«Things are Getting Better»

Pr. Fru Angwafo III, Secretary General of the Ministry of Public Health, PermanentSecretary of the Inter-Ministerial Committee For the Fight Against Cholera.

What is the actual trend of the cholera epidemic as of now?

Well, we have a little stabilisation in terms of the number of new cases. At the peak of the epidemic in the Far North Region we had as much as a 150 to 200 cases per day and as many as ten deaths per day but starting from about the 36th week, and we are the 38th week now, this has been dropping to the point where we have 40 to 50 new cases and as few as three to five deaths. It is deplorable. We want to have no deaths at all, but I think things are getting better. If it were not for certain areas such as Bogo and Kolofata, we would even be saying things are so good.

What about other towns like Yaounde and Douala where cholera cases were detected?

In Yaounde we have an imported case. We have the situation of someone who was travelling by train from Ngaoundere to Yaounde but because of the vigilance of the health personnel in CAMRAIL and the health district of Mbandjock, this case was identified, rescued and treated at the Mbandjock district hospital and is well and strong at home. Apart from this confirmed case, there has been no confirmed case of cholera in the Centre Region. The Centre Region is not in an epidemic as such. In Douala we have had one confirmed case and tens of suspected cases; we are on alert and making sure that we do not have confirmed cases of deaths from cholera.

What is the government doing now to curb the spread of the pandemic?

The government is doing a lot. The first and most important thing is that we are doing continued and strengthened reinforced information and re-education about personal hygiene and it is important for people to wash their hands with soap and water before and after meals and after stool. Secondly, it is important for people to stool only in latrines or in modern toilets. Thirdly, we tell people not to manipulate corpses or dead bodies because cholera can be very contagious. If somebody dies of cholera and you touch the body or the fluid, the vomit or the stool of that person, you are likely to have cholera and it could have dire consequences. There are basically three things: personal hygiene, using latrines, avoiding the touching of corpses or cloths or belongings of some one who is suffering from cholera. That is the information we give out.

What about those already infected?

In terms of taking care of patients, we ask all of them who are having diarrhoea or who suspect that they are having cholera because they have diarrhoea or vomiting, to drink oral dehydrated salts. These salts are found in plastics and free where they are being circulated in treatment centres. But when one cannot get to the treatment centre, they can make their own oral dehydration salt themselves. You take one litre of decanted water, boil it and let it cool off for 30 minutes, put five cubes of sugar in a litre of water; pinch three fingers of salt with half of lime fruit in it and you drink and keep drinking it. If the diarrhoea doesn’t stop within three to four hours and if you have up to ten stools a day then you must see a health officer.

Reports say some cases came from neighbouring countries like Nigeria. Is government doing anything to make sure that such cases are not reported in subsequent years?

We treat people irrespective of their origin, sex and nationalities. That is what doctors take as an oath, so we do not discriminate on the origins of people. Further, we are a free society and we cannot stop people from moving. What we do is that where we see movement of people, we sensitise them, give them all necessary information so that they prevent contracting the disease.

What are the number of cases that have been recorded so far?

I am happy to tell you that it has been quite a big fight. The personnel of the Ministry of Public Health and our community health workers, national and international partners have been working in unison to limit especially the deaths so that out of 7,306 cases reported so far, we have saved the lives of 7,048 and we can say that unfortunately we have lost 482 people but this means that our death rate is down to 6.5 percent. It would have been much less if people came to treatment centres early because almost 56 percent of these deaths occurred in homes. The performance can be better but we realised that this year, the death rate is much lower that in other years before.

 Victorine BIY

 A Stitch in Time…

For the past few months the entire nation has been thrown into a wild psychosis of fear engendered by spread of cholera. Initially identified and circumscribed to parts of the Far-North Region, the invasion of the dreaded disease soon took a wild goose chase posture as health workers and threatened populations fought the best they could to keep it at bay.

Granted, cholera is endemic because it is generally associated with lower-income populations too often unable to ensure the minimum standards of hygiene because of poverty and , sometimes also because of sheer ignorance. It is also an epidemic because of the huge numbers of people that can be affected at the same time. From the above, it is easy to determine what parts of the country are prone to cholera because of the ease in delimiting the boundaries of prosperity and poverty, especially in huge urban agglomerations where features of poverty are manifest. Available statistics also indicate a very low access rate to potable water in the rural areas, making such areas a natural destination for cholera attacks. Decision-makers are also aware of the ignorance of people living in these areas, especially with regard to numerous health risks that haunt them because of a precarious environment that naturally fires up the development of disease. This so because we fully –well know that poverty, ignorance and disease go hand-in-hand.

In Cameroon therefore, it is easy to circumscribe the various zones likely to produce cholera attacks. It is a known fact that several traditional habits in parts of the Far-North virtually promote the development of cholera. Added to these are the usage patterns of water which, in itself is already a very rare commodity. Stories have been told of numerous cases where cattle and humans drink from the same sources of water. These are age-old practices which have only come to be denounced at the time cases of attacks have been reported. The Governor of the Far-North Region has recently signed an order subjecting the obtaining of an official building permit to the initial provision of a certified latrine. This measure was greeted with a lot of relief especially as it came at the peak of a devastating attack. But few citizens also failed to note that these is abundant legislation which seeks not only to prevent potential diseases, but also to promote good hygiene habits in our towns as well as in villages. The issue here is that such legislation has remained in the drawers of policy executors who would rather want to manage crisis with all the fallouts that can come by way of massive financial aid from which many can always find loopholes through which to get huge chunks for themselves to the detriment of those for whom the aid was destined.

On paper, cholera looks like a health risk that can be well managed. The risk zones are well known. The target populations are easy to identify. All the rules of hygiene and sanitation are well known and only need to be applied. The seasons in the various parts of the country when cholera is most likely are also known. So there is absolutely no reason to let cholera surprise the nation as is the case today and to avoid revisiting the hackneyed maxim that a stitch in time saves nine.

The greater powers devolved on local councils in the new decentralized political dispensation are a good augur because of the greater and closer attention health issues should henceforth occupy on the list of priorities of locally-elected officials.

Nkendem FORBINAKE