How to eradicate cholera in Cotonou, Benin ?
Insight from Dr. Bawa BOYA
Photo: The lagoon bank of Cotonou occupied by populations producing household and fecal waste.
In Benin, the cholera epidemic began in 1970. Since then, cholera epidemics have become almost annual and usually occur during the rainy season. The four coastal departments of southern Benin (Littoral, Atlantic, Ouémé and Mono) are the most affected by cholera. The commune of Cotonou accounts for nearly half of the cholera cases each year in Benin. The causes of such an observation certainly lie in the socio-economic and sanitary conditions that do not favor the application of hygiene and sanitation provisions in the area.
The large collector of the Dantokpa market allows the drainage of most of the rainwater of the city of Cotonou towards Lake Nokoué. But for some time now, it has been used as a garbage dump by some indelicate users of the largest market in the economic capital of Benin. This unhealthy practice can promote the cholera epidemic because this water is often used for market gardening. These different market garden products are found daily in the dishes, especially those based on lettuce. Also, it is in this water that fishermen's net fish for consumption. Moreover, research done on the strains of Vibrio responsible for cholera isolated from these environments have been found to be resistant to antibiotics commonly used in hospitals. Therefore, Benin will continue to be an endemic area for cholera if there is no national hygiene and sanitation policy. Thus, wild dumpsites become places where people defecate. During the rainy season, runoff water drains fecal matter into uncovered, unlined wells that are sources of drinking water for some populations. Poor hygiene practices can increase the risk of fly proliferation, soil contamination, water and cooking utensils and thus increase the risk of cholera.
Hygiene measures have led to the eradication of cholera in developed countries, while in developing countries, raising hygiene levels is far from being achieved for economic and socio-cultural reasons.
The eradication of cholera in Cotonou requires a multi-pronged approach. The measures must combine surveillance, improvement of drinking water supply, sanitation and hygiene, and social mobilization.
Read also our article on drug-resistant cholera with Dr Angèle Ahoyo in the new book of global experts: AMR & The Environment, A Global and One Health Security Issue (see www.amrthinkdotank.org)