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In the heart of Kasenengwa District in Zambia's Eastern Province lies Thambo, a small, closely-knit village where everyone knows each other by name. Life here is simple; days are marked by the rhythms of nature and community bonds. On 4 June, a quiet storm brewed within this serene setting, a storm named cholera. Here, Kasenengwa’s index case hails.

A community approach – the story of Thambo village cholera survivor

30 juin 2024 | Zambia

Chipata ‒ Zambia declared the 2023/24 Cholera outbreak in November 2023, with the epicenter being Lusaka. Countrywide, Zambia has reported over 22,000 cases. The outbreak started waning in the last couple of months, with most districts nationwide reporting  zero cases for nore than 30  30 days. 

However, on 30 May 2024, Eastern Province reported 4 culture-positive cases of Cholera. These cases were first reported in Chipata District among marketeers at a transient market called Saturday Market, which brings together people from different districts in the province. The outbreak quickly spread to five other districts: Chadiza, Lumezi, Kasenengwa, Chipangali, and Mambwe, with cases linked to the Saturday Market.  

Cumulatively, between May 30 and 20 June 2024, the province reported over 90 cases, with zero deaths.

In response to this outbreak, the World Health Organization (WHO) has supported the Ministry of Health, providing technical and supervisory support by training community-based volunteers and other health cadres to establish an integrated community management initiative in response to the cholera outbreak in the province.
 

In the heart of Kasenengwa District in Zambia's Eastern Province lies Thambo, a small, closely-knit village where everyone knows each other by name. Life here is simple; days are marked by the rhythms of nature and community bonds. On 4 June, a quiet storm brewed within this serene setting, a storm named cholera. Here, Kasenengwa’s index case hails.

Raphael Zulu, a father of five, woke up with what he thought was a simple stomach upset. “I thought I had malaria and went on to take some medication for it. However, diarrhea set in, and within minutes, I began to vomit too,” narrates Raphael Zulu, the index case for cholera in Kasenengwa district. By midmorning, Raphael was severely dehydrated and weak.

Overwhelmed with worry, Raphael’s wife quickly asked her neighbours to help rush her husband to Muzeyi Mission Rural Health Center, 12 kilometers from the village. “The nearest health facility to us is very far. I was afraid we would not make it in time,” says Janet Zulu, Raphael’s wife. “When we got to the clinic, healthcare workers told us he had cholera, and he was admitted,” she added. A threat only heard of in passing was now real and present: cholera was in Thambo village.

All six households in the Thambo zone have one common water source, a borehole, where Mr Zulu’s fomites were washed. Because of this, five other people from the surrounding households contracted cholera. “Four of my other neighbours also got cholera. We all get our water from one borehole at the end of the village, approximately a kilometer away from my house,” Mr. Zulu said.

Raphael and surrounding households walk about a kilometer to access water, and as such, this distance inhibits the practice of good hygiene. “Because of the distance to the borehole, we only fetch water twice a day. We must use the water prudently to avoid the women and young girls walking such a long distance now and then.” Mr. Zulu said.

In collaboration with the Provincial Ministry of Health and WHO, Living Water International sunk a borehole a few meters away from Mr. Raphael Zulu’s home to make it easier for the family and surrounding households to access water anytime and improve their hygiene practices.

Further, to address the challenge of Thambo village being 12km away from the nearest health facility, with support from ECHO, WHO, working with the district health team and Thambo community members, set up a mini oral rehydration corner (ORC) to help with quicker access to oral rehydration salts and managing cholera cases. Community members were educated about cholera, clean water, sanitation, and hygiene, and at least two bottles of chlorine were distributed per household.

Six community-based volunteers from Kasenengwa district were trained in the Community Integrated Cholera Response Strategy and deployed to Thambo village to manage the ORC and cholera cases and ultimately respond to the outbreak, saving lives.

To support the cholera outbreak response in Eastern province, WHO, working with the provincial and district health teams, trained one hundred (100) community health workers in the Cholera integrated community management strategy – a WHO Zambia initiative to enhance cholera response at the community level. “I am glad I am fine now. I have learned how to practice good hygiene and drink safe water. I want to thank the health workers for saving my life, the community, and everyone else for bringing water closer to us. Our lives have surely changed,” says Raphael Zulu, a Thambo cholera survivor.

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