Mwila Mwaba Kombe | Palladium - Apr 15 2019
"Cholera Prevention is Everybody's Business": Engaging the Community in Zambia

Agnes Changala, 25, draws water at a water kiosk in Zambia. Credit: Ndumba Cosmas

Agnes Changala is only 25 years old, but she shares the wisdom of experience with waterborne disease. Early last year, Agnes’s two-year-old daughter Snevia Namufukwe suffered from cholera, an acute and potentially fatal intestinal infection caused by ingestion of contaminated water or food. Agnes suspected that her daughter acquired the disease from drinking unpurified water, since at that time she wasn’t using a water purification solution.

She incorrectly assumed that tap water from the local water kiosk was clean and safe.

Agnes no longer takes that for granted, and she ensures that she treats her drinking water with a water purification solution called Klori-Pure.

“Water may look clean, but that doesn’t mean it’s safe to drink,” says Agnes. “So I make sure that I add Klori-Pure and I advise my friends and neighbors to put it in the water so that all the germs are killed to prevent cholera.”

Disseminating Information

In Zambia, USAID DISCOVER-Health is a five-year project that supports the Ministry of Health’s mission to improve the lives of Zambians by ensuring equitable access to and use of high-quality health services and products at both district and community levels. Palladium manages the project’s social marketing and launched the potentially life-saving Klori-Pure product during a cholera outbreak last year.

In late 2018, the project initiated a door-to-door campaign focusing on key prevention messages and health education for water purification at water kiosks and households in the cholera-prone compounds of Kanyama, Chipata, and Chawama in Lusaka.

The campaign targeted women and caregivers with children under five to offer information on the benefits of good hygiene practices and the importance of purifying drinking water to stop the spread of the bacterium Vibrio cholerae, strains of which cause cholera. Through the campaign, health promoters reached 4,082 households with essential information about the Klori-Pure water purification solution, and distributed 2,000 free samples.

During this outreach, health promoters met Agnes in old Chawama Compound. After learning more about disease prevention, Agnes began enthusiastically sharing with other mothers in her neighborhood the importance of purifying water.

“I don’t want to hear the word ‘cholera’ because it brings back bad memories of how I almost lost my only child,” explains Agnes. “I wouldn’t want any mother to go through what I went through, so I try to help mothers protect themselves and their families against cholera. I tell them about the importance of purifying water with Klori-Pure, and that a bottle costs only K3.75.”

Engaging the Community

Felistus Katebe, one of the health promoters, notes that “community engagement activities by health promoters have been very beneficial to members of the communities that we reached out to, as most of them lacked information on the dangers and prevention of diarrheal and other waterborne diseases.”

Agnes is helping to spread such health information: “The message I give out is simple: purify drinking water and wash hands with soap every time you use the toilet or change the baby’s nappy, and I share my testimony with other women so that they know that cholera is real and can affect anyone. If we follow these rules, then we can prevent cholera and other waterborne diseases.”

“Many members of the communities especially in cholera-prone areas have expressed gratitude for this initiative by USAID DISCOVER-Health, as they feel enlightened and have learnt a lot on good hygiene practices and how to prevent diarrheal diseases,” observes Felistus.

“Cholera prevention is everybody’s business,” says Agnes.

The USAID Zambia District Coverage of Health Services Project (USAID DISCOVER-Health) is implemented by JSI Research & Training Institute Inc., in collaboration with Palladium.