Stigma slows down cholera fight

A file picture of a suspected cholera patient lying in bed at a health facility in Chinengundu, Chegutu

A GRUMBLING stomach, relentless vomiting and agonising dehydration are some of the symptoms that Tendai Musoko felt before she finally sought medical attention.

The symptoms are associated with cholera, a waterborne disease that continues to cast a deadly shadow over Zimbabwe.

Musoko was hesitant to seek proper medical care, fearing the shame and social isolation that often comes with the waterborne disease.

The deep-rooted misconception that cholera is “a dirty disease” associated with poor hygiene keeps patients chained to their homes, forcing many to rely on ineffective home remedies.

“I don’t know how I contracted the disease. I practice hygiene at home.  It was so embarrassing” Musoko said.

“I knew going to the clinic meant whispers and pointing fingers.

“They say cholera is for those who don’t wash their hands, who don’t keep their homes clean. I couldn’t bear that shame.”

She resorted to home remedies that offered little to no benefit.

“First, I tried warm water with flour to try to stop the running stomach, but it didn’t work,” she said.

“Then I tried that sugar and salt solution. However, I kept on having a running stomach.

“I started vomiting as well, I felt so weak. I only wanted to sleep. I could not eat anything.

“I was forced by my neighbour to go to the clinic. She saved my life.”

Musoko is a resident of Glen View, Harare’s densely packed suburb, where the recent outbreak has hit hardest.

Others patients have died after attempting to treat symptoms with homemade remedies instead of visiting healthcare facilities.

Health experts told NewsDay Weekender that the stigma acts as a barrier to care, pushing people into the shadows of self-treatment, often with tragic consequences.

Zimbabwe Nurses Association president Enock Dongo said deaths from cholera are preventable, yet fear and stigma are pushing the death toll higher.

“The lives lost are a call to action, a demand for a collective effort to break the chains of stigma and ensure that everyone, regardless of fear or circumstance, has access to the care they need,” Dongo said.

He said some people only present themselves to hospitals when in critical condition “having tried everything from herbal concoctions to hiding their symptoms out of fear”.

“This self-imposed isolation fosters a breeding ground for the disease, allowing it to spread unchecked through communities.”

He said breaking free from the stigma requires public awareness campaigns and strengthening health care systems.

“Dispelling myths, emphasising that anyone can contract cholera and promoting early medical intervention are vital steps in dismantling the walls of fear,” Dongo said.

“Community engagement and open dialogue play a crucial role in building empathy and understanding, replacing blame with collective responsibility.”

Dongo said accessible and affordable treatment for all, regardless of location or socioeconomic status, is paramount.

“This includes addressing the underlying sanitation and water challenges that create fertile ground for cholera outbreaks,” he added.

Community Working Group on Health executive director Itai Rusike said public stigma can undermine efforts by the health workers and other health stakeholders to trace and treat cholera cases within the communities.

“Stigma around cholera should never be allowed to happen given our similar experiences with HIV and Aids and recently COVID-19,” he said.

“We need to address the causes of stigma towards cholera patients and remove the existing social issues and barriers that can hinder some people from seeking early treatment resulting in unnecessary loss of lives.”

“The effects of stigmatisation are devastating socially, emotionally mentally and physically and may result in death if the cholera patients do not seek early treatment.”

Medical and Dental Private Practitioners Association of Zimbabwe president Johannes Marisa warned that piecemeal efforts without addressing underlying sanitation and infrastructure issues will always result in recurrent outbreaks.

He said cholera prevention requires a multi-pronged approach that goes beyond just treating infected individuals.

“Primary health care should thus dwell on health education and promotion, good nutrition, clean water supplies, good sanitisation, immunisations, affordable first line drugs, easy patient transfers to mention but just a few,” he said.

The treatable disease has already claimed over 200 lives.

The Health and Child Care ministry reported 196 new suspected cases of cholera and three suspected deaths on December 28.

Since the first case was detected in February this year, Zimbabwe has recorded 13 943 cases and 67 laboratory confirmed deaths as well as 235 suspected cholera deaths.

The outbreak has affected all 10 provinces in the country.

Increasing cholera trends continue to be observed with a weekly average of 1 000 new cases with over 80% recorded in Harare and Manicaland provinces.

The United Nations Office for the Co-ordination of Humanitarian Affairs has raised concern over the number of new cases of cholera in Zimbabwe.

The Red Cross Federation also said the outbreak in Zimbabwe is spreading from urban to rural areas and putting at risk over 10 million people, including more than five million children.

In October, government banned church camp meetings, open markets, communal beer binge gatherings among other interventions to stop the water-borne disease from spreading.

Government also said it had intensified risk communication and engagement, including the involvement of religious and local leadership in the fight against cholera.

Previously, the Zimbabwe Lawyers for Human Rights accused authorities of “dereliction of duty” in the handling of the cholera outbreak.

They said officials should be held accountable for their “failure to invest in and adequately manage basic water, sanitation infrastructure and public health facilities”.

Government has failed to stem the spread, invoking memories of the 2008 to 2009 outbreak, Zimbabwe’s worst in years, which left over 4 000 people dead.

The 2008 to 2009 outbreak was only stopped following the intervention by international and humanitarian partners such as Unicef, among others.

A person can get cholera by drinking water or eating food contaminated with cholera bacteria.

In an epidemic, the source of the contamination is usually the faeces of an infected person that contaminates water or food.

The disease can spread rapidly in areas with inadequate treatment of sewage and drinking water.

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