Red Cross adopts HU cholera-prevention program

System has proven effective in Kenyan displaced persons' camps.

By JUDY SIEGEL-ITZKOVICH
kenya refugee 88 (photo credit: )
kenya refugee 88
(photo credit: )
A cholera-prevention program developed by foreign public health students at the Hebrew University-Hadassah Medical School has proven effective in Kenyan displaced persons' camps. The system, utilized by the Red Cross in DP camps during the country's political crisis earlier this year, was found so useful in the prevention and management of cholera that the International Committee of the Red Cross (ICRC) and the International Federation of Red Cross and Red Crescent Movement (IFRC) are now preparing to implement the program beyond the camps. The program will also now be considered for use in certain districts by the country's ministry of public health and sanitation. The students - medical and public health professionals from Kenya, Ethiopia, Nigeria, Colombia, Uzbekistan, India and the US - are completing a one-year international master's program in public heath (IMPH) at the Braun School of Public Health and Community Medicine, part of the university's medical school. They submitted their proposal to the Red Cross as part of a scholarship scheme sponsored by the Pears Foundation and Legacy Heritage Fund. Despite the fact that cholera is one of the most understood and preventable diseases, the World Health Organization (WHO) estimates that there were about 180,000 cases diagnosed in 2007 and that cholera-related diarrheal diseases still account for 65 percent of deaths in developing countries of children under the age of five. Outbreaks of cholera are reported every year in Kenya, mostly as a result of torrential rains and the accompanying floods that contaminate already inadequate water supplies. Poor sanitation in many areas further increases the risk. The students say the disease can be prevented and fatalities easily avoided if prevention efforts are integrated into routine health care and outbreaks of the disease are reported early, in accordance with WHO requirements. Accordingly, their program aims to increase safe drinking water sources; promote community awareness about cholera prevention; improve surveillance and reporting of cholera cases; mobilize rapid response teams to areas of suspected cholera cases; facilitate post-epidemic investigations and strengthen partnerships between community and government. Team leader Solomon Nzioka, himself a Kenyan native, says cholera outbreaks in his country have become political issues, with an underestimated number of cases reported by health authorities. He claims cholera outbreaks follow a cyclical pattern, beginning with government officials' denial of the outbreak because of fears of potential economic and tourism losses. "When people continue to die, and the outbreak continues to spread, officials undertake late 'fire-fighting' measures to combat the outbreak," Nzioka explains. "Afterwards, the officials forget what occurred and eventually wait for the next report of cholera. Due to the lack of a comprehensive control program, such a pattern repeats itself time after time." Nzioka says the Kenyan government has in the past played a mostly regulatory role in the area of preventive health services, with NGOs providing the bulk of services such as water and sanitation facilities. However, since the late 1990s, many donors have shifted their focus to HIV, and so diseases such as cholera has largely been neglected. Adoption of the control program in Kenya's Bungoma district is currently being considered by the Kenyan Ministry of Public Health and Sanitation. If funding is secured, the students expect that in three years the program will increase access to safe drinking water from 47% to 80%. While the program is currently only being considered in Kenya, the students are hopeful it will soon be utilized in other countries such as Nigeria and Ethiopia, where they say cholera is endemic. Their project supervisor, Prof. Mark Spigelman, says they plan to submit their proposal to the WHO for implementation worldwide. Since its establishment over 35 years ago, Hebrew University's intensive one-year IMPH program has attracted 600 students from 85 countries around the world, among them the Palestinian Authority, Mongolia and Cameroon. Many have become government ministers, consultants to international organizations, hospital directors, and professors at schools of public health.