Lusaka ‒ One night, Lusaka resident Samuel Zyambo quickly fell right into a disturbing, dreamlike state of unconsciousness. He was unaware that when he awoke the next day, he was in a cholera remedy centre combating for his life, with no recollection of something that had taken place within the earlier 12 hours.
“I had no thought the place I used to be. There have been individuals in beds throughout me,” he says. Zyambo was in truth at a sports activities stadium that Zambia’s Ministry of Well being transformed right into a state-of-the-art cholera remedy centre. “When the physician informed me I used to be at Nationwide Heroes Stadium, I couldn’t perceive why I used to be in a spot the place I do know they play soccer,” he remembers.
Zyambo, like tens of hundreds of his fellow Zambians, contracted cholera, an acute, extraordinarily virulent an infection, throughout one the worst outbreaks within the nation’s current historical past. He says he owes his life to the speedy response of his household, who rushed him to the remedy centre, and the wonderful care he obtained from well being employees.
The outbreak peaked in January 2024, with Lusaka at its epicentre. Between 15 October 2023 and 23 July 2024, Zambia had recorded 23 382 cumulative instances and 740 deaths. No new instances have been reported since 11 July 2024, a sea change from the scenario in January, when the nation was recording a mean of 461 new instances each 24 hours.
Authorities’s multi-faceted response, supported by World Well being Group (WHO) and different companions, included surveillance, an infection prevention and management, case administration, laboratory, neighborhood engagement and enchancment of water, sanitation and hygiene companies to manage the outbreak. WHO dispatched 23 worldwide consultants to supply technical assist in every of those response areas, who in flip educated over 800 well being employees.
Along with supplying 25 tons of medical provides and tools, together with cholera kits, WHO upgraded seven community-based cholera remedy facilities in Lusaka’s Chilanga, Chipata, George, and Matero sub districts and the Southern province’s Chipepo, Namoomba and Lumbembe areas. The Group additionally offered an infection and prevention, water, sanitation, and hygiene provides to 2 different remedy facilities.
In partnership with Gavi, the Vaccine Alliance, UNICEF, and others, WHO delivered 4.1 million cholera vaccine doses over two rounds to immunize individuals at excessive threat of an infection within the worst affected areas to stem the outbreak.
“We have discovered numerous classes that I am hoping we are able to have as a part of our playbook for future responses,” says Dr Kalima Nawa, who was medical supervisor at Heroes cholera remedy centre till its closure in late February 2024. “So finally, the hope is that what we’re studying right here permits us to have a sustainable, quick response to future outbreaks, not simply the cholera outbreak, however different responses as properly”.
Early detection and reporting at neighborhood stage was a key outbreak response measure, with energetic case-finding groups visiting households every day to verify for instances, guaranteeing early referral to well being amenities, and mitigating additional unfold. Via its Built-in Illness Surveillance and Response platform, WHO offered instruments and assist with information evaluation and interpretation.
“WHO performs a key position within the surveillance system in Zambia, not only for this cholera outbreak, but in addition for different outbreaks that we’ve got within the nation,” says Dr Kapina Muzala, Head of Surveillance at Zambia’s Nationwide Public Well being Institute.
Though the outbreak is underneath management, WHO continues to assist the nation’s capability for well being emergency preparedness and response. The Group partnered with UNICEF and the European Union, which offered funding till August 2024 to, amongst different issues, deal with useful resource gaps within the cholera response plan, set up extra oral rehydration factors, enhance the present referral system, implement the neighborhood built-in cholera response plan, and procure essential cholera provides as a part of preparedness efforts for the subsequent excessive cholera transmission season that begins in October 2024.
Cholera provides safety and satisfactory emergency preparedness had been recognized as gaps in the course of the cholera intra-action evaluate carried out in April 2024.
“The collaborative efforts that ensured we may comprise the worst of the outbreak inside a matter of months is proof of the worth of concerted, coordinated motion,” says Dr Nathan Bakyaita, WHO Consultant in Zambia. “We should proceed to work collectively to make sure that the teachings discovered from this outbreak response strengthen the nation’s emergency preparedness.”
Zyambo’s spouse, Joyce, was additionally struck by cholera and was handled on the native cholera remedy unit of their neighbourhood Kalingalinga, whereas Zyambo was convalescing at Heroes. It was per week earlier than they had been reunited. “After I noticed my spouse, I felt very glad as a result of we each survived this ordeal,” he says. Now the household follows strict tips to guard themselves from the illness, like boiling water for family consumption and common hand washing.