|Case Study: Cholera|
Cholera is an intestinal disease caused by ingestion of a parasite found in contaminated water and food. Once a global scourge akin to the plague, cholera has now largely been eliminated in the developed world. Today, it is a disease associated with desperation and poverty. In most epidemic situations, it affects those who have already been hit with misfortune – those living in poor countries, refugees of war and conflict, survivors of natural disasters. It is the news story after the big news story, hitting vulnerable populations after major disruptive events, seeping in where there is already incredible hardship. Examples include massive infections from dirty water after the Asian Tsunami, outbreaks in refugee camps in Rwanda in 1994 and today in Darfur and Iraq, and everyday transmissions in crisis-ridden Zimbabwe. In a particularly cruel twist of fate, children who are orphaned in these societies are often at highest risk.
Cholera’s victims are often children who play in dirty water contaminated by fecal matter. Without proper facilities for hand-washing, humans transmit the bacteria through food and water, often infecting entire families and communities through what often begins with inadvertent contact with the contaminant. The disease kills through severe dehydration resulting from watery diarrhea. There is no vaccine; simple rehydration therapies often are out of the reach of cholera’s victims who usually live in remote, poor, or destroyed environments.
It is of great concern to health experts worldwide that cholera appears to be on the rise. The WHO notes that rates of infection rose nearly 80% from 2005 to 2006, reaching levels not seen since the 1990s and affecting countries where the disease had previously been largely eradicated. In the case of Zimbabwe, for example, the disease has made a giant comeback in recent years, one result of the failed economic and social policies of President Robert Mugabe. As public health and sanitation facilities falter in the failing state – some reports predict that fully half of Zimbabwe’s 12 million people are at risk following epidemics in 2008 – the upcoming rainy season is expected to see another resurgence of the disease.
It is estimated that only 10% of cholera cases are reported due to chaos and low public health capacities in affected areas; thus, real global trends are likely even more extreme. These trends are a travesty to many in the public health and development field because cholera infections can be prevented easily through access to proper sanitation facilities and hand-washing.