The infamoushaemorrhagic fever virus, Ebola virus, has managed to monopolize the world’s attention for the past few months. Nations, including Ghana, have been compelled to wake up from slumber in terms of disease surveillance and other public health and disease containing and combating strategies that hitherto were merely on paper. It’s a thought in the right direction if we now appreciate the fact that the world is indeed growing smaller by the day and diseases can be imported and exported easier than fake consumer goods. It remind me of the old saying, "if your hearneighbour’shouse is on fire, make sure you have water on stand-by”. Ebola is teaching the world very big lessons, which if learnt, will only better our future in terms of disease control.

Back home in Ghana where we have activated our ‘Ebola surveillance’ to code red while cholera, a deadly diarrhoeal disease is rapidly taking peoples’ lives in our cities as per its seasonal ritual. It is sad that I stress on the fact that the current and past epidemics have always affected our cities the most. In a time where the mention of Ebola disperses crowds, the least anyone will want to hear or experience in addition is a cholera epidemic. It is unfortunate but yet understandable why Ghana still experiences cholera epidemics in this 21^st century.

Cholera is an ancient intestinal infection transmitted by faecal-oral route and has as its hallmark symptom, profuse diarrhoea which can lead to severe dehydration and death. A faeco-oral route of transmission means the causative organism is shed in faeces of an infected person and enters the body through the mouth. Simply put, the organism thrives in filth. Due to the virulent nature of the bacteria, management of the disease is commencing based on suspicion. The priority here is replacing the lost fluid and electrolytes along with appropriate antibiotic when necessary.

In times like these if you present to any health facility with diarrhoea and vomiting you will be managed as having cholera until proven otherwise. At the same time it is imperative that any case of diarrhoea and vomiting is sent to a health facility. It must be noted that seeking care early also increases one’s chance of survival.

At the time of writing this piece, I asked myself if I was not going to recycle and re-echo facts from yesteryears’ cholera epidemics. In the past we have blamed city authorities, notably, Accra Metropolitan Assembly (AMA) for the filth in capital, which we are all aware, keeps fueling seasonal cholera epidemics. We have even blamed politicians for their inactions with regards to provision of sanitary infrastructure but forget our relatives and neighbours, who indiscriminately and irresponsibly dispose of waste in the gutters and streets. It is for no reason that a toilet has been referred to as ‘a place of convenience’ by humanity. An existence without it makes life very inconvenient to the extent that people die of diseases such as cholera. It is sad that in this 21^st century we still allow slums to spring up only to spend a lot of money to raise them down. Habitats are still built without drainage systems. Food vendors still prefer to sell close to gutters and filth.

The country has so far recorded over 3,000 cholera cases nationwide in the recent epidemic with over 70% of the cases in the capital. The AMA is also embarking on an exercise to clear major parts of the capital city of filth in a bid to satisfy the charge from the vice president of the republic. This just re-echo’s the fact that we are mere seasonal and reactionists who will always battle seasonal diseases such as cholera. Do we have to wait for our waste to form mountains before we clear them? Do we have to wait for an epidemic to keep our environment clean? It is common knowledge to all Ghanaians that cholera is bred in filth, and Ghanaians are known to be very religious, but seems like the old saying; “Cleanliness is next to Godliness “, has been deleted from our current religious scripts.

Diseases like cholera are practically nonexistent in the developed world. Most people attribute such developments to advancement in infrastructure and political commitment of successive governments. The little piece of this jigsaw, rarely mentioned, which is indeed sustaining this achievement is the change in attitude of citizens. The developed world did not only develop through advancement in infrastructure, but also through developing the attitudes of citizens. It is about time we elevated our reactionist status to a proactive status. After containing this cholera epidemic I would like to see the AMA and other city authorities continuously clear the capital city of filth. The continuous education and sensitization on why we need to be responsible for the cleanliness in our environment is critical if we do not want to see the ugly head of cholera claim the lives of our friends and relatives again.

 

Dr Bernard Dampson

New Crystal Hospital

bernarddampson@gmail.com