Use these affordable technologies to steer away from cholera

Introduction

Since the early 1970s, Kenya has experienced cases of cholera outbreaks. The two largest epidemics were in 1997 and 2009 where a total of over 44,000 cases were reported. Cases of cholera are experienced almost every year in Kenya. The recent cholera outbreak in some regions is, therefore, ‘normal’.

On 3^rd February 2015, the Director of Medical Services issued a cholera outbreak alert following an increase in cases of Acute Watery Diarrhoea (AWD) in several counties in the country. Cholera outbreaks were confirmed in Homa Bay, Migori and Nairobi counties. Several deaths have been reported. In the capital city’s sprawling Kibera slum, eight deaths have been recorded and 100 others hospitalised. According to Fred Majiwa, St. John’s Ambulance spokesman, “Overpopulated areas with poor drainage and sanitation such as Mathare, Kibera and Eastleigh are the most affected”.

Risk Factors and Current Efforts to Fight Cholera

According to Africhol, an organisation that collaborates with the Kenya Ministry of Health to strengthen cholera routine surveillance system within the country and to identify enhanced surveillance zones for cholera, outbreaks of cholera are related to poor access to drinking water and effective sanitation systems. A Water.Org 2012 report revealed that while 59% of Kenyans had access to safe water supplies, only 32% had access to improved sanitation. This problem is worse for rural areas as revealed in a 2010 WHO report.

Statistics show that over 60% of the urban population in Kenya rely on water vendors, water kiosks or unprotected natural sources. The water quality of these sources varies and there is a high risk of contamination through faulty and often illegal connections. This problem is exacerbated by unhygienic storage and handling in the household. Poor sanitation and unhygienic water have therefore been the major risk factors for cholera outbreaks in Kenya.

Efforts have been taken to deal with the outbreak. The Kenya Red Cross Society (KRCS) has, for instance, responded by deploying staff in Migori and Homa Bay. The responses have been sensitization of the locals regarding hygiene promotion, support community level prophylaxis and provide peripheral health facilities with case management supplies. Further, KRCS has been distributing point of use water treatment chemicals. In Nairobi, Dr. Evans Kidero has banned raw food and food hawking to contain the spread of cholera in Kibera.

Technologies to help you steer away from Cholera

Since fighting cholera is all about promoting hygiene and enhancing the quality of water, technology can address the challenges. Vestergaard Company, for instance, offers a number of technological solutions that can help the efforts by various stakeholders in the health sector to fight cholera and other waterborne diseases in Kenya. One of their products is LifeStraw® water filter which converts contaminated water into clean, safe drinking water. The company offers a range of LifeStraw® water filters for individuals, families, and communities.

According to their website, “LifeStraw® Community is a high-volume point-of-use water purifier with built-in safe storage that provides safe drinking water for community, educational and institutional settings. It prevents waterborne disease such as diarrhoea, typhoid, cholera, worms, and cryptosporidiosis”. How does it work?

• 25 litres of untreated water is poured into the top of the unit, also called the dirty water container.
• The pre-filter removes coarse particles larger than 80 microns.
• The ultrafiltration hollow-fibre membrane cartridge, located inside the main dark blue body of the filter, then stops all turbidity particles and pathogens larger than 20 nanometres (including all bacteria, viruses and protozoan cysts). Particles and microbes larger than 20 nanometres stay on the dirty side of the membrane and clean/purified water passes through the membrane.
• Purified water can be collected from any of the four taps.
• The backwashing handle allows semi-automatic backwashing; when it is pulled down and released, pathogens and dust particles on the dirty side of the membrane are lifted by backpressure and then flushed out into the red backwash container.

There are also other water purifiers in the market. For instance, Unilever Kenya has a water dispenser (Pureit) that can purifier and filter dirty water to rid it off of germs, making the water clean and safe for drinking, cooking and washing hands. Pureit works with a break-through ‘Germkill Technology’. It has an advanced Multi-Stage Purification which gives water that is completely free from harmful germs. It has a 9 litre capacity and costs about Sh. 12,000.This is cheaper but smaller compared to Vestergaard’sLifeStraw® 25 litre capacity costing Sh. 27,000. Both technologies have the advantage of not relying on electricity and can therefore be used anywhere in Kenya.

Several laboratory tests have confirmed the efficiency of this technology. A laboratory experiment by the Underwriters Laboratories Inc. in Bangalore, India, evaluated LifeStraw® Community for removal of E coli, MS2 bacteriophage and Microspheres (bacteria, virus, protozoan cysts). The results showed that there were no less than log 5 reduction for all three categories (bacteria, virus, and protozoa), which meets the required performance of WHO criteria for “highly protective” microbial water filters.Another laboratory experiment by Laborotorio Fermi in Mexico evaluated LifeStraw® Community’s performance in line with Mexican water testing standards which includes percentage reduction in total coliform and aerobic mesophilics. There was 100% reduction in total coliforms and total aerobic mesophilics.

Vestergaard reports that in October 2014, more than 1,600 LifeStraw® Community water purifiers were distributed to 301 schools to provide more than 23 million litres of safe water a year to over 125,000 school children throughout Kenya’s western province. It may be important for KRCS, the Ministry of Health, the County Governments, and the Central Government to employ the services of Vestergaard in order to fight cholera and other waterborne diseases. I would recommend that all schools and hospitals purchase LifeStraw® community product as it specifically fits the needs of these institutions. Families should also be encouraged to use such technology, especially the LifeStraw® Family, to help improve sanitation in the areas affected and also provide clean and safe water sources.