By Takura Zhangazha*
So there is a sub-regional cholera outbreak in Zambia and
Zimbabwe. There was also one in Malawi towards the end of last year.
With the evident risk that it may spread beyond the two countries’
borders where and when it is reported.
Cholera outbreaks are now run of the mill news stories in Southern
Africa. And there are many reasons for
this. The main one being the fact of
their actual occurrence.
The second being a false narrative of assuming that we, as
Southern Africans are unhygienic and therefore will be afflicted by such
diseases.
The third, which is a bit more realistically debatable, is
that of our rapid regional urbanisation. Due to urban population expansions and
lack of relevant water and other amenities render our cities, towns and
peri-urban areas to be overwhelmed.
I am not a public health expert but it is important to note
from a layman’s perspective that the continual re-emergence of Cholera
outbreaks in the region point to a critical need for us to re-think our rural
and urban landscapes and planning. And also our approaches to public
health.
The first thing that I have noticed, even as slightly
historical as it may seem, is that Zimbabwe, Zambia and Malawi have very
similar local government planning systems. Each of the three countries’ have somewhat similarly designed cities dating
back from the Federation of Rhodesia and Nyasaland (even if Southern Rhodesia-Zimbabwe
was the ultimate beneficiary of that federation).
Our cities are similarly designed. We have the former white suburbs being the
most privileged in relation to access to water and health amenities. We have what we call the ‘high density areas’
having less amenities and being densely populated by rural to urban migrants. And also migrants who historically were part
of the Witwatersrand Native Labour Association (WENELA) labour recruitment
route.
Then we have the rural areas where the majority of our
people still reside, even as they age, with limited access to basic health
care, communications and transport where and when related emergencies occur.
We also have to consider the fact that in our cultural practices
we, be it in urban or rural areas, still have to gather for that wedding,
funeral or memorial and/or church service among many newfound reasons for
get-togethers.
The problem however is the fact of how our health systems do
not match our lifestyles. And I will give at least one example.
This being that in many of our cities, based on again the
fact of our collective historical urbanisation and rural codification history
in Malawi, Zambia and Zimbabwe, we have not anticipated the explosion that
would be not only rural to urban migration.
But also the necessity of planning for the important health, water, sewage
and reticulation amenities that should come with it. In many of our cities, our rapid urbanisation
in which one can build a mansion without concomitant urban toilets or even
rural pit latrines, even if temporarily, in an urban shack while having no running
water is almost a norm.
Or even in rural areas where we still have a problem with
where people openly defecate because they cannot afford to build pit latrines
as advised by the World Health Organisation. So when it rains or when major
gatherings are held, the likelihood of an outbreak in the remotest of rural
areas increases.
But this is not about our African inability to deal with what
has been called a ‘medieval disease’. It
is a very serious matter that requires an urgent and holistic approach. Never mind the global narratives about us as
Africans from Malawi, Zambia and Zimbabwe.
We have experienced the pain and anguish of losing loved ones to this affliction.
There are a number of things that we therefore need to deal
with. The primary issue being the most
pragmatic. We need to manage our urban
and rural amenities much better in a people-centred manner. Even as we understand the rapid urbanisation
as well as the also rapid 'lifestyle' urbanisation of our rural areas. Clean water and safe toilets are more important
than ever.
These are things we have to remember based on our own
African health wisdom about the fact that you cannot defecate in the village
well.
But this is where we are.
Our people are dying of cholera, a completely preventable and
curable disease. Calling it medieval may assume a superiority of your economic placement
in society but we all go to the toilet, have to wash our hands and remember that
you cannot, with this Cholera outbreak, assume it will never get to you. We need to fix this.
-Title paraphrased from Gabriel Garcia Marques’ novel “Love
in the Time of Cholera”
*Takura Zhangazha writes here in his personal capacity
(takura-zhangazha.blogspot.com)
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