Cholera, the disease of ignorance
The last quarter of 2007 has been characterized by a period of heavy rainfalls in Djibouti. The land of the country is barren and desert, the soil is not used to receiving as much water in such a short time period. In fact it only rains an average of one week in a year. As the soil cannot absorb all that water, it therefore stagnates and forms muddy puddles around inhabited areas close by children’s playing areas in the different neighborhoods. This is how Cholera appeared in the capital city and in some districts causing the death of many people. Mrs. Hawa is one the victims of Cholera
Mrs. Hawa is a widow bringing up her 3 children (3, 4 and 7 years) since her husband’s death a year ago. She is a doughnut vendor in front of an elementary school in her neighborhood in Arhiba, in Djibouti City. Her elder son goes to the same school when the other two children wander about and play games near her little doughnut business all day long. Access to the school is made very difficult by the heavy rainfalls in the capital city in December. A huge puddle has formed with stagnating water and blocked the entrance to the school following those rainfalls; the water has turned greenish and has become home for flies, mosquitoes and little worms. The children have to go around it every morning to get into the school and sometimes they simply have to walk through and get dirty. Hawa sells her fresh doughnuts on the premises with orange juice that children buy and enjoying drinking while eating the doughnuts. Ali and Nouria, both Hawa’s children also play every day on these premises where they eat their mother’s doughnuts sharing them with their brother whenever he is on break. Hygiene is totally absent here.
One day, Nouria, the youngest of Hawa’s children got sick. In the beginning of the week she had diarrhea but that was nothing to worry for her mother who rather was contented with the belief that diarrhea is a sign of good nutrition( a widely common belief in Djibouti). As if nothing was the matter, the mother kept to business as usual while the daughter’s condition was worsening, the diarrhea did not stop and she defecated all over in front of the school mostly near the stinking water puddles to add to the stench. At the end of a two-day continuous diarrhea, she started losing weight, feeling tired with vomiting accompanied with a lot of difficulty to ingest food. Hawa then decided to take her little daughter to the community medical centre of Arhiba and requested a doctor to consult her. The nurse who welcomed her, seeing that the little girl was seriously dehydrated summoned a doctor to see her as she had become as light as a feather. Nothing could be seen of her, except her eyes protruding out of their sockets, her body was frail and agonizing. The doctor examined her and isolated her at once. There was no doubt as to Nouria’s disease; she had cholera. The mother was invited to leave her daughter at the hospital where she would get treatment. Hawa left the hospital at 11 o’clock AM anxious and back to her doughnut vending business for the 12 o’clock school leaving hour. For two days, Ali had the same symptoms as Nouria: refusal to eat, serious and abundant diarrhea, sweats and physical weakness. After work, she got home to find Ali, who had stayed in bed all day, almost dying; she took him to hospital too. She thought it was something benign but as she saw her children’s condition worsening, she got into a panic at the idea of losing them, she rushed to the community medical center in Arhiba where Ali was in his turn was hospitalized.
In the night she was admitted to the community medical center, little Nouria died, which was a shock for the mother who abandoned her small business to look after Ali who was still in bed at the hospital. “I have lost my little daughter out of ignorance. She was playing with her brother in unhealthy premises where there was no hygiene and I underestimated the seriousness of the diarrhea. Now that the doctor has explained the symptoms of cholera to me, I know how to protect myself from it, but all this is too late because my daughter is gone never to return, taken away by a stupid and mean disease”.
In Djibouti, every day there are new cases of cholera; rural populations mostly lack knowledge and information about the disease. The Health Ministry with the support of UNICEF and other partners is trying to stop the propagation of the disease and to contain it wherever it appears.