Extreme weather stirs cholera outbreaks in parts of east and southern Africa

Stagnant pools of green water stand in the streets of this impoverished town in Zambia.  Some puddles extend right up to the walls of the basic, concrete homes in the Njele compound.

Children step over them and play inches from the fetid water.

It's the same story in Lilanda, an impoverished township on the edge of the Zambian capital.

Here the Banda family have paid an awful price for the unsanitary living conditions.

In the space of two awful days in January, Mildred Banda saw her 1-year-old son die from cholera and rushed to save the life of her teenage daughter.

The Bandas exemplify the people still at the mercy of a disease that shouldn't kill anyone in 2024.

Cholera is easily treated and easily prevented — and the vaccines are relatively simple to produce.

That didn't help Banda's young son, Ndanji.

When he fell sick with diarrhoea, he was treated with an oral rehydration solution at a clinic and released.

He slipped back into dehydration that night at home. Banda feels terrible guilt.

“I should have rushed him back to the hospital as soon as I realised that he was sick instead of staying with him at home," she says, sitting her tiny house.

“Staying at home for the whole day into the night is the reason why my child died," she adds.

Some residents of these townships blame the government for not doing more to clean the streets.

“When you look at here in Njele shanty compound, it is full of water and children play in this dirty water barefoot. That is why the issue of cholera will continue in Njele compound because there are diapers with faeces all over the place," says local Elias Banda.

"When the council comes here they only look at the taps and check our water bills, and not address the sewage problem in the area," he adds.

Malawi and Zambia have experienced their worst outbreaks in recent months, while Zimbabwe has had multiple waves. Mozambique, Kenya, Ethiopia and Somalia have also been badly affected.

All of them have experienced floods or drought — in some cases, both — and health authorities, scientists and aid agencies say the unprecedented surge of the water-borne bacterial infection in Africa is the newest example of how weather partly drives disease outbreaks.

Zimbabwe and Zambia have seen cases rise as they wrestle with severe droughts and people rely on less safe water sources in their desperation.

Days after the deadly flooding in Kenya and other parts of East Africa this month, cholera cases appeared.

WHO calls cholera a disease of poverty as it thrives where there is a lack of clean water and poor sanitation. It mainly affects Africa and south Asia while it's irrelevant in the developed world.

Historically vulnerable, Africa is even more at risk as it faces the worst impacts of climate change as well as the effect of the El Nino weather phenomenon, health experts say.

In what's become a perfect storm, there's also a global shortage of cholera vaccines, which are needed only in poorer countries.

The doses that might have saved Ndanji started arriving in mid-January. He died on Jan. 6.

In Zimbabwe, a drought worsened by El Nino has seen cholera take hold in distant rural areas as well as its traditional hotspots of crowded urban neighbourhoods.

Tracy Dzinoreva from the capital, Harare, has been vaccinated but she says she lives in fear that it could come back because the root cause of the disease hasn't been dealt with.

“Nothing has changed. We don’t have safe, clean water and sewage is still flowing everywhere, the situation remains the same," she says.

Augustine Chonyera, who hails from a part of the capital that is notoriously cholera-prone, was shocked when he recently visited the sparsely populated rural district of Buhera.

Chonyera has heard grim tales of the impact of the disease; a family losing five members, a husband and wife dying within hours of each other, and local businesses using delivery trucks to take the sick to a clinic several miles away.

He says he headed back home as soon as he could — after giving a large bottle of treated water he had brought with him to an elderly woman.

“What I think is the best is instead of having more money elsewhere let's channel it to local governance, we know our pipes underground are dilapidated and they are breaking instead they should repair those pipes and put new ones for water and sewer," he says.