Ebrima Sillah
BISSAU, Apr 17 2009 (IPS) – The most recent cholera outbreak in Guinea-Bissau killed 225 people before it was brought under control in February; 14,000 people were infected by the water-borne disease, most of them in the capital, Bissau.
There have been seasonal outbreaks of cholera in Bissau in each of the past five years due to poor water infrastructure and a reliance on open wells.
Jose Manuel Ramos, a water engineer at Bissau s Ministry of Energy and Natural Resources which is also responsible for water management, told IPS that neglect and a lack of investment has left most of the capital s sewage system damaged with dirty water from ruptured pipes polluting ground water.
He said the sewage and water pipes in the city were laid in the colonial era some 45 years ago, and are now outdated and obsolete. Over time, inadequate care and maintenance has meant the colonial infrastructure has rusted.
When the water infrastructure was being built in the 1960s, Bissau had a population of not more 60,000 people. Today we have well over 350,000 people in the capital. This has put immense pressure on the existing infrastructure, he says.
As a result, residents of the capital have been forced to dig wells in their back yards in order to get water. But health experts have long warned that such water sources are not safe, especially during rainy season, when contaminated run-off finds its way into the wells.
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In its latest country report, the United Nations Children Fund, UNICEF, says only 20 percent of the population in the capital has access to pipe-borne water and even the water in the tap is of questionable quality because of lack of modern facilities to properly treat the water. Bissau also lacks proper waste disposal and according to UNICEF potentially contaminating garbage is left around the streets including the city centre.
A bloody civil war in 1998-1999 and successive military coups since then have been followed by a decade of political instability, insecurity, and economic stagnation. This has aggravated an infrastructure crisis in Bissau.
Silvia Luciani, UNICEF country representative to Guinea-Bissau, told IPS that the political instability has meant that outside assistance from donors has also been hindered. Unless there is guaranteed stability the people of this country especially women and children who are just innocent bystanders, will continue to lose.
Carlos Pedro, a doctor in the capital s main hospital Simão Mendes National Hospital, told IPS that in the past three years, especially during the rainy season from August through November residents in the capital brace themselves for cholera.
The medical system is ill-equipped to control the outbreaks. Currently most of the trained doctors have left because of lack of motivation, Pedro said. Any time there is outbreak of cholera or any other disease, we find it difficult to move around because we dont have enough vehicles and ambulances.
Water engineer Ramos said his ministry in collaboration with the World Bank has concluded a study into the water needs of the residents of the capital and other big cities and a report has been submitted to donors for funding. Already the World Bank has started building water reservoirs in the capital, laying 24 kilometres of water pipes at a cost of nearly $6 million. The European Commission has also signed a $3.9 million project with Guinea Bissau to improve its water infrastructure and rural water systems which will include solar-powered water points and pumps in rural communities.
Once these projects are complete, they will provide residents of the capital and other settlements with clean, safe drinking water, according to Ramos.
But Cesario Sa, director of Water and Electricity Services in Bissau, says even when the World Bank water project is completed, many people may still be prefer to use water from wells because that is free. This is a country where there is widespread poverty and where salaries are not paid regularly. So many will see paying for water as additional burden.
Donors spent over $800,000 before the 2008/2009 epidemic was contained, money that could have been better utilised in other areas. UNICEF and the Ministry of Health have put in place a national response for cholera epidemic plan which include message development on cholera prevention, disinfection of the capital s wells, management of potentially contaminating human waste and the distribution of hygiene and sanitation products.
This is extremely important in our cholera prevention strategy, says Luciani, because our recent study shows that only an estimated 30 percent of the population performs essential hygiene practices.
Water-borne diseases constitute one of the main causes of child mortality in Guinea-Bissau, which has the world s fifth-highest level of child mortality with almost one in five children dying before age five.
