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Special Report: ‘Have you seen the filth? We fear mass graves’. A story on Zambia’s race against cholera


Stinking piles of garbage with flies swarming all over them was a common sight as journalists from Zambia Monitor toured Lusaka’s cholera hotspots. Such was the eyesore at Chipata Compound.

The stench oozing from rotten filth and urine were unmistakable, as rubbish heaps littered the market place while garbage overran parts of the the community.

The Reporters had to walk with noses covered to fight off the putrid stench that hung in the air.

They were careful to watch their steps, or otherwise become victims of drainages that were filed with heaps of rubbish and stagnant water.

Interestingly, for the inhabitants it was business as usual, with flies pestering the surrounding garbage, food and vegetables that were being sold at the markets.

Read more: Govt shuts down two markets in Mandevu, Kanyama over cholera fears, as 15 more deaths recorded

Other traders were seen scrambling for limited space to display their wares even if it meant placing them short of the dirty slow running waters sipping from nearby mounds of garbage.

With a glance, not too far off, the Reporters could see people defecating into empty packs of the beer called Chibuku to relieve themselves, as there were no toilets available.

Not even churches in the community had a better story to tell. The pit latrines appeared filled, with human waste flowing through shallow gutters and producing foul odor.

Church members seemed oblivious of the lurking danger, as they concentrated on communing with God while those needing to relieve themselves embark on short journeys to nearby communities, asking for toilets.

Makeshift stands mounted near taverns and liquor shops were seen preparing foods such as chicken, sausages and goat meat commonly known as “michopo” in open but unhygienic spaces.

Conspicuously missing were public taps dispensing clean water. Rather, the Reporters noticed shallow wells which in most cases were dug not to far from pit latrine toilets, making the area prone to water-borne diseases such as cholera.

With such filth, lack of toilets, and general poor sanitary conditions in the communities, the residents fear Chipata compound is on the verge of becoming a mass grave.

The Reporters learnt of how patients were reportedly dying on the way to the hospital while others had succumbed to the disease at home because of concerns over stigmatization.

But how did we get here? Zambia was trying to recover from the ravages of Covid-19 when the outbreak of cholera kicked in.

So far, the disease has reportedly killed more than 500, with an alarming 14,000 plus cases recorded countrywide, and Lusaka, the capital city named the epicentre.

Indeed, as at January, 27, 2024, the government had acknowledged 14,900 as the cumulative total number of cases.

Read more: Govt shuts down two markets in Mandevu, Kanyama over cholera fears, as 15 more deaths recorded

In October last year, cholera broke out in Lusaka, but had since spread to nine Provinces, with only Luapula currently being spared.

Resumption of schools and colleges had been rescheduled twice as Health Minister, Sylvia Masebo, described the situation on the ground as “not good.”

Lusaka has seen the highest numbers mainly due to the quality of sanitation services. Of particular mention is the 60-day ‘water blues’ which characterized the period between August and October, 2023.

Apart from that, the population has grown exponentially, thereby causing a sanitation nightmare as water and hygiene infrastructure had not witnessed expansion in tandem with the growing population and commercial activities.

Cholera treatment centres particularly in Lusaka are overwhelmed with patients, especially at the country’s Heroes Stadium where makeshift beds have been mounted.

Also read: Council of Churches in Zambia directs members to worship for only two hours to cholera spread

The situation on ground can best be described as worrying, especially as the disease has managed to remain untamed for more than three months, with most of the measures put in place to contain it only yielding minimal impact at the moment.

The scenes from around the country have zeroed in on the dire poor living conditions in most communities. Residents who spoke with our Reporters could not hold back their frustrations.

Those from Chipata compound, for instance, expressed great concerns and sought government intervention over the growing filth found both in the markets and homes.

One resident said: “Here in Chipata Compound, they have not given us chlorine, so what we want is for them to bring us, including washing basins. There is a lot of garbage here so how will cholera end?

“Have you seen how our garbage are?….please think…bring chlorine here fast before the situation gets worse and before cholera cases increase… this is one of the hotspots, you are going to see a mass grave very soon if aid does not come to us soon. What we want is for the government to bring us chlorine and things to use for washing our hands.”

Another resident said: “At our first level hospital at Chipata that is where there are a lot of people admitted with cholera and just there at Heroes stadium it is worse…we are asking for help.”

At the market, one trader complained, “If you go around this place you will see water all over combined with garbage…all that is cholera, even here at the market, the situation is making customers not to buy because of the garbage.

“So what traders are doing now are using many sacks to ensure that the dirty water from the garbage does not mix with the vegetables we are selling. This market does not even have a toilet so people use other alternatives which are not healthy.”

The spread of the epidemic is like ‘wild fire’ and has called for rigorous efforts to contain it, starting from citizens, to stakeholders and government.

Zambians are concerned and scared as their homes are filled with uncollected garbage.

One of the residents from Misisi compound, Bridget Miti, pointed out garbage as one major challenges in her area.

