By Mirabelle Enaka Kima, IFRC

Fourteen-year-old Kalala Kazamboua had just been taken back home after being treated for cholera at Mpoyi Health Centre in the Ngandanjika health zone, in Lomami—one of the provinces of the Democratic Republic of Congo (DRC). A few weeks earlier, most of his playmates were infected and treated for cholera.

“In our village, we do not have water, hence, we fetch untreated water from the lake,” confessed Kalala’s father, Martin Ntoumba.

More than 150 cholera cases have been recorded in Lomami during the first eleven weeks of 2018. The outbreak, which has already claimed 17 lives in the entire province since the beginning of the year, continues to spread, especially in remote villages where vulnerable families do not have access to safe drinking water, and are therefore forced to drink whatever water is available.

Contaminated water

Ngandanjika and Kalambayi are currently the two health zones in Lomami where most cholera deaths and confirmed cases are being reported. Other remote localities of Lomami are even more affected, but they are often forgotten during awareness campaigns because of the long distances that separate them from the health zones. It is in these hard-to-reach villages where water and sanitation crises are rampant.

The only market—located in Matamba, in the Kanda-Kanda health zone—which is visited by nearly 5,000 people on a weekly basis, has neither water points nor toilets.

“In rural areas where the epidemic has found a fertile ground due to acute water shortages and poor sanitation practices, people hardly differentiate between safe water and contaminated water,” said Malick Faye, IFRC Water, Sanitation and Hygiene (WASH) Regional Disaster Response Team member (RDRT).

“Beyond these realities and constraints, the wells from which communities fetch water are unprotected and, in a context where open defecation is common, the water points are easily contaminated by human waste,” he added.

The burden of providing water to families rests with women who are often helped by their children. In the absence of adequate transportation, they travel miles to water points and barely provide enough water for their families.

In Matamba, the only available water point that serves approximately 14,000 residents, was contaminated after a woman washed her sick mother’s dresses there resulting in 250 confirmed cholera cases and seven deaths between October 2017 and January 2018.

“A number of people in the village and I started witnessing severe diarrhoea and vomiting, and before we noticed that it was cholera, many people were already infected,” said Seraphin Mbaya, a nurse in charge of the Matamba Health Centre. “As an urgent solution, a cholera treatment centre was built with support from an aid organization that also provided technical expertise to manage cases.”

Combining care, chlorination of water points and the disinfection of infected households helped to contain the health emergency in most affected villages of the country.

Red Cross volunteers promote safe practices

With many communities in DRC having no access to clean drinking water, hygiene and sanitation, disseminating messages of good practices on cholera prevention techniques remains central to an effective response.

Between January and March 2018, the DRC Red Cross was at the forefront, providing lifesaving sensitization messages on cholera, reaching 213,329 people with safe practices in water, sanitation and hygiene in five health zones of the Lomami province, namely Kabinda, Kanda-Kanda, Kamiji, Ngandanjika and Kalambayi.

“We deployed 192 volunteers in affected health zones to spread awareness messages around cholera, and ensure communities are safe, with communities in remote areas being our main target,” said Joseph Kanyinda, vice-president of the Mwene-Ditu Red Cross Branch.

“In order to guarantee the survival and development of children, we target households, schools, markets and churches with awareness messages, to ensure that all parents and communities apply hygienic measures,” he added.

In 2017 DRC experienced an unprecedented epidemic in 21 of its 26 provinces, with 54,588 people infected and 1,145 deaths. Today, the DRC ministry of health warns of an increasing caseload in Lomami. Due to its highly contagious nature, cholera remains deadly if not treated on time.