICEF’s assistance, they have organized small groups that go from shelter to shelter giving basic hygiene tips to the inhabitants. They have eventually switched to cholera prevention in the past few days.

“Young children, especially those under five, are particularly vulnerable to this deadly disease”, said Mohammed Malick Fall, UNICEF Representative in CAR. “We need to act quickly to ensure this easily-preventable disease is not taking more lives.”

In this race against bacteria, the government and its partners, WHO, UNICEF and several NGOs, work in close coordination. UNICEF teams focus on two areas of response: social mobilisation/ communication and Water, Sanitation and Hygiene (WASH) activities. It is crucial to help the population access clean water, in a country where two thirds of the population do not consume it on a regular basis.

Donaig Le Du is UNICEF’s Chief of Communications in the Central African Republic and Dede Nambeanre is the Communications Program Assistant

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