The cholera outbreak you won’t hear about anywhere else

I had this feeling when we came back from a nice long, refreshing holiday, that we may face some big new challenges when we came back to M-ville.  Last week when we were right in the middle of shuffling boxes out of one house and into another, I got a call from one of the big boys, the local leader of UNICEF.  He told me there was an outbreak of acute watery diarrhea in a near district, and asked if I could immediately announce a meeting gathering all the WASH (Water, Advocacy, Sanitation, Hygiene) organizations together to coordinate our responses to this outbreak. 

The next day the big boys all gathered in our office, and we started to discuss the issue and our responses.  We heard the startling stats and the sad stories of all the young children that had suffered and died from this outbreak of diarrhea.  The symptoms and stats had led health clinics to treat this outbreak as cholera, and yet, sadly, we learned that the Ministry of Public Health was unwilling to confirm that cholera was present.

In this meeting the hard reality struck: this disease outbreak was not going to make any news headlines whatsoever, because it is in a war area.  What do I mean?  First of all, cholera is a disease often associated with war zones, because people who are scared to leave their homes do not have good water or sanitation access, and are more susceptible to the disease.  Second reason you won’t hear a cry for international aid to respond to this outbreak is that the area has a high security risk for organizations that are unaware of how to proceed safely. 

That leaves us.  There is a handful of organizations in town, and we are all taking serious the weight of this outbreak and the possibility of it spreading.  Right now my teammate and I are the only 2 foreigners involved in the response, but some of the big boys are also quite compassionately concerned.  In our meeting some of the key leaders lobbied and persuaded hard for each organization to make sacrifices and change plans in order to redirect help to this outbreak. 

Our project’s main response is a donation of 300 of our Biosand filters.  Each one will provide a family with a sustainable source of clean water.  We are really amazed to see how God works, because a few weeks ago we were concerned that we had too large of a surplus of those filters and they were becoming a liability.  At the meeting, however, no one had any surplus of filters, and no one has the capacity to quickly build the filters either.  Our 300 are ready to roll, and we can continue to produce 50 a week, as needed.  Another organization is going to transport the filters for us, and still another organization will do the distribution in the villages, because they are already working there.  The insurgents that rule there allow this other organization to work there, so we will channel our responses through them rather than risk other personnel. 

We hope this goes well.  Other organizations here are spending heaps of money on driving water tankers into the area, chlorinating water sources, and doing medical responses.  The clinics that have been caring for the cases have designated wards and other service units for suspected cholera cases to try to contain it.  Our hope is that we can stem the spread of the disease at the village sources, by providing water filtration.  We are dependent, however, on the distributing organization to really train the recipients in how to use their filters.  To better assure that, I created a picture guidebook on our Biosand filter, showing every step of installation, use, and maintenance.  I was really encouraged in our meeting that all the big boys, including local government, were enthused about this book and ordered (and even paid for!) 500 copies to be made and accompany our filters.  I hope that this puts a positive message out about our organization, and our desire to really see people served and changed. 

Did you catch that I said we’re sending aid into an insurgent controlled area?  How does that make you feel?  Myself I’m still a bit unsettled, but I find it terribly hard to think of denying aid to women and children that are suffering disease, just because the men around them are not cooperating with the powers, plans and wishes of their government or ours.  Do I feel guilty, as if I am aiding an enemy of our state?  I suppose disease could be a weapon against one’s enemy, and failing to respond to that disease could be a war strategy, but I much prefer the weaponry of insistent care for human beings.  What better attack is there than showing our enemies that while they cannot care for their own diseased, that we will show compassion.  And also, I often read a book that says clearly, to love your enemy.  Not an altogether comfortable concept, but I believe it’s important.