Miti cited poor drainage system, poor sanitation and lack of proper toilets as other challenges being faced in the community.

“Some churches in this area do not even have proper toilets, the church members go around asking for toilets because the one they had got full and no longer in use.”

Hordes of flies can be seen in Misisi Township swarming around garbage heaps and others coming from the church toilet which was full and no longer in use.

Another resident, Monica Daka, from Chipata Township said uncollected garbage was worrying and a major health threat.

She complained that the garbage from the streets were overflowing into her yard, and even made worse as more refuse got dumped in the open by other residents within the community.

“The way it has rained now, the drainage gets full, all the garbage from the roadside comes to our place because people throw it on the road when no one is looking in the night, sometimes even during the day,” Daka narrated.

In Chipata Township, residents asked for chlorine to prevent the spread of the disease.

Floods, improper sewage disposal and lack of environmental hygiene were some of the main causes of the cholera spread as residents bared their minds to the Zambia Monitor team.

Government response has been far and in between.Health Minister, Masebo, had announced that the government had been working with international partners like the World Health Organisation (WHO) and UNICEF to secure cholera vaccines to manage the crisis.

On January 15, 2024, Zambia received 1.6 million doses of cholera vaccines from the World Health Organisation and the United Nations International Children’s Emergency Fund.

The minister specifically noted that Zambia had received a complete consignment of 1.7 million doses from GAVI through the United Nations (UN) agencies.

Since the arrival of the vaccines, the Health Ministry has conducted vaccinations, prioritising the hot spots in Lusaka Province.

The vaccinations were conducted in a phased approach targeting people aged one year and above.

Selected communities under Kanyama, Matero, Chipata and Chawama areas in Lusaka as well as Rufunsa district were targeted for this vaccination exercise based on quantity of vaccines and high-risk of transmission areas.

As at January 27, the government had completed the oral cholera vaccination exercise in the hotspot areas with the total number being 1,808,186.

The vaccination project has not been without incidents. When the exercise started it faced resistance from the members of community, especially the male folks despite the disease claiming hundred of lives.

Masebo assured that targeted vaccinations and implementation of prevention measures would be done alongside provision and use of safe water, observing good hygiene and safe sanitary practices.

This saw the Minister of Local Government and Rural Development, Gary Nkombo, taking drastic action by closing down markets in Lusaka’s Mandevu and Kanyama due to unsanitary conditions.

A three-day closure was placed on Katambalala market of Mandevu and Kalonje Market in Kanyama both of Lusaka Province.

Nkombo said: “We have closed two markets today for three days so that the owners of the markets together with the area councils should clean the markets.”

The minister instructed that the markets would only resume operation after another inspection to ensure cholera guidelines were observed.

The government has meanwhile introduced Statutory Instrument (SI) 5 of 2024 in addition to the already existing SI 79 of 2017 to reduce further spread of cholera outbreak. Indeed, it had introduced a clause that prohibited the entry of bedsides into the cholera treatment centres.

In addition, it is enforcing stringent measures regarding the safe burial of cholera suspects, directing that religious gatherings were expected to give public health messaging and keep a record of the messaging that had been given.

But this had left many families who had lost relatives at the epicentres in shock and disbelief as they could not trace their whereabouts and final resting place.

On the other hand, President Hakainde Hichilema had earlier announced what seemed to be bold steps in combating the cholera outbreak.

He had said that stringent and costly measures would be implemented to prevent future cholera outbreaks, underlining the gravity of the situation.

Hichilema directed that all shallow wells be buried across the country thereby attracting sharp criticism especially that the President’s statement did not provide an alternative or whether every household which used shallow wells would be provided with piped water.

The emphasis on constructing roads and drainages in compounds, irrespective of the associated costs, to facilitate better access for emergency services also seemed to be a long term solution.

This proactive approach, although long term, was however, acknowledged as capable of eliminating potential breeding grounds for cholera and fortifying the country’s defences against future outbreaks.

While all these measures are being executed, experts have advised that it is important for citizens to also play their role by practicing the basic rule in cholera prevention such as washing hands frequently with soap, avoiding street food and not eating raw or half cooked meat.

Other preventive ways include drinking treated purified water and maintaining good sanitation.

They counseled that these should be practiced as Zambia continued to receive more cholera vaccine doses from the WHO which would be deployed to cholera epicentres.

Many have posited that cholera, like any other fast spreading disease and virus, is a double edged sword. While taking more lives, the negative economic implications are colossal.

Indeed, implementation of new measures meant closing or losing out business, especially for the informal sector.

Analysts have, therefore, called for a policy and behavioural shift in the way Zambians carried themselves, especially where management of waste and water reticulation was concerned.

The 2023/2024 cholera outbreak is not the first time the disease was causing havoc to life and businesses.

In 1992, a record 500 people perished in Kitwe alone.

The country had continued experiencing spontaneous outbreaks with the most recent one being the 2017/18 season which claimed about 200, with the worst hit being Lusaka.

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