Cholera is not a fun illness to have and untreated can be fatal.  Without proper care, individuals can die within a few hours of the first symptoms.  The primary way that you get this horrid illness is from drinking water that has been contaminated with the feces of someone who has cholera.  As unlikely as that might seem by Western standards, if you happen to live in a village where the river that runs past your hut serves the community for everything from drinking water to bathing, laundry and waste disposal, then it is safe to say that you and your family are in danger of contracting cholera and other waterborne diseases. If there are twenty other villages upstream from you, your chances are multiplied 20 times.

Last October the hospital in São Tomé began reporting cases of cholera. Once a disease like this gets started in an impoverished nation, it can spread quickly and the death tolls can rapidly rise.  It seems like such a simple problem to fix.  Just stop drinking water that may have been contaminated. Right? Get on the radio, make a few public service announcements and the problem should be solved.  Right?  Unfortunately, poverty means that you do not have the money to buy bottled water for your family.  It may mean that you do not have a well in your village or the resources to install one.  It may mean that you may not have not had the education that you need to accept the idea that your illness could be caused by drinking the water out of the river that you have drunk out of your entire life, by a bug that is too small to see.  It is estimated that since the first reported cases in October, approximately 10% of the residents of São Tomé have had exposure.  Thirty six people have died.   

Since the outbreak, ADRA São Tomé has enriched its health education to all of the communities in which it works, to include information on cholera.  In addition, it is working with the local government to do health lectures, drama education, and distribution of water purification solution in many communities where it is not yet working.  Emanuel, the ADRA São Tomé director, noted with much interest how the villages in which ADRA has established women’s community based organizations, readily accepted the new information on cholera with confidence and trust.  They immediately implemented the recommended changes.  In other villages where ADRA has not established a presence, the information was received with more hesitancy and skepticism.  When you have done something a certain way all of your life, change is not always easy, especially when the call for change is coming from a source you have not come to respect or trust.

One of the solutions that ADRA São Tomé is endeavoring to implement is a type of latrine that is culturally appropriate and accepted.  With health education, sanitation, latrines, and water purification it is hoped that this outbreak of cholera in São Tomé can be eradicated. As they move through and past this crisis, thanks to the hard work of the ADRA staff, the people of São Tomé will have gained valuable information, improved village sanitation, and adopted personal hygiene habits that will not only prevent a future outbreak of cholera but improve overall health and well being.

As I write these words I am in the Detroit airport waiting for the last flight of my journey home.  It has been a wonderful trip.  I have met many new friends and appreciate the amazing dedication that they have for their work.  I hope to continue to discover ways that I can partner with them as they do their work of saving lives and eliminating poverty.

While my trip to Africa is over, I plan to continue this blog and update other materials to this website.  I hope that you will stop on by whenever you get a chance!