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Cholera scare shows laxity in enforcing health rules

Patients at the Mandera Refferal Hospital last year. file photo | nmg
Patients at the Mandera Refferal Hospital last year. file photo | nmg 

An upmarket Nairobi hotel was recently in the news for the wrong reasons. It was reported that some guests contracted cholera from a conference there that ironically was by doctors. A similar incident at a wedding reception in the affluent Karen suburbs of Nairobi’s also occurred not long ago.

Such cases though not on a massive scale draw an important observation as far as public health is concerned: we all are equally at risk regardless of affluence or domicile. They also highlight what failure to impose public health guidelines can cause.

For a nation aspiring to be a regional development king, basic services like access to clean water, safe disposal of sewage and other commercial effluents are important components. It seems however that more weight is placed on other infrastructural projects like roads and bridges due to their easily tangible and visible economic benefits. This is at the expense of social infrastructure like sewer lines and water piping systems.

The sporadic incidence of dysentery, typhoid and cholera cases should make health practitioners to worry. A senior colleague quipped the other day, “Unless something is done urgently, the big outbreak is coming”.

Nairobi and its environs in particular are sitting on a ticking time bomb as far as waste disposal is concerned. The number of households with running water is actually declining as a percentage, the ratio of houses connected to a sewer grid versus those being built is also low. Septic tanks are interspersed with water sources all potentially calamitous scenarios.

While the infrastructural constraints are a reason, poor enforcement of public health regulations is too.

The government is also culpable since constitution of planning and water and sewerage management boards have become politicised. Merit is thrown out of the window in appointing leadership. Whereas in other countries experts are chosen to chair and oversee such bodies, we have decided to have political appointees take charge.

Offices meant to enforce these rules are usually not equipped or staffed adequately to do so. Without creative partnerships to circumvent such bottlenecks, it is unlikely they will be able to enforce these regulations.

Since the problem cuts across many sectors, we should all come together for a discourse on the way forward. Technology can play a big role towards helping address this because it offers the easy access to information.

A starting point is having quality and up to date crosscutting accurate information. Such big data could form a starting point for the confluence between private enterprise and public health needs.

Manufacturers of water storage systems, piping and plumbing systems should spearhead this initiative.

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