Changing behaviors to stamp out cholera in Uganda

Thomas Nybo, UNICEF

HAMUKUNGU, Uganda (June 11, 2010) — As this fishing village comes to life in the early morning, a young girl wades into Lake George and fills a bright yellow plastic container with water.

It's a common sight in Kasese district: men, women and children filling water containers in rivers and lakes, despite the very real threat of cholera. Last year, cholera infected more than 500 people in this area and killed about a dozen.

Cases mounting

© UNICEF Uganda/2010/Nybo

Consuming contaminated water is a leading cause of Cholera.

"My daughter was getting water from the lake and didn't boil it. That's how she got sick," said one local woman whose eight-year-old contracted cholera. Raising four children on her husband's modest income as a fisherman, she was reluctant to purchase bottled water until her daughter's brush with death.

Cholera is a bacterial infection of the intestines that is spread by water contaminated with human excrement. In many parts of the world, the lack of safe drinking water and proper waste disposal can be a deadly combination. 

Despite efforts to improve the situation, the number of cholera cases—and deaths—keeps mounting. In Uganda this is particularly true during the rainy season, when waste is often carried into rivers and lakes. Lacking other options, people continue to collect drinking water and often fall ill.

Cholera is still deadly

While programs encouraging the use of bottled or boiled drinking water have been initiated in many districts, experts say that deeply ingrained attitudes about cholera need to change before the situation can improve.

"I think the one issue that we're not addressing is the behavior change," said UNICEF Water and Environmental Sanitation Specialist Paul Semakula. "We're not looking at what [people] think about cholera. Their perspective is "cholera is not dangerous." After all, you get treated in two or three days and you feel fine. So they don't think it's something they need to fight."

But while cholera is treatable, it contributes to lost productivity hours, keeps children out of school and continues to result in thousands of deaths worldwide. According to the World Health Organization, up to 6,300 people have died from cholera in the last three years alone.

Children in endemic areas suffer disproportionately from the disease.

Changing behavior and attitudes

UNICEF is working with local governments in Uganda to confront the continuing threat of cholera and facilitate a shift in attitudes. It offers support for basic logistics, including sanitation and hygiene services, water-purification materials and water-storage facilities—all of which can go a long way toward alleviating the burden of cholera.

UNICEF is also exploring legislative action that would protect people from exposure to contaminated food and require a latrine for every household.

The most important thing, said Semakul, is to ensure that changes in both behavior and attitude reach homes and families individually. "We need to make sure that everybody has the necessary facilities for water, sanitation and hygiene in their households," he said.

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