Life in the Times of Cholera

January 5, 2018

(This is where I was today.  Significantly less trash in the drains than usual.) 


Despite overwhelming government proclamations to the contrary back in October and November, cholera is now a crisis in Zambia.  The government has embarked on a massive clean-up, closed schools for the entire month, closed some shops and markets, and banned public gatherings of more than 5 people.


The reactions and responses are mixed.


The clean-up is so necessary and vital for good sanitation.  Despite millions of dollars in the Millennium Project, a water sanitation project mostly funded by the US, sanitation is improving very slowly here, and it is estimated that at least 70% of people who live around Lusaka have no access to clean water and electricity.  Lusaka was not built to support the influx of people that is happening in the rapid urbanization of SubSaharan Africa.


But, already one of the Army personnel involved in the cleanup has been sent to the hospital with cholera.  No masks or gloves have been provided to the Army or police involved in the work.  Citizens are being conscripted if they are in the areas being cleaned and given work to do, again without protective equipment or the ability to simply wash their hands after.  Regular cleaning of the drainage systems needs to happen.  We saw some cleaned up during the election campaigns, but it stopped.  We will see if this effort has any lasting change.


School closure is a massive hit to an already faltering system.  Even private and international schools have closed.  The measure is probably prudent as many students travel to schools, in and out of affected areas.


But, many of these children receive better care and food at school than they do at home.  And the education so vitally necessary to prevent outbreaks of cholera is most effective when taught to the younger generation.  The best place for that is school!  There is little evidence that the time will be made up by the students.  The educational deficit will be huge.


(The other side of the street.  This is an area with no indoor plumbing and few improved toilets or pit latrines.  Just imagine dirty diapers and feminine products in there.  Or where the dirty water might of after washing them.  Most people wash their laundry in front of their house.)


The closure of some of the informal markets, street vendors, and even the large produce market in the city will further the cleaning efforts.  My favorite produce stand is directly across from a trash pile (but I can afford bleach to clean our food).  There has been little talk of the future of these markets, and the likelihood is that they will start up again soon and continue to operate as they always have.  A few fast food restaurants and grocery stores have also been closed after swabs have tested positive for cholera.  These stores will now be subject to required sanitation improvements in order to reopen.


So many people will be hurting from the loss of income, unable to buy food, pay school fees, and more.  The majority of these shops are part of the informal economic sector in Zambia.  Without this economic activity, I don’t think Zambia would continue to exist, but it is not without its downsides.  There are few legal requirements or oversight for the markets, leading to unsanitary conditions and disease.  The shops do not participate in the taxation structure in this country, not only increasing the tax burden for those who do, but also failing to support the infrastructure that their shops benefit from.  Improvements and sanitation projects cannot be done without money.  However, even if the money exists, the systemic corruption and mismanagement would make improvements difficult if not impossible.  


Many churches and other groups are unable to meet.  This is an imposition and a disappointment.  Some are even calling it ‘spiritual’ and ‘demonic’ attack.  I don’t doubt the evil and brokenness of disease and death.  But we don’t fight against flesh and blood.  These restrictions seem to come from a desire for sound governance and eradicating a disease that has already infected thousands.  Many, many ministries are unable to function as usual, and modifications are being made, but it is frustrating.  However, frustration with inconvenience is better than furthering the spread of disease.


In addition to all these challenges, I have been shocked at the misinformation and lack of information available.  The Department of Health’s website has been down, misinformation is all over social media, and radio and television broadcasts have been contradictory.  


 (A little help in the form of clean water, food, soap, bleach, and washing basins.)


Someone recently told me that working in Zambia felt like working from ‘crisis to crisis’.  It is.  When obstacle after obstacle is in your way, progress is hard.  The layers of the problems are ones I cannot unravel.  I can continue to buy soap and bleach, teach over and over again the importance of washing hands and proper hygiene, distribute feminine hygiene kits to help reduce the biohazard waste all around, and do what I can to empower and educate.  And pray.  Pray for grace, wisdom, and healing for this beautiful land.

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